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Archives of Public Health
Published in: Archives of Public Health 1/2017

Open Access 01-12-2017 | Study protocol

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

Authors: Laurence Geebelen, Tinne Lernout, Benoît Kabamba-Mukadi, Veroniek Saegeman, Hein Sprong, Steven Van Gucht, Philippe Beutels, Niko Speybroeck, Katrien Tersago

Published in: Archives of Public Health | Issue 1/2017

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Abstract

Background

In 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.

Methods

The 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.

Discussion

A 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.
Appendix
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Literature
1.
2.
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43:1089–134.CrossRefPubMed
3.
Hofhuis A, Herremans T, Notermans DW, Sprong H, Fonville M, van der Giessen JW, et al. A prospective study among patients presenting at the general practitioner with a tick bite or erythema migrans in The Netherlands. PLoS One. 2013;8:e64361.CrossRefPubMedPubMedCentral
4.
Huegli D, Moret J, Rais O, Moosmann Y, Erard P, Malinverni R, et al. Prospective study on the incidence of infection by Borrelia burgdorferi sensu lato after a tick bite in a highly endemic area of Switzerland. Ticks Tick Borne Dis. 2011;2:129–36.CrossRefPubMed
5.
Wilhelmsson P, Fryland L, Lindblom P, Sjowall J, Ahlm C, Berglund J, et al. A prospective study on the incidence of Borrelia burgdorferi sensu lato infection after a tick bite in Sweden and on the Aland Islands, Finland (2008-2009). Ticks Tick Borne Dis. 2016;7:71–9.CrossRefPubMed
6.
7.
Rizzoli A, Hauffe H, Carpi G, Vourc HG, Neteler M, Rosa R. Lyme borreliosis in Europe. Euro Surveill. 2011;16
8.
Berglund J, Eitrem R, Ornstein K, Lindberg A, Ringer A, Elmrud H, et al. An epidemiologic study of Lyme disease in southern Sweden. N Engl J Med. 1995;333:1319–27.CrossRefPubMed
9.
Wilking H, Stark K. Trends in surveillance data of human Lyme borreliosis from six federal states in eastern Germany, 2009-2012. Ticks Tick Borne Dis. 2014;5:219–24.CrossRefPubMed
10.
Hofhuis A, Harms M. Bennema S, van den Wijngaard CC, van PW: physician reported incidence of early and late Lyme borreliosis. Parasit Vectors. 2015;8:161.CrossRefPubMedPubMedCentral
11.
Vandenesch A, Turbelin C, Couturier E, Arena C, Jaulhac B, Ferquel E, et al. Incidence and hospitalisation rates of Lyme borreliosis, France, 2004 to 2012. Euro Surveill. 2014:19.
12.
Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A, et al. Lyme borreliosis: clinical case definitions for diagnosis and management in Europe. Clin Microbiol Infect. 2011;17:69–79.CrossRefPubMed
13.
Aucott JN, Crowder LA, Kortte KB. Development of a foundation for a case definition of post-treatment Lyme disease syndrome. Int J Infect Dis. 2013;17:e443–9.CrossRefPubMed
14.
Aucott JN, Rebman AW, Crowder LA, Kortte KB. Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here? Qual Life Res. 2013;22:75–84.CrossRefPubMed
15.
Aucott JN. Posttreatment Lyme disease syndrome. Infect Dis Clin N Am. 2015;29:309–23.CrossRef
16.
Koedel U, Fingerle V, Pfister HW. Lyme neuroborreliosis-epidemiology, diagnosis and management. Nat Rev Neurol. 2015;11:446–56.CrossRefPubMed
17.
Marques A. Chronic Lyme disease: a review. Infect Dis Clin N Am. 2008;22:341–60.CrossRef
18.
Wormser GP, Ramanathan R, Nowakowski J, McKenna D, Holmgren D, Visintainer P, et al. Duration of antibiotic therapy for early Lyme disease. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2003;138:697–704.CrossRefPubMed
19.
Cerar D, Cerar T, Ruzic-Sabljic E, Wormser GP, Strle F. Subjective symptoms after treatment of early Lyme disease. Am J Med. 2010;123:79–86.CrossRefPubMed
20.
Cairns V, Godwin J. Post-Lyme borreliosis syndrome: a meta-analysis of reported symptoms. Int J Epidemiol. 2005;34:1340–5.CrossRefPubMed
21.
22.
Seltzer EG, Gerber MA, Cartter ML, Freudigman K, Shapiro ED. Long-term outcomes of persons with Lyme disease. JAMA. 2000;283:609–16.CrossRefPubMed
