The burden of Lyme borreliosis expressed in disability-adjusted life years

Cees C van den Wijngaard, Agnetha Hofhuis, Margriet G Harms, Juanita A Haagsma, Albert Wong, G A de Wit, Arie H Havelaar, Anna K Lugnér, Anita W M Suijkerbuijk, Wilfrid van Pelt

    Research output: Contribution to journalArticleAcademicpeer-review


    BACKGROUND: Lyme borreliosis (LB) is the most commonly reported tick-borne infection in Europe and North America. In the last 15 years a 3-fold increase was observed in general practitioner consultations for LB in the Netherlands. To support prioritization of prevention and control efforts for LB, we estimated its burden expressed in Disability-Adjusted Life Years (DALYs).

    METHODS: We used available incidence estimates for three LB outcomes: (i) erythema migrans (EM), (ii) disseminated LB and (iii) Lyme-related persisting symptoms. To generate DALYs, disability weights and duration per outcome were derived using a patient questionnaire including health-related quality of life as measured by the EQ-5D.

    RESULTS: We estimated the total LB burden for the Netherlands in 2010 at 10.55 DALYs per 100 000 population (95% CI: 8.80-12.43); i.e. 0.60 DALYs for EM, 0.86 DALYs for disseminated LB and 9.09 DALYs for Lyme-related persisting symptoms. Per patient this was 0.005 DALYs for EM, 0.113 for disseminated LB and 1.661 DALYs for a patient with Lyme-related persisting symptoms. In a sensitivity analysis the total LB burden ranged from 7.58 to 16.93 DALYs per 100 000 population.

    CONCLUSIONS: LB causes a substantial disease burden in the Netherlands. The vast majority of this burden is caused by patients with Lyme-related persisting symptoms. EM and disseminated Lyme have a more modest impact. Further research should focus on the mechanisms that trigger development of these persisting symptoms that patients and their physicians attribute to LB.

    Original languageEnglish
    Pages (from-to)1071-1078
    Number of pages8
    JournalEuropean Journal of Public Health
    Issue number6
    Publication statusPublished - Dec 2015


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