A scoping review of Lyme disease research relevant to public health.

J D Greig, I Young, S Harding, M Mascarenhas, L A Waddell
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引用次数: 7

Abstract

Lyme disease (LD) is an emerging infectious disease in Canada associated with expansion of the geographic range of the tick vector Ixodes scapularis in eastern and central Canada. A scoping review of published research was prioritized to identify and characterize the scientific evidence concerning key aspects of LD to support public health efforts. Prior to initiation of this review, an expert advisory group was surveyed to solicit insight on priority topics and scope. A pre-tested search strategy implemented in eight databases (updated September 2016) captured relevant research. Pre-tested screening and data characterization forms were completed by two independent reviewers and descriptive analysis was conducted to identify topic areas with solid evidence and knowledge gaps. Of 19,353 records screened, 2,258 relevant articles were included in the review under the following six public health focus areas: a) surveillance/monitoring in North America (n=809); b) evaluation of diagnostic tests (n=736); c) risk factors (n=545); d) public health interventions (n=205); e) public knowledge, attitudes and/or perceptions in North America (n=202); and f) the economic burden of LD or cost-benefit of interventions (n=32). The majority of research investigated Borrelia burgdorferi (n=1,664), humans (n=1,154) and Ixodes scapularis (n=459). Sufficient research was identified for potential systematic reviews in four topic areas: a) accuracy of diagnostic tests; b) risk factors for human illness; c) efficacy of LD intervention strategies; and d) prevalence and/or incidence of LD in humans or B. burgdorferi sensu stricto in vertebrate reservoirs or ticks in North America. Future primary research could focus on closing knowledge gaps, such as the role of less studied vertebrate reservoirs in the transmission cycle. Results of this scoping review can be used to quickly identify and summarize relevant research pertaining to specific questions about LD or B. burgdorferi sensu lato in humans, vertebrate hosts or vectors, providing evidence-informed information within timelines that are conducive for public health decision-making.

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与公共卫生相关的莱姆病研究范围综述。
莱姆病(LD)是加拿大一种新出现的传染病,与蜱媒肩胛硬蜱在加拿大东部和中部的地理范围扩大有关。优先对已发表的研究进行范围审查,以确定和表征与LD关键方面有关的科学证据,从而支持公共卫生工作。在开始审查之前,对一个专家咨询小组进行了调查,以征求对优先主题和范围的意见。在八个数据库中实施的预先测试的搜索策略(2016年9月更新)捕获了相关研究。两名独立评审员完成了预先测试的筛选和数据表征表格,并进行了描述性分析,以确定有确凿证据和知识差距的主题领域。在筛选的19353份记录中,2258篇相关文章被纳入以下六个公共卫生重点领域的审查:a)北美的监测/监测(n=809);b) 诊断测试评估(n=736);c) 危险因素(n=545);d) 公共卫生干预措施(n=205);e) 北美的公共知识、态度和/或看法(n=202);以及f)LD的经济负担或干预措施的成本效益(n=32)。大多数研究调查了伯氏疏螺旋体(n=1664)、人类(n=1154)和肩胛硬蜱(n=459)。在四个主题领域,为潜在的系统审查确定了充分的研究:a)诊断测试的准确性;b) 人类疾病的危险因素;c) LD干预策略的有效性;和d)LD在人类中的患病率和/或发病率,或在北美洲脊椎动物宿主或蜱虫中的狭义伯氏杆菌。未来的初步研究可能侧重于填补知识空白,例如研究较少的脊椎动物宿主在传播周期中的作用。该范围界定审查的结果可用于快速确定和总结与人类、脊椎动物宿主或媒介中LD或B.burgdorferi sensu lato相关的特定问题的相关研究,在有利于公共卫生决策的时间内提供证据信息。
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