NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.
Field Epidemiology Service, Public Health England, Liverpool, UK.
BMJ Open. 2019 Jul 31;9(7):e028064. doi: 10.1136/bmjopen-2018-028064.
Lyme disease is a tick-borne disease of increasing incidence and public concern across the Northern Hemisphere. However, the socio-demographics and geographic distribution of the population affected in England and Wales are poorly understood. Therefore, the proposed study was designed to describe the demographics and distribution of laboratory-confirmed cases of Lyme disease from a national testing laboratory.
An ecological study of routinely collected laboratory surveillance data.
Public Health England's national Lyme disease testing laboratory.
3986 laboratory-confirmed cases of Lyme disease between 2013 and 2016.
In England and Wales, the incidence of laboratory-confirmed Lyme disease rose significantly over the study period from 1.62 cases per 100 000 in 2013 to 1.95 cases per 100 000 in 2016. There was a bimodal age distribution (with peaks at 6-10 and 61-65 years age bands) with a predominance of male patients. A significant clustering of areas with high Lyme disease incidence was located in southern England. An association was found between disease incidence and socioeconomic status, based on the patient's resident postcode, with more cases found in less deprived areas. Cases were disproportionately found in rural areas compared with the national population distribution.
These results suggest that Lyme disease patients originate from areas with higher socioeconomic status and disproportionately in rural areas. Identification of the Lyme disease hotspots in southern England, alongside the socio-demographics described, will enable a targeted approach to public health interventions and messages.
莱姆病是一种在北半球发病率和公众关注度不断上升的蜱传疾病。然而，在英格兰和威尔士，受影响人群的社会人口统计学和地理分布情况了解甚少。因此，本研究旨在描述从国家检测实验室确诊的莱姆病的人口统计学和分布情况。
一项对常规收集的实验室监测数据进行的生态学研究。
英国公共卫生署国家莱姆病检测实验室。
2013 年至 2016 年间的 3986 例实验室确诊莱姆病病例。
在英格兰和威尔士，莱姆病的实验室确诊发病率在研究期间显著上升，从 2013 年的每 10 万人 1.62 例上升到 2016 年的每 10 万人 1.95 例。年龄分布呈双峰模式（高峰在 6-10 岁和 61-65 岁年龄段），男性患者居多。发病率高的地区存在明显的聚集现象，主要集中在英格兰南部。根据患者的居住邮编，发现疾病发病率与社会经济地位之间存在关联，发病率较高的地区社会经济条件较差。与全国人口分布相比，病例更多地出现在农村地区。
这些结果表明，莱姆病患者来自社会经济地位较高的地区，且在农村地区的分布不成比例。确定英格兰南部的莱姆病热点地区以及描述的社会人口统计学特征，将有助于采取有针对性的公共卫生干预和信息措施。