23.
Aucott JN, Soloski MJ, Rebman AW, Crowder LA, Lahey LJ, Wagner CA, et al. CCL19 as a Chemokine risk factor for post-treatment Lyme disease syndrome: a prospective clinical cohort study. Clin Vaccine Immunol. 2016;23:757–66.CrossRefPubMedPubMedCentral
24.
Nowakowski J, Nadelman RB, Sell R, McKenna D, Cavaliere LF, Holmgren D, et al. Long-term follow-up of patients with culture-confirmed Lyme disease. Am J Med. 2003;115:91–6.CrossRefPubMed
25.
Eikeland R, Mygland A, Herlofson K, Ljostad U. Risk factors for a non-favorable outcome after treated European neuroborreliosis. Acta Neurol Scand. 2013;127:154–60.CrossRefPubMed
26.
Krause PJ, Telford SR III, Spielman A, Sikand V, Ryan R, Christianson D, et al. Concurrent Lyme disease and babesiosis. Evidence for increased severity and duration of illness. JAMA. 1996;275:1657–60.CrossRefPubMed
27.
Cochez C, Heyman P, Heylen D, Fonville M, Hengeveld P, Takken W, et al. The presence of Borrelia miyamotoi, a relapsing fever Spirochaete, in questing Ixodes ricinus in Belgium and in The Netherlands. Zoonoses Public Health. 2015;62:331–3.CrossRefPubMed
28.
Jahfari S, Fonville M, Hengeveld P, Reusken C, Scholte EJ, Takken W, et al. Prevalence of Neoehrlichia mikurensis in ticks and rodents from north-west Europe. Parasit Vectors. 2012;5:74.CrossRefPubMedPubMedCentral
29.
Claerebout E, Losson B, Cochez C, Casaert S, Dalemans AC, De CA, et al. Ticks and associated pathogens collected from dogs and cats in Belgium. Parasit Vectors. 2013;6:183.CrossRefPubMedPubMedCentral
30.
Borgermans L, Goderis G, Vandevoorde J, Devroey D. Relevance of chronic lyme disease to family medicine as a complex multidimensional chronic disease construct: a systematic review. Int J Family Med. 2014;2014:138016.CrossRefPubMedPubMedCentral
31.
32.
33.
34.
Wang TJ, Liang MH, Sangha O, Phillips CB, Lew RA, Wright EA, et al. Coexposure to Borrelia burgdorferi and Babesia microti does not worsen the long-term outcome of lyme disease. Clin Infect Dis. 2000;31:1149–54.CrossRefPubMed
35.
36.
Bleyenheuft C, Lernout T, Berger N, Rebolledo J, Leroy M, Robert A, et al. Epidemiological situation of Lyme borreliosis in Belgium, 2003 to 2012. Arch Public Health. 2015;73:33.CrossRefPubMedPubMedCentral
37.
Vanthomme K, Bossuyt N, Boffin N, Van C. V: incidence and management of presumption of Lyme borreliosis in Belgium: recent data from the sentinel network of general practitioners. Eur J Clin Microbiol Infect Dis. 2012;31:2385–90.CrossRefPubMed
38.
Lantos PM. Chronic Lyme disease: the controversies and the science. Expert Rev Anti-Infect Ther. 2011;9:787–97.CrossRefPubMed
39.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed
40.
Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, et al. Translation, validation, and norming of the Dutch language version of the SF-36 health survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1055–68.CrossRefPubMed
41.
Razavi D, Gandek B. Testing Dutch and French translations of the SF-36 health survey among Belgian angina patients. J Clin Epidemiol. 1998;51:975–81.CrossRefPubMed
42.
Vom Hofe A, Mainemarre G, Vannier L-C. Sensitivity to everyday failures and cognitive inhibition: are they related? European Review of Applied Psychology / Revue Européenne de Psychologie Appliquée. 1998;48:49–56.
43.
Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The cognitive failures questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982;21(Pt 1):1–16.CrossRefPubMed
44.
EuroQol--a new facility for the measurement of health-related quality of life. Health Policy 1990, 16: 199-208.
45.
Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20:1727–36.CrossRefPubMedPubMedCentral
46.
Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, et al. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 2013;22:1717–27.CrossRefPubMed
47.
Robine JM, Jagger C. Creating a coherent set of indicators to monitor health across Europe: the Euro-REVES 2 project. Eur J Pub Health. 2003;13:6–14.CrossRef
48.
