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英国莱姆病的发病率:一项基于人群的队列研究。

Incidence of Lyme disease in the UK: a population-based cohort study.

作者信息

Cairns Victoria, Wallenhorst Christopher, Rietbrock Stephan, Martinez Carlos

机构信息

Retired, Oxford, UK.

Epidemiology, Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt, Germany.

出版信息

BMJ Open. 2019 Jul 31;9(7):e025916. doi: 10.1136/bmjopen-2018-025916.

Abstract

OBJECTIVES

The purpose of this study was to estimate the annual incidence of Lyme disease (LD) in the UK.

DESIGN

This was a retrospective descriptive cohort study.

SETTING

Study data were extracted from the Clinical Practice Research Datalink (CPRD), a primary care database covering about 8% of the population in the UK in 658 primary care practices.

PARTICIPANTS

Cohort of 8.4 million individuals registered with general practitioners with 52.4 million person-years of observation between 1 January 2001 and 31 December 2012.

PRIMARY AND SECONDARY OUTCOME MEASURES

LD was identified from recorded medical codes, notes indicating LD, laboratory tests and use of specific antibiotics. Annual incidence rates and the estimated total number of LD cases were calculated separately for each UK region.

RESULTS

The number of cases of LD increased rapidly over the years 2001 to 2012, leading to an estimated incidence rate of 12.1 (95% CI 11.1 to 13.2) per 100 000 individuals per year and a UK total of 7738 LD cases in 2012. LD was detected in every UK region with highest incidence rates and largest number of cases in Scotland followed by South West and South England. If the number of cases has continued to rise since the end of the study period, then the number in the UK in 2019 could be over 8000. : : The incidence of LD is about threefold higher than previously estimated, and people are at risk throughout the UK. These results should lead to increased awareness of the need for preventive measures.

TRIAL REGISTRATION NUMBER

This study was approved by the Independent Scientific Advisory Committee for CPRD research (Protocol number 13_210R).

摘要

目的

本研究旨在估算英国莱姆病(LD)的年发病率。

设计

这是一项回顾性描述性队列研究。

背景

研究数据取自临床实践研究数据链(CPRD),这是一个初级保健数据库,涵盖了英国658家初级保健机构中约8%的人口。

参与者

840万注册全科医生的队列,在2001年1月1日至2012年12月31日期间有5240万人年的观察期。

主要和次要观察指标

通过记录的医疗编码、表明患有莱姆病的记录、实验室检查以及特定抗生素的使用来确定莱姆病。分别计算英国每个地区的年发病率和莱姆病病例估计总数。

结果

2001年至2012年期间,莱姆病病例数迅速增加,导致估计发病率为每年每10万人中12.1例(95%置信区间11.1至13.2),2012年英国莱姆病病例总数为7738例。英国每个地区都检测到了莱姆病,发病率最高且病例数最多的是苏格兰,其次是西南部和英格兰南部。如果自研究期结束后病例数持续上升,那么2019年英国的病例数可能超过8000例。莱姆病的发病率比之前估计的高出约三倍,全英国的人都有风险。这些结果应会提高对采取预防措施必要性的认识。

试验注册号

本研究获CPRD研究独立科学咨询委员会批准(方案编号13_210R)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ea/6677952/3d898150492e/bmjopen-2018-025916f01.jpg

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