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Eur J Public Health. 2015 Dec;25(6):1071-8. doi: 10.1093/eurpub/ckv091. Epub 2015 Jun 16.

The burden of Lyme borreliosis expressed in disability-adjusted life years.

Author information

1
1 National Institute of Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands kees.van.den.wijngaard@rivm.nl.
2
1 National Institute of Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands.
3
2 Erasmus MC, Department of Public Health, Rotterdam, The Netherlands.
4
3 National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
5
4 National Institute of Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Care, Bilthoven, The Netherlands 5 Julius Centre for Health Sciences and Primary Care, University Medical Hospital Utrecht, Utrecht, The Netherlands.
6
1 National Institute of Public Health and the Environment (RIVM), Centre for Infectious Disease Control, Bilthoven, The Netherlands 6 Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
7
4 National Institute of Public Health and the Environment (RIVM), Centre for Nutrition, Prevention and Health Care, Bilthoven, The Netherlands.

Abstract

BACKGROUND:

Lyme borreliosis (LB) is the most commonly reported tick-borne infection in Europe and North America. In the last 15 years a 3-fold increase was observed in general practitioner consultations for LB in the Netherlands. To support prioritization of prevention and control efforts for LB, we estimated its burden expressed in Disability-Adjusted Life Years (DALYs).

METHODS:

We used available incidence estimates for three LB outcomes: (i) erythema migrans (EM), (ii) disseminated LB and (iii) Lyme-related persisting symptoms. To generate DALYs, disability weights and duration per outcome were derived using a patient questionnaire including health-related quality of life as measured by the EQ-5D.

RESULTS:

We estimated the total LB burden for the Netherlands in 2010 at 10.55 DALYs per 100,000 population (95% CI: 8.80-12.43); i.e. 0.60 DALYs for EM, 0.86 DALYs for disseminated LB and 9.09 DALYs for Lyme-related persisting symptoms. Per patient this was 0.005 DALYs for EM, 0.113 for disseminated LB and 1.661 DALYs for a patient with Lyme-related persisting symptoms. In a sensitivity analysis the total LB burden ranged from 7.58 to 16.93 DALYs per 100,000 population.

CONCLUSIONS:

LB causes a substantial disease burden in the Netherlands. The vast majority of this burden is caused by patients with Lyme-related persisting symptoms. EM and disseminated Lyme have a more modest impact. Further research should focus on the mechanisms that trigger development of these persisting symptoms that patients and their physicians attribute to LB.

PMID:
26082446
DOI:
10.1093/eurpub/ckv091
[Indexed for MEDLINE]

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