Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data
Lyme borreliosis (LB) is the most common tick-borne disease in Europe and can manifest as localized erythema migrans (EM) or further disseminate into Lyme neuroborreliosis (LNB), Lyme arthritis (LA) or other manifestations. However, public health surveillance in Denmark and Ireland only captures LNB...
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Elsevier
2025-07-01
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| Series: | Ticks and Tick-Borne Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1877959X25000731 |
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| author | Gordon Brestrich Madiha Shafquat Frederick J. Angulo Alexander Davidson Ye Tan Kate Halsby Julie Davis Jennifer C Moïsi James H. Stark |
| author_facet | Gordon Brestrich Madiha Shafquat Frederick J. Angulo Alexander Davidson Ye Tan Kate Halsby Julie Davis Jennifer C Moïsi James H. Stark |
| author_sort | Gordon Brestrich |
| collection | DOAJ |
| description | Lyme borreliosis (LB) is the most common tick-borne disease in Europe and can manifest as localized erythema migrans (EM) or further disseminate into Lyme neuroborreliosis (LNB), Lyme arthritis (LA) or other manifestations. However, public health surveillance in Denmark and Ireland only captures LNB, while published LB data for Sweden only includes LNB. To enhance the understanding of LB disease burden in these countries, this study aimed to estimate LB incidence by clinical manifestation using the ratio of each manifestation to LNB. These ratios were derived using random effects meta-analysis of published data from other European countries. We estimated the ratios for EM/LNB, LA/LNB and other manifestations/LNB to be 42.8 (95 % confidence interval [CI]: 36.4–50.4), 0.9 (95 % CI: 0.7–1.0), and 0.8 (95 % CI; 0.4–1.4), respectively. Applying these ratios to the LNB incidence resulted in an estimated overall LB incidence of 151.5 cases per 100,000 population per year (PPY) in Denmark, 285.2 per 100,000 PPY in Sweden and 9.5 per 100,000 PPY in Ireland. These correspond to >36,000 LB cases per year compared to approximately 800 LNB cases reported in these three countries. Furthermore, the estimated incidence of disseminated manifestations was 8.7 and 16.4 per 100,000 PPY in Denmark and Sweden, respectively. These estimates across LB manifestations highlight the LB health burden on the national healthcare systems. Future studies that directly estimate the incidence of medically-attended LB from healthcare registries, claims data or administrative medical records may help validate these estimates. |
| format | Article |
| id | doaj-art-0e4c683f997e4850b3917c84d7b3e6ac |
| institution | Kabale University |
| issn | 1877-9603 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ticks and Tick-Borne Diseases |
| spelling | doaj-art-0e4c683f997e4850b3917c84d7b3e6ac2025-08-20T03:32:23ZengElsevierTicks and Tick-Borne Diseases1877-96032025-07-0116410250910.1016/j.ttbdis.2025.102509Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis dataGordon Brestrich0Madiha Shafquat1Frederick J. Angulo2Alexander Davidson3Ye Tan4Kate Halsby5Julie Davis6Jennifer C Moïsi7James H. Stark8Global Vaccines and Anti-infectives Medical Affairs, Pfizer, Berlin, BE, Germany; Corresponding author.Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USAGlobal Vaccines and Anti-infectives Medical Affairs, Pfizer, Collegeville, PA, USAGlobal Vaccines and Anti-infectives Medical Affairs, Pfizer, NY, NY, USAEvidence Generation Statistics, Pfizer Research and Development, Cambridge, MA, USAGlobal Vaccines and Anti-infectives Medical Affairs, Pfizer, Walton Oaks, Surrey, UKLife Sciences and Healthcare, Clarivate Analytics, Philadelphia, PA, USAGlobal Vaccines and Anti-infectives Medical Affairs, Pfizer, Paris, FranceEvidence Generation Statistics, Pfizer Research and Development, Cambridge, MA, USALyme borreliosis (LB) is the most common tick-borne disease in Europe and can manifest as localized erythema migrans (EM) or further disseminate into Lyme neuroborreliosis (LNB), Lyme arthritis (LA) or other manifestations. However, public health surveillance in Denmark and Ireland only captures LNB, while published LB data for Sweden only includes LNB. To enhance the understanding of LB disease burden in these countries, this study aimed to estimate LB incidence by clinical manifestation using the ratio of each manifestation to LNB. These ratios were derived using random effects meta-analysis of published data from other European countries. We estimated the ratios for EM/LNB, LA/LNB and other manifestations/LNB to be 42.8 (95 % confidence interval [CI]: 36.4–50.4), 0.9 (95 % CI: 0.7–1.0), and 0.8 (95 % CI; 0.4–1.4), respectively. Applying these ratios to the LNB incidence resulted in an estimated overall LB incidence of 151.5 cases per 100,000 population per year (PPY) in Denmark, 285.2 per 100,000 PPY in Sweden and 9.5 per 100,000 PPY in Ireland. These correspond to >36,000 LB cases per year compared to approximately 800 LNB cases reported in these three countries. Furthermore, the estimated incidence of disseminated manifestations was 8.7 and 16.4 per 100,000 PPY in Denmark and Sweden, respectively. These estimates across LB manifestations highlight the LB health burden on the national healthcare systems. Future studies that directly estimate the incidence of medically-attended LB from healthcare registries, claims data or administrative medical records may help validate these estimates.http://www.sciencedirect.com/science/article/pii/S1877959X25000731Lyme borreliosisLyme neuroborreliosisLyme arthritisEpidemiologyIncidenceSweden |
| spellingShingle | Gordon Brestrich Madiha Shafquat Frederick J. Angulo Alexander Davidson Ye Tan Kate Halsby Julie Davis Jennifer C Moïsi James H. Stark Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data Ticks and Tick-Borne Diseases Lyme borreliosis Lyme neuroborreliosis Lyme arthritis Epidemiology Incidence Sweden |
| title | Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data |
| title_full | Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data |
| title_fullStr | Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data |
| title_full_unstemmed | Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data |
| title_short | Using meta-analysis to estimate the incidence of Lyme borreliosis clinical manifestations in Denmark, Ireland and Sweden based on publicly-available Lyme neuroborreliosis data |
| title_sort | using meta analysis to estimate the incidence of lyme borreliosis clinical manifestations in denmark ireland and sweden based on publicly available lyme neuroborreliosis data |
| topic | Lyme borreliosis Lyme neuroborreliosis Lyme arthritis Epidemiology Incidence Sweden |
| url | http://www.sciencedirect.com/science/article/pii/S1877959X25000731 |
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