Epidemiology and cost of hospital care for Lyme borreliosis in Germany: Lessons from a health care utilization database analysis

Lohr, Benedikt; Müller, Iris; Mai, Ming-Hsin; Norris, Douglas E.; Schöffski, Oliver; Hunfeld, Klaus-Peter

doi:10.1016/j.ttbdis.2014.09.004

Cited by 47 publications

(44 citation statements)

References 42 publications

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“…7). 14,[113][114][115][116][117][118] The number of reported cases in the United States is highest among boys aged 5 to 9. 14 A shift in more infections in men has been observed in recent years.…”

Section: Risk Factors For Lyme Diseasementioning

confidence: 99%

Ecology and Epidemiology of Lyme Borreliosis

Schotthoefer

Frost

2015

Clinics in Laboratory Medicine

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Section: Risk Factors For Lyme Diseasementioning

confidence: 99%

Ecology and Epidemiology of Lyme Borreliosis

Schotthoefer

Frost

2015

Clinics in Laboratory Medicine

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“…It occurs with an incidence of about 111/100,000 inhabitants in Central Europe, of which approximately 2–3 % will develop neurological manifestations [ 1 , 2 ], based on the large population-based study from central Germany. A bimodal pattern with two age peaks can be observed, one in children aged 5–14 years and one in elderly people aged 65–74 years [ 2 , 3 ]. By far the most frequent early manifestation of Lyme borreliosis is erythema migrans, although other manifestations of the disease can occur without dermal signs [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Common clinical manifestations of Lyme neuroborreliosis in children are cranial nerve palsy and meningitis [ 3 , 5 ]. Late manifestations, like myelitis or encephalitis, are rarely seen in children [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis in children: a systematic review

et al. 2016

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BackgroundMany aspects of pharmacological treatment of Lyme neuroborreliosis in children, such as choice of drug, dosage, and duration are subject to intense debates, leading to uncertainties in patients’ parents and healthcare providers alike. To assess the available evidence for pharmacological treatment for children with Lyme neuroborreliosis we conducted a systematic review.MethodsThe comprehensive systematic literature search included randomized-controlled trials (RCTs) and non-randomized studies (NRS) on treatment of Lyme neuroborreliosis in children (age <18 years). Our primary outcome was neurological symptoms after treatment. Risk of bias was assessed with the Cochrane risk of bias tools for RCTs and NRS. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsTwo RCTs and four NRS were eligible for inclusion. Risk of bias in RCTs and NRS was generally high. Reporting of studies was generally poor. Regarding the primary outcome neurological symptoms at 1–3 months, no statistically significant difference could be found in cohort studies between doxycycline and beta-lactam antibiotics. In two RCTs comparing penicillin G and ceftriaxone, no patient experienced residual neurological symptoms at the last reported time points. Quality of evidence according to GRADE was judged very low.ConclusionsData is scarce and with limited quality. Several issues could not be addressed due to scarcity of information. No eligible study compared different treatment durations. According to the available evidence, there seems to be no difference between different antibiotic agents for the treatment of Lyme neuroborreliosis in children regarding neurological symptoms. We found no evidence that supports extended antibiotic regimes.Review registrationSystematic review registration: CRD42014008839.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0708-y) contains supplementary material, which is available to authorized users.

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“…A few European studies have examined the costs associated with Lyme borreliosis but often only part of the costs were included (e.g. costs of Lyme neuroborreliosis in Sweden [ 70 ], cost of testing [ 71 ] and of hospital care in Germany [ 72 ]). One study in Scotland included both direct and indirect costs for early and late Lyme borreliosis patients and follow-up costs [ 73 ].…”

Section: Discussionmentioning

confidence: 99%

The HUMTICK study: protocol for a prospective cohort study on post-treatment Lyme disease syndrome and the disease and cost burden of Lyme borreliosis in Belgium

Geebelen¹,

Lernout²,

Kabamba-Mukadi³

et al. 2017

Arch Public Health

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BackgroundIn Belgium, different routine surveillance systems are in place to follow-up Lyme borreliosis trends. However, accurate data on the disease and monetary burden for the different clinical manifestations are lacking. Despite recommended antibiotic treatment, a proportion of Lyme patients report persisting aspecific symptoms for six months or more (e.g. fatigue, widespread musculoskeletal pain, cognitive difficulties), a syndrome now named “post-treatment Lyme disease syndrome” (PTLDS). Controversy exists on the cause, incidence and severity of PTLDS. This study aims to estimate the incidence of PTLDS in patients with Lyme borreliosis and to quantify the disease burden and economic costs associated with the different clinical manifestations of Lyme borreliosis in Belgium.MethodsThe project is a prospective cohort study in which about 600 patients with an erythema migrans and 100 patients with disseminated Lyme borreliosis will be followed up. Questionnaires, including the SF-36 vitality and pain subscale, the Cognitive Failure Questionnaire and the EQ-5D-5L, will be used to collect information on acute and persisting symptoms and the impact on quality of life. Symptom frequency and severity will be compared with self-reported pre-Lyme health status, a control group and existing Belgian population norms. Additionally, information on the associated costs and possible risk factors for the development of PTLDS will be collected.DiscussionA study of the health burden will allow evaluation of the relative importance of Lyme borreliosis in Belgium and information on the economic cost will help to formulate cost-effective measures. There are only few prospective studies conducted estimating the incidence of PTLDS and even though discussion exists about the prevalence of subjective symptoms in the general population, a control group of non-Lyme borreliosis participants has often not been included.Electronic supplementary materialThe online version of this article (doi:10.1186/s13690-017-0202-z) contains supplementary material, which is available to authorized users.

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Epidemiology and cost of hospital care for Lyme borreliosis in Germany: Lessons from a health care utilization database analysis

Cited by 47 publications

References 42 publications

Ecology and Epidemiology of Lyme Borreliosis

Ecology and Epidemiology of Lyme Borreliosis

Efficacy and safety of pharmacological treatments for Lyme neuroborreliosis in children: a systematic review

The HUMTICK study: protocol for a prospective cohort study on post-treatment Lyme disease syndrome and the disease and cost burden of Lyme borreliosis in Belgium

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