Limits...
Lyme disease: Knowledge and practices of family practitioners in southern Quebec.

Ferrouillet C, Milord F, Lambert L, Vibien A, Ravel A - Can J Infect Dis Med Microbiol (2015 May-Jun)

Bottom Line: Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices.The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, St Hyacinthe; ; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal;

ABSTRACT

Background: Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD) with surveillance activities and education for family physicians (FPs) who are key actors in both vigilance and case management.

Objectives: To describe FPs' clinical experience with LD, their degree of knowledge, and their practices in two areas, one with known infected tick populations (Montérégie) and one without (regions nearby Montérégie).

Methods: In the present descriptive cross-sectional study, FPs were recruited during educational sessions. They were asked to complete a questionnaire assessing their clinical experience with Lyme disease, their knowledge of signs and symptoms of LD, and their familiarity with accepted guidelines for diagnosing and treating LD in two clinical scenarios (tick bite and erythema migrans).

Results: A total of 201 FPs participated, mostly from Montérégie (n=151). Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices. A majority of participants agreed to more education on LD. As expected, FPs from Montérégie had a higher clinical experience with tick bites (57% versus 25%), better knowledge of LD endemic areas in Canada and erythema migrans characteristics, and better management of erythema migrans (72% versus 50%).

Conclusion: The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes. Such practices should be discouraged because they are unnecessary and overuse collective laboratory and medical resources. In addition, public health authorities must pursue their education efforts regarding FPs to optimize case management.

No MeSH data available.


Related in: MedlinePlus

Regions of Quebec included in the present study
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4507841&req=5

f1-idmm-26-151: Regions of Quebec included in the present study

Mentions: Lyme disease is a vector-borne zoonotic disease caused by the bacterium Borrelia burgdorferi and is transmitted by the tick Ixodes scapularis in the northeastern region of the United States bordering Canada (1), where this illness is endemic. It is the first tick-borne disease that has emerged in southwestern Quebec, more specifically in the region of Montérégie (2–4) (Figure 1). In 2008, a predictive model mapped high-risk regions for I scapularis establishment in the southern area of Quebec (5). Five areas were further confirmed by active surveillance in south-central Montérégie and along the Saint Lawrence River in Montérégie (3). None have been confirmed in the region of Estrie. The Lanaudière region was not sampled at that time because it was further away from the high-risk areas for tick establishment identified by the model. From 2010 to 2012, southern Quebec regional public health authorities conducted an awareness campaign of Lyme disease for family physicians and informed them about the areas with established tick populations in Montérégie. Since then, surveillance activities support that ticks have become established in high-risk areas further north and east of Montérégie (6). Lyme disease has been a reportable disease in Quebec since November 2003. Between 2004 and 2012 inclusively, 138 cases have been reported, with 101 of the cases contracted outside the province, 31 contracted indigenously and six unknown. Most of the indigenous cases occurred after exposure to the Montérégie region (27 of 31) (7). Despite the low number of reported cases, the average number of serologies for Lyme disease processed by the public health laboratory increased from 1380 in 2004 to 2600 in 2012 (B Serhir, Laboratoire national de santé publique du Quebec, personal communication, 2012). The annual number of positive serologies for new patients corresponds grossly to the number of declared cases of Lyme disease. Twenty-five patients with a positive serology were identified in 2011 and 43 were identified in 2012.


Lyme disease: Knowledge and practices of family practitioners in southern Quebec.

Ferrouillet C, Milord F, Lambert L, Vibien A, Ravel A - Can J Infect Dis Med Microbiol (2015 May-Jun)

Regions of Quebec included in the present study
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507841&req=5

f1-idmm-26-151: Regions of Quebec included in the present study
Mentions: Lyme disease is a vector-borne zoonotic disease caused by the bacterium Borrelia burgdorferi and is transmitted by the tick Ixodes scapularis in the northeastern region of the United States bordering Canada (1), where this illness is endemic. It is the first tick-borne disease that has emerged in southwestern Quebec, more specifically in the region of Montérégie (2–4) (Figure 1). In 2008, a predictive model mapped high-risk regions for I scapularis establishment in the southern area of Quebec (5). Five areas were further confirmed by active surveillance in south-central Montérégie and along the Saint Lawrence River in Montérégie (3). None have been confirmed in the region of Estrie. The Lanaudière region was not sampled at that time because it was further away from the high-risk areas for tick establishment identified by the model. From 2010 to 2012, southern Quebec regional public health authorities conducted an awareness campaign of Lyme disease for family physicians and informed them about the areas with established tick populations in Montérégie. Since then, surveillance activities support that ticks have become established in high-risk areas further north and east of Montérégie (6). Lyme disease has been a reportable disease in Quebec since November 2003. Between 2004 and 2012 inclusively, 138 cases have been reported, with 101 of the cases contracted outside the province, 31 contracted indigenously and six unknown. Most of the indigenous cases occurred after exposure to the Montérégie region (27 of 31) (7). Despite the low number of reported cases, the average number of serologies for Lyme disease processed by the public health laboratory increased from 1380 in 2004 to 2600 in 2012 (B Serhir, Laboratoire national de santé publique du Quebec, personal communication, 2012). The annual number of positive serologies for new patients corresponds grossly to the number of declared cases of Lyme disease. Twenty-five patients with a positive serology were identified in 2011 and 43 were identified in 2012.

Bottom Line: Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices.The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Groupe de recherche en épidémiologie des zoonoses et santé publique, Faculté de médecine vétérinaire, Université de Montréal, St Hyacinthe; ; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Montréal;

ABSTRACT

Background: Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD) with surveillance activities and education for family physicians (FPs) who are key actors in both vigilance and case management.

Objectives: To describe FPs' clinical experience with LD, their degree of knowledge, and their practices in two areas, one with known infected tick populations (Montérégie) and one without (regions nearby Montérégie).

Methods: In the present descriptive cross-sectional study, FPs were recruited during educational sessions. They were asked to complete a questionnaire assessing their clinical experience with Lyme disease, their knowledge of signs and symptoms of LD, and their familiarity with accepted guidelines for diagnosing and treating LD in two clinical scenarios (tick bite and erythema migrans).

Results: A total of 201 FPs participated, mostly from Montérégie (n=151). Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices. A majority of participants agreed to more education on LD. As expected, FPs from Montérégie had a higher clinical experience with tick bites (57% versus 25%), better knowledge of LD endemic areas in Canada and erythema migrans characteristics, and better management of erythema migrans (72% versus 50%).

Conclusion: The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes. Such practices should be discouraged because they are unnecessary and overuse collective laboratory and medical resources. In addition, public health authorities must pursue their education efforts regarding FPs to optimize case management.

No MeSH data available.


Related in: MedlinePlus