Faculty of Medicine, Clinic of Infectious Diseases, University Clinical Center of Kosovo, University of Pristina "Hasan Pristina," Pristina, Kosovo.
Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia.
Vector Borne Zoonotic Dis. 2021 Apr;21(4):247-255. doi: 10.1089/vbz.2020.2717. Epub 2021 Feb 2.
Lyme borreliosis (LB) occurs throughout Europe. No clinical and seroprevalence studies for LB in Kosovo have been publicly available thus far. Therefore, this study aimed to investigate LB from a tick bite perspective in the Pristina region, Kosovo. This single-center prospective observational study enrolled consecutive adult participants (≥18 years of age) with tick bite (embedded tick in the skin), who were examined at the Clinic of Infectious Diseases, Pristina, between January 2015 and August 2018. At the first visit related to the index tick bite, ticks (the complete ticks or parts of the ticks) were removed from the skin, blood samples were taken for serological tests, and antibiotic treatment was started when deemed necessary. The complete, undamaged ticks removed were proceeded for entomological identification. Participants were followed up at 2 months (serological tests were repeated) and 6 months after the index event for the development of clinical manifestations of LB and/or seroconversion against . A total of 380 subjects were included in the study. Most cases were seen in May and June in all study years. All 117 preserved ticks were identified as . Immunoglobulin G seroprevalence among subjects during the first visit in the study was 28/380 (7.4%). Erythema migrans (EM) was clinically diagnosed in 74/380 patients (19.5%, 95% confidence interval 15.6-23.8). Only 15 clinically diagnosed EM (in seronegative patients) were serologically confirmed with seroconversion (2 months later), 3.9% of all subjects included in the study. There were three cases with clinical manifestation between the second and third visit: EM recidivans, multiple erythema, or several nonspecific systemic symptoms. Doxycycline and amoxicillin were mainly used for the treatment of borrelial skin lesions. This assessment can help indicate the need for disease awareness and reinforce the importance of primary prevention measures, early diagnosis, and appropriate treatment.
莱姆病（LB）在整个欧洲都有发生。到目前为止，科索沃还没有公开的关于 LB 的临床和血清流行率研究。因此，本研究旨在调查科索沃普里什蒂纳地区的蜱传莱姆病。 这项单中心前瞻性观察研究纳入了 2015 年 1 月至 2018 年 8 月在普里什蒂纳传染病诊所就诊的连续成年蜱叮咬（皮肤内嵌入蜱）患者（≥18 岁）。在与索引蜱叮咬相关的首次就诊时，从皮肤中取出蜱（完整的蜱或蜱的部分），采集血样进行血清学检测，并在必要时开始抗生素治疗。取出的完整无损的蜱进行昆虫学鉴定。在索引事件后 2 个月（重复血清学检测）和 6 个月时对患者进行随访，以观察 LB 的临床症状表现和/或针对 的血清学转换。 共有 380 名患者纳入研究。所有研究年份中，大多数病例发生在 5 月和 6 月。所有 117 个保存的蜱均鉴定为. 在研究的首次就诊时，研究对象的 IgG 血清流行率为 28/380（7.4%）。380 例患者中，74 例（19.5%，95%置信区间 15.6-23.8）临床诊断为游走性红斑（EM）。仅在 15 例（血清阴性患者）中，通过血清学转换（2 个月后），对 15 例临床诊断为 EM 的患者进行了血清学确诊，占研究纳入的所有患者的 3.9%。在第二次和第三次就诊之间有 3 例出现临床表现：EM 复发性、多处红斑或多种非特异性全身症状。多西环素和阿莫西林主要用于治疗伯氏皮肤病变。 这种评估可以帮助确定对疾病的认识的需求，并加强对初级预防措施、早期诊断和适当治疗的重要性。
