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Traynor O, Martin A, Johnstone A, Chng NR, Kenny J, McCrorie P. A Low-Cost Method for Understanding How Nature-Based Early Learning and Childcare Impacts Children's Health and Wellbeing. Front Psychol 2022; 13:889828. [PMID: 35814071 PMCID: PMC9260060 DOI: 10.3389/fpsyg.2022.889828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Nature-based play and learning provision is becoming increasingly popular across the early learning and childcare (ELC) sector in Scotland. However, there remains a lack of understanding of how the program is expected to function. This has implications for program learning and may affect wider rollout of the program. Secondary data analysis of parent interviews (n = 22) and observations (n = 7) in Scottish ELC settings, and review of internationally published studies (n = 33) were triangulated to develop a program theory using the Theory of Change approach. This approach makes a program's underlying assumptions explicit by systematically demonstrating the relationship between each component: inputs, activities, outcomes, impact, and the contexts of the program. Findings suggested that location of outdoor nature space, affordances, availability of trained practitioners, and transport to location lead to activities such as free play, educator-led activities, and interactions with nature, resulting in longer durations of physical activity, interactions with peers and educators, and increased engagement with the natural environment. These activities are vital for supporting children's physical, cognitive, social, and emotional development. Our results demonstrate the value of using secondary data analysis to improve our understanding of the underlying theory of nature-based ELC which can support future evaluation designs. These findings will be of interest to program evaluators, researchers, practitioners, and funders, who find themselves with limited resources and want to better understand their program before investing in an evaluation. We encourage researchers and evaluators in the field of early years and outdoor play in other countries to refine this logic model in their own context-specific setting.
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Affiliation(s)
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Avril Johnstone
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Nai Rui Chng
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Jessica Kenny
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Paul McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
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Johnstone A, McCrorie P, Cordovil R, Fjørtoft I, Iivonen S, Jidovtseff B, Lopes F, Reilly JJ, Thomson H, Wells V, Martin A. Nature-Based Early Childhood Education and Children's Physical Activity, Sedentary Behavior, Motor Competence, and Other Physical Health Outcomes: A Mixed-Methods Systematic Review. J Phys Act Health 2022; 19:456-472. [PMID: 35537707 PMCID: PMC7613039 DOI: 10.1123/jpah.2021-0760] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/04/2022] [Accepted: 04/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose was to synthesize evidence on the association between nature-based Early Childhood Education (ECE) and children's physical activity (PA) and motor competence (MC). METHODS A literature search of 9 databases was concluded in August 2020. Studies were eligible if (1) children were aged 2-7 years old and attending ECE, (2) ECE settings integrated nature, and (3) assessed physical outcomes. Two reviewers independently screened full-text articles and assessed study quality. Synthesis was conducted using effect direction (quantitative), thematic analysis (qualitative), and combined using a results-based convergent synthesis. RESULTS 1370 full-text articles were screened and 39 (31 quantitative and 8 qualitative) studies were eligible; 20 quantitative studies assessed PA and 6 assessed MC. Findings indicated inconsistent associations between nature-based ECE and increased moderate to vigorous PA, and improved speed/agility and object control skills. There were positive associations between nature-based ECE and reduced sedentary time and improved balance. From the qualitative analysis, nature-based ECE affords higher intensity PA and risky play, which could improve some MC domains. The quality of 28/31 studies was weak. CONCLUSIONS More controlled experimental designs that describe the dose and quality of nature are needed to better inform the effectiveness of nature-based ECE on PA and MC.
