2009年至2012年加拿大莱姆病监测
Surveillance for Lyme disease in Canada, 2009 to 2012.
作者信息
Ogden N H, Koffi J K, Lindsay L R, Fleming S, Mombourquette D C, Sanford C, Badcock J, Gad R R, Jain-Sheehan N, Moore S, Russell C, Hobbs L, Baydack R, Graham-Derham S, Lachance L, Simmonds K, Scott A N
机构信息
Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, ON.
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB.
出版信息
Can Commun Dis Rep. 2015 Jun 4;41(6):132-145. doi: 10.14745/ccdr.v41i06a03.
OBJECTIVES
To summarize the first four years of national surveillance for Lyme disease in Canada from 2009 to 2012 and to conduct a preliminary comparison of presenting clinical manifestations in Canada and the United States.
METHODS
The numbers and incidence of reported cases by province, month, year, age and sex were calculated. Logistic regression was used to examine trends over time. Acquisition locations were mapped and presenting clinical manifestations reported for jurisdictions where data was available. Variations by province, year, age and sex as well as presenting clinical symptoms were explored by logistic regression. An initial comparative analysis was made of presenting symptoms in Canada and the United States.
RESULTS
The numbers of reported cases rose significantly from 144 in 2009 to 338 in 2012 (coefficient = 0.34, standard error = 0.07, P <0.05), mostly due to an increased incidence of infections acquired in Canada. More cases were classified as 'confirmed' (71.5%) than 'probable' (28.5%). Most cases occurred in locations where vector tick populations were known to be present. More men than women were affected (53.4% versus 46.6%), incidence was highest in adults aged 55 to 74 years and in children aged five to 14 years. Most cases (95%) were acquired from April to November. Of cases acquired in endemic areas, 39.7% presented with manifestations of early Lyme disease, while 60.3% had manifestations of disseminated Lyme disease. There were significant differences among age groups, sexes and provinces in the frequencies of reported clinical manifestations. The proportion of cases acquired in endemic areas presenting with early Lyme disease was lower than that reported in the US.
CONCLUSION
Lyme disease incidence is increasing in Canada. Most cases are acquired where vector tick populations are spreading and this varies geographically within and among provinces. There is also variation in the frequency of age, season and presenting manifestations. The lower proportion of cases presenting with early Lyme disease in Canada compared with the US suggests lower awareness of early Lyme disease in Canada, but this requires further study.
目的
总结2009年至2012年加拿大全国莱姆病监测的头四年情况，并对加拿大和美国出现的临床表现进行初步比较。
方法
计算按省份、月份、年份、年龄和性别报告的病例数及发病率。采用逻辑回归分析来研究随时间的趋势。绘制感染地点地图，并报告有数据的司法管辖区出现的临床表现。通过逻辑回归分析探讨省份、年份、年龄和性别的差异以及出现的临床症状。对加拿大和美国出现的症状进行了初步比较分析。
结果
报告病例数从2009年的144例显著增加到2012年的338例（系数 = 0.34，标准误 = 0.07，P <0.05），主要原因是在加拿大感染的发病率上升。更多病例被归类为“确诊”（71.5%）而非“可能”（28.5%）。大多数病例发生在已知存在媒介蜱虫种群的地区。男性受影响的人数多于女性（53.4%对46.6%），发病率在55至74岁的成年人以及5至14岁的儿童中最高。大多数病例（95%）是在4月至11月感染的。在流行地区感染的病例中，39.7%表现为早期莱姆病，而60.3%表现为播散性莱姆病。报告的临床表现频率在年龄组、性别和省份之间存在显著差异。在流行地区感染且表现为早期莱姆病的病例比例低于美国报告的比例。
结论
加拿大莱姆病发病率正在上升。大多数病例是在媒介蜱虫种群正在扩散的地区感染的，且在省内和省际之间存在地理差异。年龄、季节和出现的临床表现频率也存在差异。与美国相比，加拿大出现早期莱姆病的病例比例较低，这表明加拿大对早期莱姆病的认识较低，但这需要进一步研究。
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