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Omar A, Grenier LN, Marquez O, Faber S, Darling EK. Perinatal transmission of Lyme disease: A qualitative study investigating the research priorities of patients with Lyme disease in pregnancy. PLoS One 2024; 19:e0294265. [PMID: 38319904 PMCID: PMC10846734 DOI: 10.1371/journal.pone.0294265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/27/2023] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Lyme disease is one of the most prevalent vector-borne disease in North America, yet its implications during pregnancy are poorly understood. Our knowledge of perinatal transmission of Lyme disease is limited due to the lack of robust epidemiological studies and longitudinal follow-up. OBJECTIVES This study aimed to understand the research priorities of people who have experienced Lyme disease in pregnancy and the feasibility of recruiting this population for future studies on perinatal transmission of Lyme disease. We also sought to understand the barriers and enablers to participating in research on perinatal transmission of Lyme disease. METHODS We conducted a qualitative study using focus groups and interviews with people who had experienced Lyme disease during pregnancy. English speaking participants were recruited through an online survey. There was no geographic restriction on participation. The focus groups and the interview were recorded and transcribed. Data were analyzed using interpretive content analysis. RESULTS Twenty people participated in four semi-structured focus groups and one semi-structured individual interview. The majority of participants were from North America. Participants' research priorities fell into five categories: transmission, testing, treatment, disease presentation, and education. All study participants expressed interest in future participation in research on Lyme disease in pregnancy and highlighted barriers and enablers to participation that could be addressed to facilitate future study recruitment. CONCLUSION The research priorities identified in this research would be well addressed through prospective research. People who experience Lyme disease in pregnancy are invested in continued research into perinatal transmission of Lyme disease.
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Affiliation(s)
- Abeer Omar
- Trent/Fleming School of Nursing, Trent University, Peterborough, ON, Canada
| | - Lindsay N. Grenier
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada
| | - Olivia Marquez
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada
| | | | - Elizabeth K. Darling
- McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
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Nesgos AT, Harrington LC, Mader EM. Experience and knowledge of Lyme disease: A scoping review of patient-provider communication. Ticks Tick Borne Dis 2021; 12:101714. [PMID: 33780825 PMCID: PMC10044390 DOI: 10.1016/j.ttbdis.2021.101714] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 12/25/2022]
Abstract
There has been limited research on patient-provider communication dynamics regarding Lyme disease (LD) diagnosis and treatment. Evidence suggests communication in the clinical encounter improves when both patient and healthcare provider (HCP) have concordant orientations (or beliefs) on discussed topics, resulting in higher patient satisfaction and care outcomes. The purpose of this scoping review was to characterize and summarize current research findings on patient and provider knowledge and experiences regarding LD - two factors that may influence the orientation of both patients and providers toward LD in the clinical setting. None of the articles included in the review specifically addressed patient-provider interaction and relationships as the main objective. However, the existing literature indicates notable HCP uncertainty regarding LD diagnosis, treatment, and applied practice patterns. Current research also describes limited knowledge of LD among patient populations and a high prevalence of negative perceptions of care received in mainstream healthcare settings among individuals with persistent symptoms. We identified a critical gap in research that seeks to understand the dynamic of patients and HCPs communicating on the topic of LD in the clinical setting. Future research may identify opportunities where the patient-provider communication dynamic can be improved.
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Affiliation(s)
- Anna T Nesgos
- Department of Biological Sciences, Cornell University, Ithaca, NY 14853, USA.
| | - Laura C Harrington
- Northeast Regional Center for Excellence in Vector-Borne Diseases, 3138 Comstock Hall, Department of Entomology, Cornell University, Ithaca, NY 14853, USA.
| | - Emily M Mader
- Northeast Regional Center for Excellence in Vector-Borne Diseases, 3138 Comstock Hall, Department of Entomology, Cornell University, Ithaca, NY 14853, USA.