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Affiliation(s)
- A Johnstone
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - P McCrorie
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - R Cordovil
- CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499-002 Cruz Quebrada, Lisboa, Portugal
| | - I Fjørtoft
- Faculty of Humanities, Sports and Education Sciences, University of South-Eastern Norway, Lærerskoleveien 40, 3679 Notodden, Norway
| | - S Iivonen
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Yliopistokatu 2, FI-80100 Joensuu, Finland
| | - B Jidovtseff
- Research Unit on Childhood, Department of Sport and Rehabilitation Sciences, University of Liege, 2 Allee des sports, 4000 Liege, Belgium
| | - F Lopes
- Laboratory of Motor Behavior, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz-Quebrada, 1499-002 Portugal
| | - JJ Reilly
- School of Psychological Sciences and Health, University of Strathclyde, 50 George Street, Glasgow G1 1QE, UK
| | - H Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - V Wells
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
| | - A Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow G3 7HR, UK
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Vieira Lista MC, Belhassen-García M, Vicente Santiago MB, Sánchez-Montejo J, Pedroza Pérez C, Monsalve Arteaga LC, Herrador Z, del Álamo-Sanz R, Benito A, Soto López JD, Muro A. Identification and Distribution of Human-Biting Ticks in Northwestern Spain. INSECTS 2022; 13:insects13050469. [PMID: 35621803 PMCID: PMC9144542 DOI: 10.3390/insects13050469] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary We conducted a tick surveillance study in northwestern Spain. Nymphs of Ixodes ricinus were the most frequently collected. Rhipicephalus bursa, Rhipicephalus sanguineus sensu lato (s.l.), Hyalomma marginatum, Hy. lusitanicum, Dermacentor marginatus, D. reticulatus and Haemaphysalis punctata were also found, with adults as the main stage. The number of collected Hyalomma spp. and R. bursa has been progressively increasing over time. Although bites occurred throughout the year, the highest number of incidents was reported from April to July. The distribution patterns of the tick species were different between the north and the south of the region, which was related to cases detected in humans of the pathogens they carried. Adult men were more likely to be bitten by ticks than women. Ticks were most frequently removed from adults from the lower limbs, while for children, they were mainly attached to the head. Epidemiological surveillance is essential given the increase in tick populations in recent years. Abstract Ticks transmit a wide diversity of pathogens to a great variety of hosts, including humans. We conducted a tick surveillance study in northwestern Spain between 2014 and 2019. Ticks were removed from people and identified. Tick numbers, species, development stages, the timeline, seasonal and geographical distribution and epidemiological characteristics of people bitten by ticks were studied. We collected ticks from 8143 people. Nymphs of I. ricinus were the most frequently collected. Rhipicephalus bursa, R. sanguineus s.l., Hy. marginatum, Hy. lusitanicum, D. marginatus, D. reticulatus and H. punctata were also found, with adults as the main stage. The number of collected Hyalomma spp. and R. bursa has been progressively increasing over time. Although bites occurred throughout the year, the highest number of incidents was reported from April to July. The distribution patterns of the tick species were different between the north and the south of the region, which was related to cases detected in humans of the pathogens they carried. Adult men were more likely to be bitten by ticks than women. Ticks were most frequently removed from adults from the lower limbs, while for children, they were mainly attached to the head. Epidemiological surveillance is essential given the increase in tick populations in recent years, mainly of species potentially carrying pathogens causing emerging diseases in Spain, such as Crimean–Congo hemorrhagic fever (CCFH).
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Affiliation(s)
- María Carmen Vieira Lista
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
| | - Moncef Belhassen-García
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital of Salamanca, 37008 Salamanca, Spain
- Correspondence: (M.B.-G.); (A.M.)
| | - María Belén Vicente Santiago
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
| | - Javier Sánchez-Montejo
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
| | - Carlos Pedroza Pérez
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
| | | | - Zaida Herrador
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII), 28029 Madrid, Spain; (Z.H.); (A.B.)
| | | | - Agustin Benito
- National Centre for Tropical Medicine, Health Institute Carlos III (ISCIII), 28029 Madrid, Spain; (Z.H.); (A.B.)
| | - Julio David Soto López
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, 37008 Salamanca, Spain; (M.C.V.L.); (M.B.V.S.); (J.S.-M.); (C.P.P.); (J.D.S.L.)
- Correspondence: (M.B.-G.); (A.M.)
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Torkar G, Kos M. Do tick-borne diseases affect outdoor teaching in Slovenian preschools? Ticks Tick Borne Dis 2021; 12:101728. [PMID: 33848797 DOI: 10.1016/j.ttbdis.2021.101728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
Childhood experiences with nature are decisive for children's wellbeing. The need for outdoor activities has been duly recognized in the preschool curriculum in Slovenia. However, there are some obstacles to this approach-specifically, tick-borne diseases. This study examines the views and experiences of Slovenian preschool teachers (n = 158) with ticks and tick-borne diseases in order to create a safer environment for the further development of outdoor education. The majority of the respondents engage in outdoor teaching once or several times a week. They have very frequent contact with ticks and tick-borne diseases in their professional lives. More than four-fifths of the respondents carry out some tick-prevention measures in preschools, but room for improvement remains. The respondents report rare cases in which parents or guardians have tried to prohibit them from visiting outdoor areas because of tick-borne diseases, and they explain how they dealt with the situation. The attitude of preschool teachers toward ticks and tick-borne diseases did not correlate significantly with the frequency with which they went outdoors in preschools. This study therefore concludes that, despite the objective risks associated with tick-borne diseases, there is still broad consensus among educators and parents on the importance of outdoor education in the early years.
