Vaccines and Antivirals Medical Affairs, Pfizer US Commercial Division, 500 Arcola Road, Collegeville, PA, 19426, USA.
Hologic, Inc, Marlborough, MA 01752, USA.
Parasit Vectors. 2024 Sep 5;17(1):378. doi: 10.1186/s13071-024-06449-5.
Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato (Bbsl), is the most common tick-borne disease in Europe. Although public health surveillance for LB has been conducted in Romania since 2007, the extent of under-detection of Bbsl infections by LB surveillance has not been estimated. We therefore estimated the under-detection of symptomatic Bbsl infections by LB surveillance to better understand the LB burden in Romania.
The number of incident symptomatic Bbsl infections were estimated from a seroprevalence study conducted in six counties (population 2.3 M) and estimates of the symptomatic proportion and duration of persistence of anti-Bbsl immunoglobulin G (IgG) antibodies. The number of incident symptomatic Bbsl infections were compared with the number of surveillance-reported LB cases to derive an under-detection multiplier, and then the under-detection multiplier was applied to LB surveillance data to estimate the incidence of symptomatic Bbsl infection from 2018 to 2023.
We estimate that there were 1968 individuals with incident symptomatic Bbsl infection in the six counties where the seroprevalence study was conducted in 2020, compared with the 187 surveillance-reported LB cases, resulting in an under-detection multiplier of 10.5 (i.e., for every surveillance-reported LB case, there were 10.5 symptomatic incident Bbsl infections). The incidence of symptomatic Bbsl infection in the six counties was 86.9/100,000 population in 2023, similar to the incidence in 2018-2020 (86.0) and higher than in 2021-2022 (40.3).
There is a higher incidence of symptomatic Bbsl infection than is reported through public health surveillance for LB in Romania. Additional efforts are needed to strengthen disease prevention and address the important public health problem of LB.
莱姆病（LB）由伯氏疏螺旋体（Bbsl）引起，是欧洲最常见的蜱传疾病。虽然自 2007 年以来罗马尼亚一直在进行 LB 公共卫生监测，但尚未估计 LB 监测对 Bbsl 感染的漏检程度。因此，我们估计了 LB 监测对有症状的 Bbsl 感染的漏检程度，以更好地了解罗马尼亚的 LB 负担。
从在六个县（人口 230 万）进行的血清流行率研究中估计了有症状的 Bbsl 感染的发病数，并估计了有症状的 Bbsl 免疫球蛋白 G（IgG）抗体的比例和持续时间。将有症状的 Bbsl 感染发病数与报告的 LB 病例数进行比较，得出漏检倍数，然后将漏检倍数应用于 LB 监测数据，以估计 2018 年至 2023 年有症状的 Bbsl 感染的发病率。
我们估计，在 2020 年进行血清流行率研究的六个县中，有 1968 人患有新发生的有症状的 Bbsl 感染，而报告的 LB 病例为 187 例，漏检倍数为 10.5（即每例报告的 LB 病例，有 10.5 例有症状的新发生的 Bbsl 感染）。2023 年，六个县有症状的 Bbsl 感染发病率为每 10 万人 86.9 例，与 2018-2020 年（86.0）相似，高于 2021-2022 年（40.3）。
罗马尼亚 LB 公共卫生监测报告的有症状 Bbsl 感染发病率高于实际情况。需要加强努力，以加强疾病预防和解决 LB 这一重要的公共卫生问题。
