Coyle B S, Strickland G T, Liang Y Y, Peña C, McCarter R, Israel E
Dept. of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
J Infect Dis. 1996 May;173(5):1260-2. doi: 10.1093/infdis/173.5.1260.
The purpose of this study was to estimate the health burden imposed by Lyme disease (LD) in Maryland during 1992 and 1993. A cross-sectional 1-in-15 survey of physicians (total, 1200) in Maryland was conducted to estimate the incidence of diagnosed LD, presumptive cases of LD, patients with tick bites, and diagnostic tests ordered for LD. Results show that LD is underreported by 10- to 12-fold in Maryland, that 80% of cases are managed by primary care physicians, and that there is discordance between the actual clinical treatment of patients and the recommended approach. In addition, the much greater numbers of patients treated for presumptive LD, seen and given prophylaxis for tick bites, and having diagnostic tests indicate that real and perceived LD is a far greater public health problem and uses more medical resources than official surveillance data suggest.
本研究的目的是估算1992年至1993年期间莱姆病（LD）给马里兰州带来的健康负担。对马里兰州的医生进行了一项横断面的15选1调查（共1200名），以估算确诊的莱姆病发病率、莱姆病疑似病例、蜱叮咬患者以及针对莱姆病所做的诊断检测。结果显示，在马里兰州，莱姆病的报告病例数少报了10至12倍，80%的病例由初级保健医生处理，并且患者的实际临床治疗与推荐方法之间存在不一致。此外，接受疑似莱姆病治疗、因蜱叮咬就诊并接受预防措施以及进行诊断检测的患者数量要多得多，这表明实际存在的和人们认为存在的莱姆病是一个远比官方监测数据所显示更为严重的公共卫生问题，且消耗了更多的医疗资源。
