アブストラクト | BACKGROUND: Primary care is likely to see the highest number of Lyme disease patients. Despite this, there is limited published data regarding Lyme disease patients accessing primary care in the UK. We aim to describe trends in the incidence of a new diagnosis, and demographics of patients identified in a primary care electronic health database. METHODS: A descriptive epidemiological study of Lyme disease coded patients in UK primary care. 3725 patients coded for Lyme disease during 1998-2016 were identified within The Health Improvement Network (THIN). Incidence rates and the demographics of cases identified were described. Poisson regression was used to analyse socio-demographic characteristics of the cases. RESULTS: There was an increase in annual crude incidence rates, peaking in 2015 at 5.47 (95% CI 4.85-6.14) cases per 100,000 population per year. Multivariable analysis showed there were significant differences in the ages of those affected, incidence of a new diagnosis rose as deprivation levels improved, and that there was a higher incidence of cases living in rural areas compared to urban areas. There was no significant difference between sexes for the UK. Cases were significantly more likely to identify with being white compared to the national population. CONCLUSIONS: An increasing incidence of patients newly coded with Lyme disease related Read codes was identified using data from a UK national primary care database. By comparing these incidence figures with national laboratory-confirmed surveillance data, a multiplication factor of 2.35 (95%CI 1.81-2.88) can be calculated in order to estimate the annual number of cases seen in primary care. The significant socio-demographic variables associated with a Lyme disease diagnosis likely reflect a complex interplay of socio-economic issues, which needs to be further explored. Future work is needed to examine the treatment and management of patients within this database. |
投稿者 | Tulloch, John S P; Christley, Robert M; Radford, Alan D; Warner, Jenny C; Beadsworth, Mike B J; Beeching, Nick J; Vivancos, Roberto |
組織名 | NIHR Health Protection Research Unit in Emerging and Zoonotic Infections,;University of Liverpool, Liverpool, L69 3GL, UK. jtulloch@liverpool.ac.uk.;Public Health England, L3 1DS, Liverpool, UK. jtulloch@liverpool.ac.uk.;University of Liverpool, Liverpool, L69 3GL, UK.;Institute of Infection and Global Health, University of Liverpool, Liverpool,;CH64 7TE, UK.;NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Public;Health England, Porton Down, SP4 0JQ, UK.;Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, SP4;0JQ, UK.;Tropical and Infectious Disease Unit, Royal Liverpool University Hospital,;Liverpool, L7 8XP, UK.;Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.;Public Health England, L3 1DS, Liverpool, UK.;Health England, Liverpool, L3 1DS, UK. |