Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015

BMC Family Practice

Research Article

Sapha Barkati¹  François Milord²  Ariane Adam-Poupart²  Patrick A. Leighton³  Karine Thivierge⁴  Salima Gasmi⁵  Nicholas H. Ogden⁶  L. Robbin Lindsay⁷ 

[1] Department of Microbiology and Immunology, Faculty of Medicine, University of Montreal, 2900, boul. Édouard-Montpetit, H3T 1J4, Montréal, Canada;Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, 190, boulevard Crémazie Est, H2P 1E2, Montréal, Canada;Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, J2S 7C6, Saint-Hyacinthe, Canada;Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, H9X 3R5, Sainte-Anne-de-Bellevue, Canada;Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, H9X 3R5, Sainte-Anne-de-Bellevue, Canada;Policy Integration and Zoonoses Division, Centre for Food-borne, Environmental & Zoonotic Infectious Diseases, Public Health Agency of Canada, 3200 Sicotte, J2S 7C6, Saint-Hyacinthe, Canada;Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, 3200 Sicotte, J2S 7C6, Saint-Hyacinthe, Canada;Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), 3200 Sicotte, J2S 7C6, Saint-Hyacinthe, Canada;Zoonotic Diseases & Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, R3E 3R2, Winnipeg, Canada;

关键词: Ixodes scapularis;    Lyme disease;    Treatment;    Diagnosis;    Prophylaxis;    Canada;   

DOI  :  10.1186/s12875-017-0636-y

 received in 2016-12-29, accepted in 2017-05-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described.MethodsEight years (2008 to 2015) of retrospective demographic and clinical data on patients bitten by infected Ixodes scapularis (I. scapularis) ticks and on the management of suspected and confirmed LD cases by Quebec GPs were analysed.ResultsAmong 50 patients, all the antimicrobial treatments of LD clinical cases were appropriate according to current guidelines. However, more than half (62.8%) of erythema migrans (EM) were possibly misdiagnosed, 55.6%, (n = 27) of requested serologic tests were possibly unnecessary and the majority (96.5%, n = 57) of prophylactic antimicrobial treatments were not justified according to current guidelines.ConclusionsThese observations underline the importance for public health to enhance the knowledge of GPs where LD is emerging, to minimise the impact of the disease on patients and the financial burden on the health system.

【 授权许可】

CC BY   
© The Author(s). 2017