Scientific rationale for medical and preventive measures improvement in lyme disease endemic areas (based on the data of Udmurt Republic)

Abstract

Aim. To provide the scientific rationale for medical and preventive measures improvement in Lyme disease endemic areas. Methods. Epidemiologic and biostatistical analysis of preventive measures holding in Lyme disease endemic areas was performed. Results. A decrease in mean longstanding prevalence of Lyme borreliosis by 31.5% was observed in the Udmurt Republic since 1999 to 2010. The tick-invaded area has increased by 25%, there was an increase in a borrelia-harboring ticks rate by 34.6%. The number of patients seeking medical aid because of the tick bites has increased by 25.4%, which can be attributed to increased social awareness. 62.5% of patients diagnosed with Lyme borreliosis were over 41 years old, the rate of unemployed patients was 61.1%. High prevalence of Lyme borreliosis in peasants living in highly endemic areas (southern part of the Udmurt Republic) related to low medical aid appealability due to tick bites and therefore untimely medical preventive measures, was registered. The prevalence of erythema migrans-free disease has increased 4.3 times. Among the Lyme borreliosis forms associated with erythema migrans, the 1.6 times increase in multiple erythema prevalence was observed, with increase by 24 times in the areas of high disease prevalence. The most severe disease course was observed in patients over 61 years old with erythema migrans-free disease. A single oral dose of doxycycline should be used for disease prevention in all patients seeking medical aid because of the tick bite. Conclusion. The offered preventive algorithm for Lyme disease allowed to prevent the disease development in 99.7% of all cases, the economical efficacy of doxycycline prophylaxis counted on 1 borrelia-harboring tick bite was estimated as 20 400 rubles.