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Affiliation(s)
- Gregor Torkar
- Faculty of Education, University of Ljubljana, Slovenia.
| | - Marjanca Kos
- Faculty of Education, University of Ljubljana, Slovenia
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Omodior O, Anderson KR, Clark W, Eze P, Donohoe H. Preventing tick-bites among children in Indiana, USA: An analysis of factors associated with parental protective behaviors. Ticks Tick Borne Dis 2021; 12:101647. [PMID: 33445070 DOI: 10.1016/j.ttbdis.2020.101647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/27/2022]
Abstract
Despite evidence to the effect that there is low parental adoption of tick-bite personal protective behavior (PPB) for their children - a population at high risk for tick exposure, very limited information is available on factors associated with parental adoption of PPB. The objective of this study was to identify the most significant factors associated with parental adoption of tick-bite PPB on behalf of a child or children at risk of tick encounters. A cross-section of parents in Indiana, USA whose child had spent time outdoors in tick habitat during the summer were recruited from representative online panels maintained by Qualtrics. Binary logistic regression was used to model determinants of five tick-bite PPBs. Our results revealed that the application of tick repellent (89 %, n = 718) followed by conducting a tick check of the child's body soon after returning from the outdoors (84 %, n = 676) were the PPBs most frequently adopted by parents. Conversely, tucking one's shirt into pants and pants into socks was the least frequently adopted PPB (48 %, n = 386). Compared to other factors evaluated in logistic regression models, parents who reported implementing one or more residential tick control practices were significantly more likely to adopt nearly all five tick-bite PPBs for their children. Additionally, parents who were more worried about their health due to ticks and reported being more likely to avoid the outdoors because of ticks were more likely to adopt at least three PPBs on behalf of their children. To ensure children can most safely engage in outdoor activity, identifying the factors associated with parental adoption of tick-bite preventive behaviors represents an important mechanism in the prevention of tick-borne diseases.
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Affiliation(s)
- Oghenekaro Omodior
- Department of Health & Wellness Design, School of Public Health, Indiana University Bloomington, United States.
| | - Kristina R Anderson
- Department of Health & Wellness Design, School of Public Health, Indiana University Bloomington, United States
| | - William Clark
- Department of Epidemiology & Biostatistics, Indiana University School of Public Health-Bloomington, United States
| | - Paul Eze
- Department of Health Policy & Administration, Pennsylvania State University, University Park, United States
| | - Holly Donohoe
- Department of Economics and Geography, University of North Florida, United States
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Cull B, Pietzsch ME, Gillingham EL, McGinley L, Medlock JM, Hansford KM. Seasonality and anatomical location of human tick bites in the United Kingdom. Zoonoses Public Health 2019; 67:112-121. [PMID: 31705595 DOI: 10.1111/zph.12659] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/17/2019] [Accepted: 10/11/2019] [Indexed: 12/15/2022]
Abstract
Tick bites on humans can occur in a variety of habitats and may result in the transmission of tick-borne pathogens, such as the causative agent of Lyme borreliosis (LB), Borrelia burgdorferi sensu lato. As the risk of transmission of this pathogen to the host increases with the duration of tick feeding, the recognition and removal of ticks as soon as possible following attachment is important for reducing the risk of infection. Performing a thorough body examination for ticks following potential exposure is recommended by tick awareness campaigns. Knowledge of where on the body feeding ticks are frequently found, and at which times of year peak tick exposure occurs, provides important information for public health messaging and may aid those bitten by ticks to engage more effectively with tick-checking behaviour. This paper summarizes human tick bites in the United Kingdom (UK) during 2013-2018 reported to Public Health England's passive Tick Surveillance Scheme and further examines the anatomical location and seasonality of bites from the most commonly encountered tick and LB vector Ixodes ricinus. A total of 1,328 tick records from humans were received of which 93% were I. ricinus. Humans were most commonly bitten by I. ricinus nymphs (70% bites). Tick bites were recorded on all parts of the body, but there were significant differences in their anatomical location on adults and children. Most tick bites on adults occurred on the legs (50%), whereas on children tick bites were mostly on the head and neck (43%). Bites from I. ricinus were recorded throughout the year but were most numerous during May to August. This study adds to the body of research on the seasonality and anatomical location of human tick bites in temperate Europe and highlights the importance of data collected through passive surveillance in addition to research and epidemiological studies.
