Prevalence and factors associated with a prescription of a Lyme borreliosis serology for erythema migrans diagnosis in general practice: a study from the French sentinel network, 2009–2020

BMC Primary Care

Research

Benoît Jaulhac¹  Sylvie de Martino¹  Alexandra Septfons²  Henriette de Valk²  Julie Figoni²  Lucie Fournier³  Cécile Souty³  Camille Bonnet³  Thierry Blanchon³  Thomas Hanslik⁴ 

[1] CNR des Borrelia et Institut de Bactériologie, Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, CHRU Strasbourg, UR7290, ITI InnoVec, 67000, Strasbourg, France;Santé publique France, F94410, Saint-Maurice, France;Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France;Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France;Service de Médecine Interne, APHP, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France;Université Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine Simone Veil, Versailles, France;

关键词: Lyme borreliosis;    Erythema Chronicum Migrans;    Serologic tests;    General Practice;    Sentinel surveillance;   

DOI  :  10.1186/s12875-023-02108-3

 received in 2022-06-14, accepted in 2023-07-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSerological testing of patients consulting for typical erythema migrans (EM) is not recommended in European recommendations for diagnosis of Lyme borreliosis (LB). Little is known on the level of adherence of French general practitioners to these recommendations. The objectives were to estimate the proportion of Lyme borreliosis serological test prescription in patients with erythema migrans seen in general practice consultations in France, and to study the factors associated with this prescription.MethodsLB cases with an EM reported by the French general practitioners (GPs) of the Sentinelles network between January 2009 and December 2020 were included. To assess the associations with a prescription of a serological test, multilevel logistic regression models were used.ResultsAmong the 1,831 EM cases included, a prescription for a LB serological test was requested in 24.0% of cases. This proportion decreased significantly over the study period, from 46.8% in 2009 to 15.8% in 2020. A LB serological prescription was associated with patients with no reported tick bite (Odds Ratio (OR): 1.95; 95% confidence interval [1.23–3.09]), multiple EM (OR: 3.82 [1.63–8.92]), EM of five centimeters or more (OR: 4.34 [2.33–8.08]), and GPs having diagnosed less than one EM case per year during the study period (OR: 5.28 [1.73–16.11]).ConclusionsSerological testing of patients consulting for EM is not recommended in European recommendations for diagnosis of Lyme borreliosis. Therefore, the significant decrease in the rate of LB serological test for EM over the study period is encouraging. The factors identified in this study can be used to improve messaging to GPs and patients. Further efforts are needed to continue to disseminate diagnostic recommendations for LB to GPs, especially those who rarely see patients with EM.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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