Mavin Sally, Guntupalli Swapna, Robb Michael
Scottish Lyme Disease and Tick-borne Infections Reference Laboratory, Raigmore Hospital, Inverness, UK
Scottish Lyme Disease and Tick-borne Infections Reference Laboratory, Raigmore Hospital, Inverness, UK.
BJGP Open. 2024 Oct 29;8(3). doi: 10.3399/BJGPO.2023.0241. Print 2024 Oct.
The true burden of Lyme disease in primary care in Scotland is unknown. Epidemiological data are currently based on laboratory-confirmed reports as there is no mandatory reporting of clinical cases.
To analyse data from general practice in NHS Highland (North) over a 6-year period to assess the incidence and management of Lyme disease in primary care.
DESIGN & SETTING: This was a retrospective descriptive study. Study data from 2017 to 2022 were extracted from all 63 general practices within NHS Highland (North).
Consultations for Lyme disease were identified via Lyme-related clinical Read codes, requests for borrelia tests , free text, 'tags' and/or Lyme disease antibiotic scripts.
Using Read codes to identify patients with Lyme disease or suspected Lyme disease gave an estimated average annual incidence of 124/100 000 population, which was 2.1 times more than estimates based solely on laboratory-confirmed reports. The incidence figures increased 5.2 times (362/100 000 population) when patients with Lyme disease or suspected Lyme disease (identified via Read codes, laboratory test requests, and free text tags) who were given antibiotic treatment were taken into account. Local 'hot spots' of infection were identified. Analysis of the antibiotic data indicates that antibiotic prescribing in NHS Highland largely follows the National Institute for Health and Care Excellence (NICE) guidelines.
This data analysis pathway can, and should, be rolled out across the whole of Scotland to assess the incidence and management of Lyme disease in primary care and allow appropriate allocation of resources.
在苏格兰初级医疗保健中，莱姆病的实际负担尚不清楚。由于临床病例没有强制报告，目前的流行病学数据基于实验室确诊报告。
分析NHS高地（北部）6年期间全科医疗的数据，以评估初级医疗保健中莱姆病的发病率和管理情况。
这是一项回顾性描述性研究。2017年至2022年的研究数据从NHS高地（北部）的所有63家全科诊所提取。
通过与莱姆病相关的临床Read编码、疏螺旋体检测请求、自由文本、“标签”和/或莱姆病抗生素处方来识别莱姆病咨询。
使用Read编码识别莱姆病或疑似莱姆病患者，估计年平均发病率为每10万人中有124例，这比仅基于实验室确诊报告的估计值高出2.1倍。当考虑接受抗生素治疗的莱姆病或疑似莱姆病患者（通过Read编码、实验室检测请求和自由文本标签识别）时，发病率数字增加了5.2倍（每10万人中有362例）。确定了局部感染“热点”。抗生素数据分析表明，NHS高地的抗生素处方在很大程度上遵循了英国国家卫生与临床优化研究所（NICE）的指南。
这种数据分析途径可以而且应该在全苏格兰推广，以评估初级医疗保健中莱姆病的发病率和管理情况，并允许进行适当的资源分配。