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Journault AA, Richard L, Aenishaenslin C. Lyme disease prevention: A content analysis of Canadian patient group and government websites. Zoonoses Public Health 2019; 67:177-185. [PMID: 31808311 DOI: 10.1111/zph.12669] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 11/15/2019] [Accepted: 11/17/2019] [Indexed: 11/29/2022]
Abstract
The quality of information presented on health-related websites-in terms of comprehensiveness, accuracy and consistency-is a public health concern. To date, the consistency of information across Canadian websites devoted to Lyme disease (LD) prevention has not been evaluated. The first aim of this study was to describe the contents and recommendations of LD prevention websites provided by two types of Canadian organizations: government (n = 3) and patient groups (n = 3). A second objective was to analyse the level of convergence among these websites in terms of their prevention-related content. Initial coding of the content resulted in information segments grouped into 114 subthemes related to nine overarching themes: tick habitat suitability, risk period, transmission, personal protection, peridomestic environmental management, tick identification and removal, early symptoms, testing and diagnosis and preventive treatment. Comparative content analyses were performed both within and between the content of websites of the two organization types. The themes most frequently addressed by both organization types were personal protection (20% of the prevention-related content in patient group websites and 22% of the prevention-related content in government websites), transmission (12% and 16%, respectively) and tick identification and removal (19% and 15%, respectively). Government websites' information was generally convergent with that of patient group websites (four highly convergent themes, three moderately convergent and two divergent). Nevertheless, of particular concern were divergent messages and inaccurate information found on 11 subthemes out of 103. Examples included other possible modes of transmission and the ineffectiveness of DEET insect repellent. These results suggest the need for public health and health communications research on the issue of the quality of LD prevention information found on the Internet.
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Affiliation(s)
- Audrey-Ann Journault
- Department of Psychology, University of Montreal, Montreal, QC, Canada.,IRSPUM, Montreal, QC, Canada
| | - Lucie Richard
- IRSPUM, Montreal, QC, Canada.,Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Cécile Aenishaenslin
- IRSPUM, Montreal, QC, Canada.,Faculty of Veterinary Medicine, University of Montreal, Montreal, QC, Canada
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Peri F, Nisticò D, Morabito G, Occhipinti A, Ventura A, Barbi E, Cozzi G. Somatic symptom disorder should be suspected in children with alleged chronic Lyme disease. Eur J Pediatr 2019; 178:1297-1300. [PMID: 31254072 DOI: 10.1007/s00431-019-03416-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/08/2019] [Accepted: 06/16/2019] [Indexed: 11/30/2022]
Abstract
We report a case series of seven children admitted to a tertiary level pediatric ward for long-lasting physical symptoms with a previous diagnosis of chronic Lyme disease. In these children, medical history and clinical features were strongly suggestive of a psychopathological disorder, mainly a somatic symptom disorder. What is Known: • There is an increasing number of diagnoses of chronic Lyme disease both in North America and in Europe. Adults receive this diagnosis to explain chronic physical complaints often with negative history and serology. What is New: • Somatic symptom disorder should be suspected in children and adolescents with non-specific symptoms diagnosed with chronic Lyme disease.
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Affiliation(s)
- Francesca Peri
- University of Trieste, Piazzale Europa, 1, Via dell'Istria, 34127, Trieste, TS, Italy.
| | - Daniela Nisticò
- University of Trieste, Piazzale Europa, 1, Via dell'Istria, 34127, Trieste, TS, Italy
| | - Giuliana Morabito
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria, 65, 34137, Trieste, TS, Italy
| | - Alessandro Occhipinti
- University of Trieste, Piazzale Europa, 1, Via dell'Istria, 34127, Trieste, TS, Italy
| | - Alessandro Ventura
- University of Trieste, Piazzale Europa, 1, Via dell'Istria, 34127, Trieste, TS, Italy
| | - Egidio Barbi
- University of Trieste, Piazzale Europa, 1, Via dell'Istria, 34127, Trieste, TS, Italy
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria, 65, 34137, Trieste, TS, Italy
| | - Giorgio Cozzi
- University of Trieste, Piazzale Europa, 1, Via dell'Istria, 34127, Trieste, TS, Italy
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria, 65, 34137, Trieste, TS, Italy
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Cheema J, Huynh AC, Prat SS. Multiple Sclerosis and psychosis: A case report. Mult Scler Relat Disord 2019; 34:158-161. [PMID: 31302591 DOI: 10.1016/j.msard.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/28/2019] [Accepted: 06/02/2019] [Indexed: 11/25/2022]
Abstract
Psychiatric symptoms resulting from Multiple Sclerosis (MS) itself or its treatment are well known. However, the relationship between psychotic episodes and Multiple Sclerosis remains debated. In this paper, we present the case of a woman who developed a chronic psychotic disorder a few months after the onset of MS. We describe the process which led us to make the diagnosis of Psychotic Disorder due to Medical Condition (Multiple Sclerosis). Because her criminal charges brought significant attention to her case, we also address the difficulty in treating a neurological condition with psychiatric features within the forensic context. Moreover, one of the main concerns of the patient was that Lyme Disease was the correct diagnosis as opposed to MS. We also report the difficulty of treating and initiating successful follow-up for a patient whose paranoia is enabled by the opinions of certain health advocacy groups.
