Nilsson Per-Olof, Tjernberg Ivar
Medical Programme, Faculty of Medicine and Health Sciences, Linköping University, 58 183 Linköping, Sweden.
Department of Clinical Chemistry and Transfusion Medicine, Region Kalmar County, and Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linköping University, 581 83 Linköping, Sweden.
Microorganisms. 2023 Apr 1;11(4):917. doi: 10.3390/microorganisms11040917.
The aim of this study was to perform a detailed epidemiological overview of Lyme neuroborreliosis (LNB) 2008-2021 in a highly Lyme borreliosis-endemic area in Sweden using a geographic information system (GIS). Diagnosis of LNB was based on clinical symptoms and analysis of cerebrospinal fluid (CSF) according to European guidelines. From laboratory databases and medical records, we detected all patients with CSF pleocytosis and intrathecal anti- antibody production and listed clinical features. The distribution of LNB cases within Kalmar County, Sweden was investigated using GIS. In total, 272 cases of definite LNB were confirmed with an average yearly incidence of 7.8/100,000. Significant differences in incidence were noted between children 0-17 years (16/100,000) and adults 18+ years (5.8/100,000) ( < 0.001), between rural (16/100,000) and urban areas (5.8/100,000) ( < 0.001) and between selected municipalities ( < 0.001). Distinct clinical differences in presentation of LNB were also noted between children and adults. Thus, the incidence of LNB varies significantly locally and in relation to age, and clinical presentation shows differences between children and adults. Surveillance of LNB and knowledge of local epidemiological conditions may facilitate preventive measures.
本研究的目的是利用地理信息系统（GIS）对2008 - 2021年瑞典莱姆病高度流行地区的莱姆病神经疏螺旋体病（LNB）进行详细的流行病学概述。LNB的诊断基于临床症状以及根据欧洲指南对脑脊液（CSF）进行的分析。我们从实验室数据库和医疗记录中，找出所有脑脊液细胞增多和鞘内抗体产生的患者，并列出临床特征。利用GIS调查了瑞典卡尔马县内LNB病例的分布情况。总共确诊了272例确诊LNB病例，年平均发病率为7.8/10万。0 - 17岁儿童（16/10万）和18岁及以上成年人（5.8/10万）之间的发病率存在显著差异（<0.001），农村地区（16/10万）和城市地区（5.8/10万）之间存在显著差异（<0.001），在选定的各市镇之间也存在显著差异（<0.001）。儿童和成人在LNB表现上也存在明显的临床差异。因此，LNB的发病率在当地和与年龄相关方面存在显著差异，并且临床表现显示儿童和成人之间存在差异。对LNB进行监测并了解当地流行病学情况可能有助于采取预防措施。