Van OH, Van der Heyden J, Perenboom R, Jagger C. Monitoring population disability: evaluation of a new Global activity limitation indicator (GALI). Soz Praventivmed. 2006;51:153–61.CrossRef
49.
Berger N, Van OH, Cambois E, Fouweather T, Jagger C, Nusselder W, et al. Assessing the validity of the Global activity limitation indicator in fourteen European countries. BMC Med Res Methodol. 2015;15:1.CrossRefPubMedPubMedCentral
50.
51.
52.
53.
54.
Ponds R, van Boxtel M, Jolles J. De "cognitive failure questionnaire" als maat voor subjectief functioneren. Tijdschrift voor neuropsychologie. 2006;1(2):37–42.
55.
Jahfari S, Hofhuis A. Fonville M, van der Giessen J, van PW, Sprong H: molecular detection of tick-borne pathogens in humans with tick bites and Erythema Migrans, in the Netherlands. PLoS Negl Trop Dis. 2016;10:e0005042.CrossRefPubMedPubMedCentral
56.
Devleesschauwer B, Havelaar AH, Maertens de NC, Haagsma JA, Praet N, Dorny P, et al. Calculating disability-adjusted life years to quantify burden of disease. Int J Public Health. 2014;59:565–9.CrossRefPubMed
57.
Devleesschauwer B, Havelaar AH, Maertens de NC, Haagsma JA, Praet N, Dorny P, et al. DALY calculation in practice: a stepwise approach. Int J Public Health. 2014;59:571–4.CrossRefPubMed
58.
Murray CJ. Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ. 1994;72:429–45.PubMedPubMedCentral
59.
60.
van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. 2012;15:708–15.CrossRefPubMed
61.
Cleemput I. A social preference valuations set for EQ-5D health states in Flanders, Belgium. Eur J Health Econ. 2010;11:205–13.CrossRefPubMed
62.
Maertens de NC, Devleesschauwer B, Gielens L, Plasmans MHD, Haagsma JA, Speybroeck N. Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: results of two pilot studies in Belgium. Arch Public Health. 2017;75:6.CrossRef
63.
Bilcke J, Hens N, Beutels P. Quality-of-life: a many-splendored thing? Belgian population norms and 34 potential determinants explored by beta regression. Qual Life Res. 2017;
64.
65.
McNutt LA, Wu C, Xue X, Hafner JP. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol. 2003;157:940–3.CrossRefPubMed
66.
67.
Kretzschmar M, Mangen MJ, Pinheiro P, Jahn B, Fevre EM, Longhi S, et al. New methodology for estimating the burden of infectious diseases in Europe. PLoS Med. 2012;9:e1001205.CrossRefPubMedPubMedCentral
68.
van Lier A, SA MD, Bouwknegt M, Kretzschmar ME, Havelaar AH, Mangen MJ, et al. Disease burden of 32 infectious diseases in the Netherlands, 2007-2011. PLoS One. 2016;11:e0153106.CrossRefPubMedPubMedCentral
69.
van den Wijngaard CC, Hofhuis A, Harms MG, Haagsma JA, Wong A, de Wit GA, et al. The burden of Lyme borreliosis expressed in disability-adjusted life years. Eur J Pub Health. 2015;
70.
Henningsson AJ, Malmvall BE, Ernerudh J, Matussek A, Forsberg P. Neuroborreliosis--an epidemiological, clinical and healthcare cost study from an endemic area in the south-east of Sweden. Clin Microbiol Infect. 2010;16:1245–51.CrossRefPubMed
71.
Muller I, Freitag MH, Poggensee G, Scharnetzky E, Straube E, Schoerner C, et al. Evaluating frequency, diagnostic quality, and cost of Lyme borreliosis testing in Germany: a retrospective model analysis. Clin Dev Immunol. 2012;2012:595427.CrossRefPubMed
72.
Lohr B, Muller I, Mai M, Norris DE, Schoffski O, Hunfeld KP. Epidemiology and cost of hospital care for Lyme borreliosis in Germany: lessons from a health care utilization database analysis. Ticks Tick Borne Dis. 2015;6:56–62.CrossRefPubMed
73.
Joss AW, Davidson MM, Ho-Yen DO, Ludbrook A. Lyme disease--what is the cost for Scotland? Public Health. 2003;117:264–73.CrossRefPubMed
74.
Metadata
Title
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
Authors
Laurence Geebelen
Tinne Lernout
Benoît Kabamba-Mukadi
Veroniek Saegeman
Hein Sprong
Steven Van Gucht
Philippe Beutels
Niko Speybroeck
Katrien Tersago
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2017
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-017-0202-z

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