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Affiliation(s)
- Benjamin Cull
- Medical Entomology and Zoonoses Ecology Group, Emergency Response Department, Public Health England, Salisbury, UK
| | - Maaike E Pietzsch
- Medical Entomology and Zoonoses Ecology Group, Emergency Response Department, Public Health England, Salisbury, UK
| | - Emma L Gillingham
- Medical Entomology and Zoonoses Ecology Group, Emergency Response Department, Public Health England, Salisbury, UK.,NIHR Health Protection Research Unit in Environmental Change and Health, London, UK
| | - Liz McGinley
- Medical Entomology and Zoonoses Ecology Group, Emergency Response Department, Public Health England, Salisbury, UK
| | - Jolyon M Medlock
- Medical Entomology and Zoonoses Ecology Group, Emergency Response Department, Public Health England, Salisbury, UK.,NIHR Health Protection Research Unit in Environmental Change and Health, London, UK.,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - Kayleigh M Hansford
- Medical Entomology and Zoonoses Ecology Group, Emergency Response Department, Public Health England, Salisbury, UK.,NIHR Health Protection Research Unit in Environmental Change and Health, London, UK
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Pun SB, Agrawal S, Jha S, Bhandari LN, Chalise BS, Mishra A, Shah R. First report of Lyme disease in Nepal. JMM Case Rep 2018; 5:e005128. [PMID: 29623212 PMCID: PMC5884958 DOI: 10.1099/jmmcr.0.005128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/27/2017] [Indexed: 11/27/2022] Open
Abstract
Introduction Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi and is widely reported in the USA, Central Europe, South East Asia and Latin America. Until recently, no scientific report regarding Lyme disease in Nepal had been published. Case presentation A 32-year-old, previously healthy female visited the hospital with a history of joint pains, fatigue, neck stiffness, tingling sensation and headache. She was initially treated for typhoid fever, brucellosis and malaria, but did not show significant improvement. Doxycycline was prescribed empirically for 3 weeks for the treatment of suspected tick-borne illness. A two-tiered immunoglobulin laboratory testing confirmed Borrelia burgdorferi. She developed post-treatment Lyme disease syndrome after completion of antibiotic therapy. Conclusion To the best of our knowledge, this is the first report of Lyme disease in Nepal and probably the first documented case of post-treatment Lyme disease syndrome in Asia. Lyme disease might have been overlooked in Nepal and, therefore, patients having clinical signs and symptoms similar to Lyme disease should not be disregarded in differential diagnosis.
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Affiliation(s)
- Sher Bahadur Pun
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
- *Correspondence: Sher Bahadur Pun,
| | - Sumit Agrawal
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Santoshananda Jha
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Lila Nath Bhandari
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | | | - Abadhesh Mishra
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Rajesh Shah
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
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Dessau RB, van Dam AP, Fingerle V, Gray J, Hovius JW, Hunfeld KP, Jaulhac B, Kahl O, Kristoferitsch W, Lindgren PE, Markowicz M, Mavin S, Ornstein K, Rupprecht T, Stanek G, Strle F. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis. Clin Microbiol Infect 2017; 24:118-124. [PMID: 28887186 DOI: 10.1016/j.cmi.2017.08.025] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/26/2017] [Accepted: 08/29/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lyme borreliosis (LB) is a tick-borne infection caused by Borrelia burgdorferi sensu lato. The most frequent clinical manifestations are erythema migrans and Lyme neuroborreliosis. Currently, a large volume of diagnostic testing for LB is reported, whereas the incidence of clinically relevant disease manifestations is low. This indicates overuse of diagnostic testing for LB with implications for patient care and cost-effective health management. AIM The recommendations provided in this review are intended to support both the clinical diagnosis and initiatives for a more rational use of laboratory testing in patients with clinically suspected LB. SOURCES This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national and international guidelines and supplemented with specific citations. IMPLICATIONS The main recommendations according to current European case definitions for LB are as follows. Typical erythema migrans should be diagnosed clinically and does not require laboratory testing. The diagnosis of Lyme neuroborreliosis requires laboratory investigation of the spinal fluid including intrathecal antibody production, and the remaining disease manifestations require testing for serum antibodies to B. burgdorferi. Testing individuals with non-specific subjective symptoms is not recommended, because of a low positive predictive value.
