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

Abstract

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.

Efficacy of Short-Term High Dose Pulsed Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-Infections: A Report of Three Cases and Literature Review

“…There is considerable medical debate regarding the etiology, incidence, and severity of CLD/PTLDS [ 71 ], with treatments remaining controversial. PTLDS is characterized by incapacitating fatigue, pain, and neurocognitive dysfunction that persists for more than 6-months, with intermittent or constant symptoms that are often subjective and varied in nature [ 72 ].…”

No molecular detection of tick-borne pathogens in the blood of patients with erythema migrans in Belgium

“…However, to increase GPs’ awareness, each year, reminder emails were sent at the beginning of and halfway through the tick season, emphasizing the need to enroll both patient groups. There was no difference in the GP’s work load in terms of including patients of both groups in the study, but willingness to participate could have been higher for those patients with fever after a recent tick bite as the questionnaire was shorter and there was no follow-up, in contrast to the case of EM patients in part of another study [ 56 ].…”

Clinical mimics and diagnostic challenges in tick-borne borreliosis: a systematic review

“…Другие исследователи в патогенезе этих процессов рассматривают аутоиммунные реакции, снижение активности церебральных серотонинэргических структур, приводящее к разнообразной соматогенной симптоматике [42]. Нет единой точки зрения и на природу постлаймского синдрома, предложенного для обозначения резидуальныx проявлений ИКБ [57,65].…”