Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer SAS, Paris, France.
IQVIA Opérations France, Courbevoie, France.
Vector Borne Zoonotic Dis. 2023 Apr;23(4):221-229. doi: 10.1089/vbz.2022.0050.
Lyme borreliosis (LB) is a growing public health concern requiring accurate and comprehensive epidemiological knowledge to inform health care interventions. This study compared the epidemiology of LB in primary care and hospital settings, using for the first time in France three sources of data, and highlighted specific populations at higher risk of developing LB. This study analyzed data from general practitioner networks (., Sentinel network, Electronic Medical Records [EMR]) and the national hospital discharge database to describe the LB epidemiology from 2010 to 2019. The average annual incidence rates of LB in primary care increased from 42.3 cases/100,000 population in 2010-2012 to 83.0/100,000 in 2017-2019 for the Sentinel Network and 42.7/100,000 to 74.6/100,000 for the EMR, following a marked rise in 2016. The annual hospitalization rate remained stable from 2012 to 2019 fluctuating between 1.6 and 1.8 hospitalizations/100,000. Women were more likely to present with LB in primary care setting compared with men (male-to-female incidence rate ratio [IRR] = 0.92), whereas men were predominant among hospitalizations (IRR = 1.4), with the largest discordance among adolescents aged 10-14 years (IRR = 1.8) and adults aged 80 years and older (IRR = 2.5). In 2017-2019, the average annual incidence rate peaked among persons aged 60-69 years in primary care (>125/100,000) and aged 70-79 years among hospitalized patients (3.4/100,000). A second peak occurred in children aged 0-4 or 5-9 years depending on sources. Incidence rates in Limousin and the north-eastern regions were the highest for both primary care and hospital settings. Analyses showed disparities in the evolution of incidence, sex-specific incidence rates, and predominant age groups between primary care and hospital settings that merit further exploration.
莱姆病（LB）是一个日益严重的公共卫生问题，需要准确和全面的流行病学知识来为医疗保健干预提供信息。本研究比较了初级保健和医院环境中 LB 的流行病学，这是法国首次使用三种数据源，并强调了具有更高 LB 发病风险的特定人群。本研究分析了来自全科医生网络（例如，哨兵网络，电子病历 [EMR]）和国家医院出院数据库的数据，以描述 2010 年至 2019 年 LB 的流行病学。初级保健中 LB 的平均年发病率从 2010-2012 年的 42.3 例/100,000 人增加到 2017-2019 年的 Sentinel 网络的 83.0/100,000 人，和 EMR 的 42.7/100,000 人至 74.6/100,000 人，2016 年出现明显上升。2012 年至 2019 年，年住院率保持稳定，波动在 1.6 至 1.8 例/100,000 人之间。与男性相比，女性在初级保健环境中更有可能出现 LB（男女发病率比 [IRR] = 0.92），而男性在住院患者中更为常见（IRR = 1.4），10-14 岁青少年（IRR = 1.8）和 80 岁及以上成年人（IRR = 2.5）之间的差异最大。2017-2019 年，初级保健中 60-69 岁人群的年平均发病率最高（>125/100,000），而住院患者中 70-79 岁人群的发病率最高（3.4/100,000）。第二个高峰取决于来源，出现在儿童 0-4 岁或 5-9 岁之间。初级保健和医院环境中发病率最高的地区是利穆赞和东北部地区。分析表明，初级保健和医院环境中发病率的变化、性别特异性发病率和主要年龄组之间存在差异，值得进一步探讨。