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Affiliation(s)
- R B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Region Sjælland, Denmark.
| | - A P van Dam
- OLVG General Hospital and Public Health Laboratory, Amsterdam, The Netherlands
| | - V Fingerle
- National Reference Centre for Borrelia, Munich, Oberschleissheim, Germany
| | - J Gray
- UCD School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - J W Hovius
- Centre for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K-P Hunfeld
- Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe-University, Frankfurt/Main and INSTAND e.V., Düsseldorf, Germany
| | - B Jaulhac
- National Reference Centre for Borrelia, Hôpitaux Universitaires de Strasbourg, France
| | - O Kahl
- Tick-radar GmbH, Berlin, Germany
| | - W Kristoferitsch
- Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria
| | | | - M Markowicz
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - S Mavin
- National Lyme Borreliosis Testing Laboratory, Raigmore Hospital, Inverness, UK
| | - K Ornstein
- Division of Medicine, Skånevård Kryh, Region Skåne, Sweden
| | - T Rupprecht
- Department of Neurology, HELIOS Klinikum München West, Munich, Germany
| | - G Stanek
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - F Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Sonnleitner A, Trobisch A, Klobassa D, Zenz W. Borreliose im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2015. [DOI: 10.1007/s00112-014-3251-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Seropositivity of Lyme borreliosis and associated risk factors: a population-based study in Children and Adolescents in Germany (KiGGS). PLoS One 2012; 7:e41321. [PMID: 22905101 PMCID: PMC3419690 DOI: 10.1371/journal.pone.0041321] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 06/20/2012] [Indexed: 11/19/2022] Open
Abstract
Background Lyme borreliosis (LB) caused by spirochetes of the Borrelia burgdorferi sensu lato complex is the most common tick-borne disease in the northern hemisphere. Data on the distribution and on risk factors in Germany are sketchy. Methodology/Principal Findings Blood samples of a nationwide population-based cross-sectional study from 2003–2006 in children and adolescents aged 1 to 17 years in Germany (KiGGS) were analysed (n = 12,614) to assess the seroprevalence of anti-Borrelia antibodies. Data from standardized interviews were used to assess potential risk factors. First, sera were screened for anti-Borrelia antibodies by ELISA. The overall prevalence was 4.8% (95% confidence interval (CI) 4.3–5.4%). Positive and borderline ELISA test results were confirmed by a line blot revealing a combined prevalence of 4.0% (95% CI 3.6–4.5%). Seroprevalence of ELISA was significantly higher in males (odds ratio (OR) = 1.37; CI 1.15–1.63) and in the southern part of Germany (OR = 1.41; CI 1.09–1.83), but significantly lower in children and adolescents with migration background (OR = 0.33; CI 0.24–0.44). Study participants from households with cats had a higher chance of seropositivity (OR = 6.7; CI 5.6–8.0). In a multivariable model the odds of seropositivity increases by 11% for every year of age for boys and 6% for girls. Conclusions/Significance This survey is the first nationwide, representative seroprevalence survey of LB in children and young adolescents. The study shows that infections with Borrelia burgdorferi are endemic in all parts of Germany despite regional differences. Even at a young age children are exposed to tick bites including seropositivity. Encouraging a thorough check for ticks and promptly removal of ticks are the key public health strategies to reduce the risk of LB and other tick-borne diseases in children and adolescents. Further epidemiological studies are warranted to better understand the burden of disease related to LB.
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[Dermato-epidemiology]. Hautarzt 2011; 62:859-68; quiz 869-70. [PMID: 22069002 DOI: 10.1007/s00105-011-2175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Dermato-epidemiology is an important scientific discipline which investigates skin diseases using epidemiological methods. Epidemiology is the science of the distribution and determinants of disease in specified populations. We describe fundamental terms of dermato-epidemiology (measures of disease occurrence, measures of risk), different study types (observational studies, interventional studies), the selection of statistical tests, bias and confounding as well as the principles of evidence-based dermatology, and give illustrative examples.
