Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015
Abstract Background Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among...
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| Format: | Article |
| Language: | English |
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BMC
2017-05-01
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| Series: | BMC Family Practice |
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| Online Access: | http://link.springer.com/article/10.1186/s12875-017-0636-y |
| _version_ | 1818233568530268160 |
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| author | Salima Gasmi Nicholas H. Ogden Patrick A. Leighton Ariane Adam-Poupart François Milord L. Robbin Lindsay Sapha Barkati Karine Thivierge |
| author_facet | Salima Gasmi Nicholas H. Ogden Patrick A. Leighton Ariane Adam-Poupart François Milord L. Robbin Lindsay Sapha Barkati Karine Thivierge |
| author_sort | Salima Gasmi |
| collection | DOAJ |
| description | Abstract Background Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described. Methods Eight years (2008 to 2015) of retrospective demographic and clinical data on patients bitten by infected Ixodes scapularis (I. scapularis) ticks and on the management of suspected and confirmed LD cases by Quebec GPs were analysed. Results Among 50 patients, all the antimicrobial treatments of LD clinical cases were appropriate according to current guidelines. However, more than half (62.8%) of erythema migrans (EM) were possibly misdiagnosed, 55.6%, (n = 27) of requested serologic tests were possibly unnecessary and the majority (96.5%, n = 57) of prophylactic antimicrobial treatments were not justified according to current guidelines. Conclusions These observations underline the importance for public health to enhance the knowledge of GPs where LD is emerging, to minimise the impact of the disease on patients and the financial burden on the health system. |
| first_indexed | 2024-12-12T11:24:15Z |
| format | Article |
| id | doaj.art-7769ffaa628144289bb829ab8efd58b6 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-12-12T11:24:15Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-7769ffaa628144289bb829ab8efd58b62022-12-22T00:25:57ZengBMCBMC Family Practice1471-22962017-05-011811810.1186/s12875-017-0636-yPractices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015Salima Gasmi0Nicholas H. Ogden1Patrick A. Leighton2Ariane Adam-Poupart3François Milord4L. Robbin Lindsay5Sapha Barkati6Karine Thivierge7Laboratoire de santé publique du Québec, Institut national de santé publique du QuébecPublic Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of CanadaFaculty of Veterinary Medicine, University of MontrealDirection des risques biologiques et de la santé au travail, Institut national de santé publique du QuébecDirection des risques biologiques et de la santé au travail, Institut national de santé publique du QuébecZoonotic Diseases & Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of CanadaDepartment of Microbiology and Immunology, Faculty of Medicine, University of MontrealLaboratoire de santé publique du Québec, Institut national de santé publique du QuébecAbstract Background Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described. Methods Eight years (2008 to 2015) of retrospective demographic and clinical data on patients bitten by infected Ixodes scapularis (I. scapularis) ticks and on the management of suspected and confirmed LD cases by Quebec GPs were analysed. Results Among 50 patients, all the antimicrobial treatments of LD clinical cases were appropriate according to current guidelines. However, more than half (62.8%) of erythema migrans (EM) were possibly misdiagnosed, 55.6%, (n = 27) of requested serologic tests were possibly unnecessary and the majority (96.5%, n = 57) of prophylactic antimicrobial treatments were not justified according to current guidelines. Conclusions These observations underline the importance for public health to enhance the knowledge of GPs where LD is emerging, to minimise the impact of the disease on patients and the financial burden on the health system.http://link.springer.com/article/10.1186/s12875-017-0636-yIxodes scapularisLyme diseaseTreatmentDiagnosisProphylaxisCanada |
| spellingShingle | Salima Gasmi Nicholas H. Ogden Patrick A. Leighton Ariane Adam-Poupart François Milord L. Robbin Lindsay Sapha Barkati Karine Thivierge Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 BMC Family Practice Ixodes scapularis Lyme disease Treatment Diagnosis Prophylaxis Canada |
| title | Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 |
| title_full | Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 |
| title_fullStr | Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 |
| title_full_unstemmed | Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 |
| title_short | Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008–2015 |
| title_sort | practices of lyme disease diagnosis and treatment by general practitioners in quebec 2008 2015 |
| topic | Ixodes scapularis Lyme disease Treatment Diagnosis Prophylaxis Canada |
| url | http://link.springer.com/article/10.1186/s12875-017-0636-y |
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