Pfizer Pharma GmbH, Berlin, Germany.
Pfizer Pharma GmbH, Berlin, Germany.
Ticks Tick Borne Dis. 2024 May;15(3):102326. doi: 10.1016/j.ttbdis.2024.102326. Epub 2024 Feb 27.
Lyme borreliosis (LB) is the most common tick-borne disease in Germany. Although the incidence of LB in Germany has been assessed in several studies, those studies either used data from statutory surveillance, which frequently underreport cases, or data from health claims databases, which may overestimate cases due to non-specific LB case definitions. Here, using a more specific case definition, we describe the incidence of medically-attended LB by disease manifestation, age group, and federal state for the period 2015-2019. Both inpatient and outpatient cases were analyzed from a claims database. To be eligible for inclusion, patients were required to have an LB specific ICD-10 GM diagnosis code plus an antibiotic prescription, and for disseminated manifestations, a laboratory test order additionally. LB cases were classified as erythema migrans (EM), or disseminated disease including Lyme arthritis (LA), Lyme neuroborreliosis (LNB), and all other disease manifestations (OTH). Between 2015 and 2019, the incidence of medically-attended LB cases ranged from 195.7/100,000 population per year (95% confidence interval [CI], 191.0 - 200.5) to 254.5/100,000 population per year (95% CI, 249.0 - 260.0) per year. The majority of cases (92.2%) were EM, while 2.8% presented as LA, 3.8% as LNB, and 1.2% as OTH. For both EM and disseminated disease, the incidence peaked in children aged 5-9 years and in older adults. By federal state, the incidence of medically-attended EM ranged from 74.4/100,000 population per year (95% CI, 71.9 - 77.0) per year in Hamburg, to 394.1/100,000 population per year (95% CI, 370.7 - 417.6) per year in Saxony, whereas for medically-attended disseminated disease, the highest incidence was in Thuringia, Saxony, and Bavaria (range: 22.0 [95% CI, 19.9 - 24.0] to 35.7 [95% CI, 34.7 - 36.7] per 100,000 population per year). This study comprehensively estimated the incidence of all manifestations of medically-attended LB and showed a high incidence of LB throughout Germany. Results from the study support performing epidemiological studies in all federal states to measure the burden of LB and to invest in public health interventions for prevention.
莱姆病（LB）是德国最常见的蜱传疾病。尽管已有多项研究评估了德国 LB 的发病率，但这些研究要么使用法定监测数据，而这些数据经常漏报病例，要么使用健康索赔数据库数据，而这些数据可能由于非特异性 LB 病例定义而高估病例。在这里，我们使用更具体的病例定义，描述了 2015 年至 2019 年期间按疾病表现、年龄组和联邦州划分的有医疗记录的 LB 发病率。索赔数据库中分析了住院和门诊病例。为了符合纳入标准，患者必须有 LB 特定的 ICD-10 GM 诊断代码和抗生素处方，对于播散性表现，还必须有实验室检查订单。LB 病例分为游走性红斑（EM），或包括莱姆关节炎（LA）、莱姆神经Borreliosis（LNB）和所有其他疾病表现（OTH）的播散性疾病。2015 年至 2019 年间，有医疗记录的 LB 病例发病率范围为每年每 100,000 人口 195.7 例（95%置信区间[CI]，191.0-200.5）至每年每 100,000 人口 254.5 例（95%CI，249.0-260.0）。大多数病例（92.2%）为 EM，2.8%为 LA，3.8%为 LNB，1.2%为 OTH。对于 EM 和播散性疾病，发病率在 5-9 岁儿童和老年人群中最高。按联邦州划分，有医疗记录的 EM 发病率范围从汉堡每年每 100,000 人口 74.4 例（95%CI，71.9-77.0）到萨克森每年每 100,000 人口 394.1 例（95%CI，370.7-417.6），而有医疗记录的播散性疾病发病率最高的是图林根州、萨克森州和巴伐利亚州（范围：每 100,000 人口每年 22.0[95%CI，19.9-24.0]至 35.7[95%CI，34.7-36.7]）。本研究全面估计了有医疗记录的 LB 所有表现的发病率，并显示德国各地 LB 的发病率很高。该研究的结果支持在所有联邦州开展流行病学研究，以衡量 LB 的负担，并投资于预防的公共卫生干预措施。
