Lyme borreliosis in Finland: a register-based linkage study
Abstract Background In Finland, the routine surveillance of Lyme borreliosis (LB) is laboratory-based. In addition, we have well established national health care registers where countrywide data from patient visits in public health care units are collected. In our previous study based on these regis...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-11-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05555-w |
| _version_ | 1818269124624646144 |
|---|---|
| author | Eeva Feuth Mikko Virtanen Otto Helve Jukka Hytönen Jussi Sane |
| author_facet | Eeva Feuth Mikko Virtanen Otto Helve Jukka Hytönen Jussi Sane |
| author_sort | Eeva Feuth |
| collection | DOAJ |
| description | Abstract Background In Finland, the routine surveillance of Lyme borreliosis (LB) is laboratory-based. In addition, we have well established national health care registers where countrywide data from patient visits in public health care units are collected. In our previous study based on these registers, we reported an increasing incidence of both microbiologically confirmed and clinically diagnosed LB cases in Finland during the past years. Here, we evaluated our register data, refined LB incidence estimates provided in our previous study, and evaluated treatment practices considering LB in the primary health care. Methods Three national health care registers were used. The Register for Primary Health Care Visits (Avohilmo) and the National Hospital Discharge Register (Hilmo) collect physician-recorded data from the outpatient and inpatient health care visits, respectively, whereas the National Infectious Diseases Register (NIDR) represents positive findings in LB diagnostics notified electronically by microbiological laboratories. We used a personal identification number in register-linkage to identify LB cases on an individual level in the study year 2014. In addition, antibiotic purchase data was retrieved from the Finnish Social Insurance Institution in order to evaluate the LB treatment practices in the primary health care in Finland. Results Avohilmo was found to be useful in monitoring clinically diagnosed LB (i.e. erythema migrans (EM) infections), whereas Hilmo did not add much value next to existing laboratory-based surveillance of disseminated LB. However, Hilmo gave valuable information about uncertainties related to physician-based surveillance of disseminated LB and the total annual number of EM infections in our country. Antibiotic purchases associated with the LB-related outpatient visits in the primary health care indicated a good compliance with the recommended treatment guidelines. Conclusions Avohilmo and laboratory-based NIDR together are useful in monitoring LB incidence in Finland. A good compliance was observed with the recommended treatment guidelines of clinically diagnosed LB in the primary health care. In 2018, Avohilmo was introduced in the routine surveillance of LB in Finland next to laboratory-based surveillance of disseminated LB. |
| first_indexed | 2024-12-12T20:49:24Z |
| format | Article |
| id | doaj.art-e425e76ccd83441b9967253cbafa7d3e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T20:49:24Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e425e76ccd83441b9967253cbafa7d3e2022-12-22T00:12:29ZengBMCBMC Infectious Diseases1471-23342020-11-012011810.1186/s12879-020-05555-wLyme borreliosis in Finland: a register-based linkage studyEeva Feuth0Mikko Virtanen1Otto Helve2Jukka Hytönen3Jussi Sane4Institute of Biomedicine, University of TurkuDepartment of Health Security, Finnish Institute for Health and WelfareDepartment of Health Security, Finnish Institute for Health and WelfareInstitute of Biomedicine, University of TurkuDepartment of Health Security, Finnish Institute for Health and WelfareAbstract Background In Finland, the routine surveillance of Lyme borreliosis (LB) is laboratory-based. In addition, we have well established national health care registers where countrywide data from patient visits in public health care units are collected. In our previous study based on these registers, we reported an increasing incidence of both microbiologically confirmed and clinically diagnosed LB cases in Finland during the past years. Here, we evaluated our register data, refined LB incidence estimates provided in our previous study, and evaluated treatment practices considering LB in the primary health care. Methods Three national health care registers were used. The Register for Primary Health Care Visits (Avohilmo) and the National Hospital Discharge Register (Hilmo) collect physician-recorded data from the outpatient and inpatient health care visits, respectively, whereas the National Infectious Diseases Register (NIDR) represents positive findings in LB diagnostics notified electronically by microbiological laboratories. We used a personal identification number in register-linkage to identify LB cases on an individual level in the study year 2014. In addition, antibiotic purchase data was retrieved from the Finnish Social Insurance Institution in order to evaluate the LB treatment practices in the primary health care in Finland. Results Avohilmo was found to be useful in monitoring clinically diagnosed LB (i.e. erythema migrans (EM) infections), whereas Hilmo did not add much value next to existing laboratory-based surveillance of disseminated LB. However, Hilmo gave valuable information about uncertainties related to physician-based surveillance of disseminated LB and the total annual number of EM infections in our country. Antibiotic purchases associated with the LB-related outpatient visits in the primary health care indicated a good compliance with the recommended treatment guidelines. Conclusions Avohilmo and laboratory-based NIDR together are useful in monitoring LB incidence in Finland. A good compliance was observed with the recommended treatment guidelines of clinically diagnosed LB in the primary health care. In 2018, Avohilmo was introduced in the routine surveillance of LB in Finland next to laboratory-based surveillance of disseminated LB.http://link.springer.com/article/10.1186/s12879-020-05555-wLyme borreliosisEpidemiologySurveillanceFinlandRegister-based study |
| spellingShingle | Eeva Feuth Mikko Virtanen Otto Helve Jukka Hytönen Jussi Sane Lyme borreliosis in Finland: a register-based linkage study BMC Infectious Diseases Lyme borreliosis Epidemiology Surveillance Finland Register-based study |
| title | Lyme borreliosis in Finland: a register-based linkage study |
| title_full | Lyme borreliosis in Finland: a register-based linkage study |
| title_fullStr | Lyme borreliosis in Finland: a register-based linkage study |
| title_full_unstemmed | Lyme borreliosis in Finland: a register-based linkage study |
| title_short | Lyme borreliosis in Finland: a register-based linkage study |
| title_sort | lyme borreliosis in finland a register based linkage study |
| topic | Lyme borreliosis Epidemiology Surveillance Finland Register-based study |
| url | http://link.springer.com/article/10.1186/s12879-020-05555-w |
| work_keys_str_mv | AT eevafeuth lymeborreliosisinfinlandaregisterbasedlinkagestudy AT mikkovirtanen lymeborreliosisinfinlandaregisterbasedlinkagestudy AT ottohelve lymeborreliosisinfinlandaregisterbasedlinkagestudy AT jukkahytonen lymeborreliosisinfinlandaregisterbasedlinkagestudy AT jussisane lymeborreliosisinfinlandaregisterbasedlinkagestudy |