PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.
P95 Pharmacovigilance and Epidemiology, Leuven, Belgium.
Vector Borne Zoonotic Dis. 2023 Apr;23(4):230-236. doi: 10.1089/vbz.2022.0048. Epub 2023 Jan 27.
There is a need for updated incidence rates (IRs) of Lyme borreliosis (LB) in Europe, including the Netherlands. We estimated LB IRs stratified by geographic area, year, age, sex, immunocompromised status, and socioeconomic status (SES). All subjects registered in the PHARMO General Practitioner (GP) Database without prior diagnosis of LB or disseminated LB and having ≥1 year of continuous database enrolment were included. IRs and corresponding confidence intervals (CIs) of GP-recorded LB, erythema migrans (EM), and disseminated LB were estimated during the period 2015‒2019. We identified 14,794 events (suspected, probable, or confirmed) with a diagnostic code for LB that included 8219 with a recorded clinical manifestation: 7985 (97%) with EM and 234 (3%) with disseminated LB. National annual LB IRs were relatively consistent, ranging from 111 (95% CI 106‒115) in 2019 to 131 (95% CI 126‒136) in 2018 per 100,000 person-years. Incidence of LB showed a bimodal age distribution, with peak IRs observed among subjects aged 5‒14 and 60‒69 years in men and women. Higher LB incidence was found in subjects who were residents of the provinces of Drenthe and Overijssel, immunocompromised, or of lower SES. Similar patterns were observed for EM and disseminated LB. Our findings confirm that LB incidence remains substantial throughout the Netherlands with no indication of decline in the past 5 years. Foci in two provinces and among vulnerable populations suggest potential initial target groups for preventive strategies such as vaccination.
在欧洲，包括荷兰在内，都需要更新莱姆病（LB）的发病率（IR）数据。我们根据地理位置、年份、年龄、性别、免疫功能低下状态和社会经济地位（SES）对 LBIR 进行了分层。所有在 PHARMO 全科医生（GP）数据库中注册且无 LB 或播散性 LB 既往诊断记录且数据库连续登记≥1 年的患者均被纳入研究。我们在 2015-2019 年期间估计了 GP 记录的 LB、游走性红斑（EM）和播散性 LB 的发病率（IR）和相应的置信区间（CI）。我们确定了 14794 例（疑似、可能或确诊）具有 LB 诊断代码的事件，其中 8219 例记录了临床表现：7985 例（97%）为 EM，234 例（3%）为播散性 LB。全国 LB 年发病率相对稳定，从 2019 年的每 10 万人年 111 例（95%CI 106-115）到 2018 年的 131 例（95%CI 126-136）。LB 的发病率呈双峰年龄分布，男性和女性中发病率最高的年龄组为 5-14 岁和 60-69 岁。在 Drenthe 和 Overijssel 省的居民、免疫功能低下或 SES 较低的人群中，LB 的发病率更高。EM 和播散性 LB 也存在类似的模式。我们的研究结果证实，过去 5 年来，荷兰的 LB 发病率仍然很高，没有下降的迹象。在两个省和弱势人群中存在的发病热点提示了疫苗等预防策略的潜在初始目标人群。
