Estimating the population health burden of Lyme disease in Ontario, Canada: a microsimulation modelling approach

The objective of this study was to develop a microsimulation model to estimate the population-level health burden of Lyme disease in Ontario, Canada.METHODS: We developed a Lyme disease history model using microsimulation, simulating 100 000 people (mean age 37.6 yr, 51% female) from 2017 in Ontario over a lifetime risk of infection and time horizon. We extracted the sensitivity and specificity of the 2-tier testing recommended by the Canadian Public Health Laboratory Network, probabilities and health state utility values from the published literature and health administrative data. Our reported outcomes from our stochastic analysis include diagnosed cases of Lyme disease (stratified by stage), undiagnosed infections, sequelae, individuals with PTLDS and quality-adjusted life-years (QALYs) lost.RESULTS: Our model estimated 333 (95% confidence interval [CI] 329-337) infections over the lifetime of 100 000 simulated people (mean age 37.6 yr, 51% female), with 92% (95% CI 91%-93%) of infections diagnosed. Of those 308 people with Lyme Disease diagnoses, 67 (95% CI 65-69) developed sequelae (e.g., arthritic, cardiac, neurologic sequelae), and 34 (95% CI 33-35) developed PTLDS. Lyme disease resulted in a loss of 84.5 QALYs (95% CI 82.9-86.2) over the lifetime of the simulated cohort. Sensitivity and scenario analysis showed that increasing incidence rates of Lyme disease, potential underreporting, duration of PTLDS and quality of life (health state utility) associated with PTLDS h...
Source: cmaj - Category: General Medicine Authors: Source Type: research

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The objective of this study was to develop a microsimulation model to estimate the population-level health burden of Lyme disease in Ontario, Canada.METHODS: We developed a Lyme disease history model using microsimulation, simulating 100 000 people (mean age 37.6 yr, 51% female) from 2017 in Ontario over a lifetime risk of infection and time horizon. We extracted the sensitivity and specificity of the 2-tier testing recommended by the Canadian Public Health Laboratory Network, probabilities and health state utility values from the published literature and health administrative data. Our reported outcomes from our stochasti...
Source: cmaj - Category: General Medicine Authors: Source Type: research
is the most common tick-borne illness in the USA and Europe. Pathogens involved include Borrelia burgdorferi in the USA and B. afzelii and B. garinii in Europe. The characteristic rash of erythema migrans occurs in 70 –80% of patients. Neurological disease, including facial palsy, meningo-encephalitis, aseptic meningitis and polyradiculopathy, occurs in 10–15%. Cardiac disease, primarily manifest as heart block, is seen in 1–4%. Arthritis is a late complication in about 30% of untreated patients.
Source: Medicine - Category: Internal Medicine Authors: Tags: Bacterial infections Source Type: research
ConclusionThe majority of the RA patients had Pc immune responses. The correlation of IgA Pc antibody responses, particularly to Pc-p27, with ACPA supports the hypothesis that specific microbial antigens in the mucosa have a role in shaping or amplifying immune responses in RA joints.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Brief Report Source Type: research
Conclusions: Operative management of pediatric patients with Lyme arthritis is associated with increased resource utilization and costs while being similarly efficacious to nonoperative management. As the US Lyme epidemic expands, improved diagnosis and management of acute undifferentiated arthritis may prevent unneeded operative intervention. Level of Evidence: Level III—retrospective cohort study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Infection Source Type: research
CONCLUSIONS: The presence of IgG antibodies against a number of Borreliella antigens and the differences in the IL-2 and MMP2 levels in seropositive or seronegative individuals and symptomatic LB patients, may indicate differences in the intensity of the immune response to the infection and, consequently, may induce development of clinical manifestations of the disease in seropositive and seronegative individuals.PMID:34558260 | DOI:10.26444/aaem/124088
Source: Annals of Agricultural and Environmental Medicine : AAEM - Category: Environmental Health Authors: Source Type: research
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