NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, L69 3GL, UK.
Public Health England, L3 1DS, Liverpool, UK.
BMC Infect Dis. 2020 Apr 16;20(1):285. doi: 10.1186/s12879-020-05018-2.
Primary care is likely to see the highest number of Lyme disease patients. Despite this, there is limited published data regarding Lyme disease patients accessing primary care in the UK. We aim to describe trends in the incidence of a new diagnosis, and demographics of patients identified in a primary care electronic health database.
A descriptive epidemiological study of Lyme disease coded patients in UK primary care. 3725 patients coded for Lyme disease during 1998-2016 were identified within The Health Improvement Network (THIN). Incidence rates and the demographics of cases identified were described. Poisson regression was used to analyse socio-demographic characteristics of the cases.
There was an increase in annual crude incidence rates, peaking in 2015 at 5.47 (95% CI 4.85-6.14) cases per 100,000 population per year. Multivariable analysis showed there were significant differences in the ages of those affected, incidence of a new diagnosis rose as deprivation levels improved, and that there was a higher incidence of cases living in rural areas compared to urban areas. There was no significant difference between sexes for the UK. Cases were significantly more likely to identify with being white compared to the national population.
An increasing incidence of patients newly coded with Lyme disease related Read codes was identified using data from a UK national primary care database. By comparing these incidence figures with national laboratory-confirmed surveillance data, a multiplication factor of 2.35 (95%CI 1.81-2.88) can be calculated in order to estimate the annual number of cases seen in primary care. The significant socio-demographic variables associated with a Lyme disease diagnosis likely reflect a complex interplay of socio-economic issues, which needs to be further explored. Future work is needed to examine the treatment and management of patients within this database.
初级保健可能会看到数量最多的莱姆病患者。尽管如此，关于英国初级保健中莱姆病患者就诊的已发表数据有限。我们旨在描述新诊断的发病率趋势和在初级保健电子健康数据库中确定的患者人群统计学特征。
对英国初级保健中莱姆病编码患者进行描述性流行病学研究。在 1998-2016 年间，在健康改进网络（THIN）中发现了 3725 例莱姆病编码患者。描述了病例的发病率和人群统计学特征。使用泊松回归分析病例的社会人口统计学特征。
年粗发病率呈上升趋势，2015 年达到峰值，为 5.47（95%CI 4.85-6.14）/10 万人/年。多变量分析显示，受影响人群的年龄存在显著差异，新诊断发病率随着贫困程度的改善而上升，农村地区的发病率高于城市地区。在英国，男女之间的发病率没有显著差异。与全国人口相比，病例更有可能自认为是白人。
使用来自英国全国初级保健数据库的数据，发现新编码莱姆病相关 Read 代码的患者发病率增加。通过将这些发病率数据与全国实验室确诊监测数据进行比较，可以计算出 2.35（95%CI 1.81-2.88）的倍增系数，以便估计初级保健中每年看到的病例数。与莱姆病诊断相关的显著社会人口统计学变量可能反映了复杂的社会经济问题相互作用，需要进一步探讨。未来需要对该数据库中患者的治疗和管理进行研究。
