PDF(Pubmed)
Abstract：
Background: Lyme borreliosis (LB), a tick bite-transmitted infection caused by Borrelia burgdorferi sensu lato (Bbsl) complex spirochetes, is the most common tickborne disease in Europe. Studies in European countries have reported LB seroprevalence (prevalence of antibodies to Bbsl infection) and diagnostic strategies used for testing. We conducted a systematic literature review to summarize contemporary LB seroprevalence in Europe. Methods: PubMed, Embase, and CABI Direct (Global Health) databases were searched from 2005 to 2020 to identify studies reporting LB seroprevalence in European countries. Reported single-tier and two-tier test results were summarized; algorithms (standard or modified) were used to interpret final test results from studies that used two-tier testing. Results: The search yielded 61 articles from 22 European countries. Studies used a range of diagnostic testing methods and strategies (48% single-tier, 46% standard two-tier, and 6% modified two-tier). In 39 population-based studies, of which 14 were nationally representative, seroprevalence estimates ranged from 2.7% (Norway) to 20% (Finland). There was substantial heterogeneity among studies in terms of design, cohort types, periods sampled, sample sizes, and diagnostics, which limited cross-study comparisons. Nevertheless, among studies that reported seroprevalence in persons with greater exposure to ticks, LB seroprevalence was higher among these groups than in the general population (40.6% vs. 3.9%). Furthermore, among studies that used two-tier testing, general population LB seroprevalence was higher in Western Europe (13.6%) and Eastern Europe (11.1%) than in Northern Europe (4.2%) and Southern Europe (3.9%). Conclusion: Despite variations in LB seroprevalence between and within European subregions and countries, high seroprevalence was observed in certain geographic regions and particular risk groups, suggesting significant disease burden and supporting the need for improved, targeted public health interventions such as vaccination. Harmonized approaches to serologic testing and more nationally representative seroprevalence studies are needed to better understand the prevalence of Bbsl infection in Europe.
摘要：
背景：莱姆病（LB），由伯氏疏螺旋体（Bbsl）复杂螺旋体引起的蜱叮咬传播感染，是欧洲最常见的蜱传疾病。欧洲国家的研究已经报道了LB血清阳性率(针对Bbsl感染的抗体的患病率)和用于测试的诊断策略。我们进行了系统的文献综述，以总结欧洲当代LB血清阳性率。方法:PubMed,Embase,从2005年到2020年,我们搜索了CABIDirect(全球卫生)数据库,以确定欧洲国家报告LB血清阳性率的研究.总结了报告的单层和两层测试结果；使用算法（标准或修改的）来解释使用两层测试的研究的最终测试结果。结果：检索了来自22个欧洲国家的61篇文章。研究使用了一系列诊断测试方法和策略(48%是单层的，46%标准两层，和6%修改的两层)。在39项基于人群的研究中，其中14人具有全国代表性，血清阳性率估计范围为2.7％（挪威）至20％（芬兰）。在设计方面，研究之间存在很大的异质性，队列类型,采样周期，样本大小，和诊断，这限制了交叉研究的比较。然而，在报告暴露于蜱的人血清阳性率的研究中，这些人群的LB血清阳性率高于普通人群（40.6％vs.3.9%）。此外，在使用两层测试的研究中，一般人群LB血清阳性率在西欧(13.6%)和东欧(11.1%)高于北欧(4.2%)和南欧(3.9%).结论：尽管欧洲次区域和国家之间和内部的LB血清阳性率存在差异，在某些地理区域和特定风险人群中观察到高血清阳性率，提示重大的疾病负担和支持改善的需要，有针对性的公共卫生干预措施，如疫苗接种。需要统一的血清学检测方法和更具全国代表性的血清阳性率研究，以更好地了解欧洲Bbsl感染的患病率。