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Weisshaar E, Kallen U, Klintworth N, Zenk J. Pruritus, Erytheme & Co. HNO 2011; 59:301-9; quiz 310. [DOI: 10.1007/s00106-011-2260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Lyme-Borreliose: Forschungsbedarf und Forschungsansätze. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008; 51:1329-39. [DOI: 10.1007/s00103-008-0703-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Fülöp B, Poggensee G. Epidemiological situation of Lyme borreliosis in Germany: Surveillance data from six Eastern German States, 2002 to 2006. Parasitol Res 2008; 103 Suppl 1:S117-20. [DOI: 10.1007/s00436-008-1060-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 05/26/2008] [Indexed: 11/29/2022]
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Pourel J. Le diagnostic clinique des manifestations articulaires et musculaires de la borréliose de Lyme. Med Mal Infect 2007; 37:523-31. [PMID: 17368783 DOI: 10.1016/j.medmal.2006.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2006] [Accepted: 01/15/2006] [Indexed: 11/22/2022]
Abstract
The diagnosis of Lyme borreliosis in case of joint and muscular presentations is generally suggested by epidemiological factors. However, as a rule, laboratory testing is required to confirm the diagnosis. When considering the epidemiology of Lyme borreliosis in France, the only areas free of ticks infected by Borrelia burgdorgeri sl, are those close to the Mediterranean sea or at high altitude. The risk is greatest in the Alsace region. Exposure is particularly high among forest workers and people who use the countryside for their leisure activities. The likelihood of infection following a tick bite is difficult to assess; indeed, the bite site may remain unnoticed. A medical history of erythema migrans, if untreated, is a major diagnostic clue, although the association appears to be less consistent in France than in the US. Lyme arthritis generally arises apparently spontaneously. It is characteristically mono- or oligo-articular, asymmetrical, predominantly affects the knee, and has an intermittent course. Synovial cysts and enthesitis are common. Myositis is rare, polymorphic, and has been linked to other symptoms in the same localizations. Minor arthralgia and myalgia frequently occur, principally early in the course of the infection. It was suggested that sequels of the disease include so-called fibromyalgic syndromes. The principal differential diagnosis as far as arthritis is concerned, is made on spondylarthropathy and chronic juvenile arthritis. Rheumatoid arthritis is another pathology, although Lyme arthritis does sometimes evolve to chronicity.
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Affiliation(s)
- J Pourel
- Service de rhumatologie et UMR CNRS 7561, CHU de Nancy, rue du Morvan, 54511 Vandoeuvre-lès-Nancy cedex, France.
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Guy N. [Lyme disease: basis for treatment strategy, primary preventive care and secondary preventive care]. Med Mal Infect 2007; 37:381-93. [PMID: 17408897 DOI: 10.1016/j.medmal.2006.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2006] [Accepted: 01/15/2006] [Indexed: 10/23/2022]
Abstract
Lyme disease is the most common tick borne disease and is caused by Borrelia burgdorferi sensu lato. Ticks of the genus Ixodes are the vectors that transmit the infection to host mammals in endemic foci. Ixodes is infected by Borrelia at larval stage when it feeds on infected mammals. Man is an occasional host. The infection risk is linked to interaction between human and the natural environment. Strategies for prevention are closely related to the enzootic cycle of the Ixodes tick. Environmental measures to reduced tick density or host mammals are expensive, need to be repeated annually and cannot be applied to large areas. The primary prevention could be reduced to personal preventive measures such as reducing the amount of exposed skin and frequent checking for ticks. The risk of Lyme disease transmission after a tick bite is relatively low, and remains under 4%. The transmission rate depends on the duration of feeding. A rapide tick removal with fine tweezers or preferably special forceps and disinfection of the bite site appear to be the best technique. The absence of scientific evidence, and the risk of adverse events does not lead to recommending antimicrobial prophylaxis. Follow-up and educating the patients on the disease, clinical manifestation, and later primary prevention should be undertaken.
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Affiliation(s)
- N Guy
- Service de neurologie, CHU de Clermont-Ferrand, BP 69, 63003 Clermont-Ferrand cedex 01, France.
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