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Affiliation(s)
- Jasreen Cheema
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
| | | | - Sébastien S Prat
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
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Wormser GP. Should Patients Infected with Borrelia burgdorferi No Longer Be Referred to as Having Lyme Disease? Am J Med 2019; 132:11-12. [PMID: 30012359 DOI: 10.1016/j.amjmed.2018.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Gary P Wormser
- Division of Infectious Diseases, New York Medical College, Valhalla.
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Djokic V, Primus S, Akoolo L, Chakraborti M, Parveen N. Age-Related Differential Stimulation of Immune Response by Babesia microti and Borrelia burgdorferi During Acute Phase of Infection Affects Disease Severity. Front Immunol 2018; 9:2891. [PMID: 30619263 PMCID: PMC6300717 DOI: 10.3389/fimmu.2018.02891] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/26/2018] [Indexed: 12/17/2022] Open
Abstract
Lyme disease is the most prominent tick-borne disease with 300,000 cases estimated by CDC every year while ~2,000 cases of babesiosis occur per year in the United States. Simultaneous infection with Babesia microti and Borrelia burgdorferi are now the most common tick-transmitted coinfections in the U.S.A., and they are a serious health problem because coinfected patients show more intense and persisting disease symptoms. B. burgdorferi is an extracellular spirochete responsible for systemic Lyme disease while B. microti is a protozoan that infects erythrocytes and causes babesiosis. Immune status and spleen health are important for resolution of babesiosis, which is more severe and even fatal in the elderly and splenectomized patients. Therefore, we investigated the effect of each pathogen on host immune response and consequently on severity of disease manifestations in both young, and 30 weeks old C3H mice. At the acute stage of infection, Th1 polarization in young mice spleen was associated with increased IFN-γ and TNF-α producing T cells and a high Tregs/Th17 ratio. Together, these changes could help in the resolution of both infections in young mice and also prevent fatality by B. microti infection as observed with WA-1 strain of Babesia. In older mature mice, Th2 polarization at acute phase of B. burgdorferi infection could play a more effective role in preventing Lyme disease symptoms. As a result, enhanced B. burgdorferi survival and increased tissue colonization results in severe Lyme arthritis only in young coinfected mice. At 3 weeks post-infection, diminished pathogen-specific antibody production in coinfected young, but not older mice, as compared to mice infected with each pathogen individually may also contribute to increased inflammation observed due to B. burgdorferi infection, thus causing persistent Lyme disease observed in coinfected mice and reported in patients. Thus, higher combined proinflammatory response to B. burgdorferi due to Th1 and Th17 cells likely reduced B. microti parasitemia significantly only in young mice later in infection, while the presence of B. microti reduced humoral immunity later in infection and enhanced tissue colonization by Lyme spirochetes in these mice even at the acute stage, thereby increasing inflammatory arthritis.
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Affiliation(s)
- Vitomir Djokic
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Shekerah Primus
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Lavoisier Akoolo
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Monideep Chakraborti
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Nikhat Parveen
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers New Jersey Medical School, Newark, NJ, United States
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Straight Talk About Chronic Lyme Disease. Am J Med 2018; 131:592-594. [PMID: 29284115 DOI: 10.1016/j.amjmed.2017.11.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 11/22/2022]
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Petit A. [What's new in clinical dermatology?]. Ann Dermatol Venereol 2017; 144 Suppl 4:IVS1-IVS9. [PMID: 29249246 DOI: 10.1016/s0151-9638(17)31059-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In addition to continuous medical education, medical journals offer to dermatologists a huge variety of news that differ by their content, validity, originality and clinical relevance. I collected here various articles relative to clinical dermatology that have been published between September, 2016 and September, 2017. These papers have been chosen in the aim of reflecting such diversity. I just excluded, as far as possible, articles dealing with other issues that the reader will find further in this booklet (such as research, pediatric, instrumental, oncologic or therapeutic dermatology, or dermatology and internal medicine). Space restriction required to skip some commentaries while keeping the references to the selected papers, which the reader will be able to read carefully in its original form.
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Affiliation(s)
- A Petit
- Service de dermatologie, AP-HP hôpital Saint-Louis, Paris, France.
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Affiliation(s)
- Eugene D Shapiro
- Departments of Pediatrics, Epidemiology, and Investigative Medicine, Yale University, New Haven, Conn
| | | | - Gary P Wormser
- Division of Infectious Diseases, New York Medical College, Valhalla
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Chronic Lyme Disease: An Unresolved Controversy. Am J Med 2017; 130:e423. [PMID: 28838739 DOI: 10.1016/j.amjmed.2017.03.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 03/22/2017] [Accepted: 03/24/2017] [Indexed: 11/21/2022]
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