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通过两个监测系统:国家全科医生网络 Sentinel 网络和国家医院出院数据库,对莱姆病螺旋体病的流行病学监测:2005 年至 2016 年法国。

Epidemiology of Lyme borreliosis through two surveillance systems: the national Sentinelles GP network and the national hospital discharge database, France, 2005 to 2016.

机构信息

Santé publique France, Paris, France.

European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.

出版信息

Euro Surveill. 2019 Mar;24(11). doi: 10.2807/1560-7917.ES.2019.24.11.1800134.

Abstract

BACKGROUND

Lyme borreliosis (LB) is the most frequent vector-borne disease in France. Since 2009, surveillance of LB is conducted by a sentinel network of general practitioners (GPs). This system, in conjunction with the national hospitalisation database was used to estimate the incidence and describe the characteristics of LB in France.

AIM

To describe the estimated incidence and trends in GP consultations and hospital admissions for LB in France and identify risk groups and high-incidence regions.

RESULTS

From 2011 to 2016, the mean yearly incidence rate of LB cases was 53 per 100,000 inhabitants (95% CI: 41-65) ranging from 41 in 2011 to 84 per 100 000 in 2016. A mean of 799 cases per year were hospitalised with LB associated diagnoses 2005-16. The hospitalisation incidence rate (HIR) ranged from 1.1 cases per 100,000 inhabitants in 2005 to 1.5 in 2011 with no statistically significant trend. We observed seasonality with a peak during the summer, important inter-regional variations and a bimodal age distribution in LB incidence and HIR with higher incidence between 5 and 9 year olds and those aged 60 years. Erythema migrans affected 633/667 (95%) of the patients at primary care level. Among hospitalised cases, the most common manifestation was neuroborreliosis 4,906/9,594 (51%).

CONCLUSION

Public health strategies should focus on high-incidence age groups and regions during the months with the highest incidences and should emphasise prevention measures such as regular tick checks after exposure and prompt removal to avoid infection.

摘要

背景

莱姆病(LB)是法国最常见的虫媒传染病。自 2009 年以来,由全科医生(GP)组成的监测网络对 LB 进行监测。该系统与国家住院数据库一起,用于估计法国 LB 的发病率并描述其特征。

目的

描述法国 GP 就诊和因 LB 住院的估计发病率和趋势,并确定风险群体和高发地区。

结果

2011 年至 2016 年,LB 病例的年平均发病率为 53 例/10 万居民(95%CI:41-65),2011 年为 41 例,2016 年为 84 例/10 万居民。2005 年至 2016 年,每年平均有 799 例 LB 相关诊断住院。住院发病率(HIR)从 2005 年的每 10 万居民 1.1 例到 2011 年的 1.5 例,无统计学意义的趋势。我们观察到季节性,夏季发病率最高,区域间差异很大,LB 发病率和 HIR 呈双峰年龄分布,5-9 岁和 60 岁年龄组发病率较高。在初级保健水平,633/667(95%)患者出现游走性红斑。在住院病例中,最常见的表现是神经莱姆病 4906/9594(51%)。

结论

公共卫生策略应在发病率最高的月份针对高发年龄组和地区,强调预防措施,如暴露后定期检查蜱虫和及时清除,以避免感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b636/6425552/4731c412f509/1800134-f1.jpg

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