Lyme’s disease. Clinical and social aspects

Abstract

Introduction: Lyme disease is an infectious disease with chronic relapsing evolution induced by microorganisms of the genus Borrelia, transmitted by tick bite. It affects the skin, joints, central nervous system (CNS) and internal organs. The affectation of the skin is manifested by the presence of erythematous-oedematous macules with round-oval shape, with well defined edges, with pale center and an erythematous shallow at the periphery. Purpose: To acquaint with epidemiology, etiopathogenesis, clinical examinations, paraclinical examinations and treatment of Lyme’s disease by studying a group of patients admitted to public medical institution DDVR in Republic of Moldova, in the period of 2004-2011. Aims: To study reference literature on the etiology, pathogenesis, clinical data, modern diagnostic and therapeutic approach of Lyme’s disease To study the aspects of clinical evolutionsof 57 patients diagnosed with Lyme’s disease Estimation of the efficacy of introduction of an antibiotic in the treatment of Lyme’s disease Establishing the correct diagnosis depending on clinical stage Assessment of epidemiological features of Lyme’s disease in Republic of Moldova Materials and methods: This study included 57 patients, aged between 5 and 70 years, all diagnosed with Lyme’s disease. All the patients were examined, diagnosed and treated in Dermatovenerology Clinic of Medical University ,,N. Testemitanu” located within DDVR public medical institution. Results: After complete researches of the 57 patients the following data were obtained: a big number of patients were treated from 2004 to 2011 in hospital. The number of positive results diagnosed and confirmed in laboratory conditions in Republic of Moldova was 254 patients. From the group of patients examined it was determined that 23 patients (40%) were from rural areas and the peak of 34 patients (60%) was from urban areas. The infection occured more frequently during warmer months of the year: April (17,5%), May (14%), June (23%), July (21%), August(14%), September (10,5%). The basic symptoms and frequently complaints of the patients were: headache, which was found in more than 50%, also low appetite, fatigue and general malaise. Primary manifestations occur more often on the legs-53%, and are followed by other body regions that are less affected. General laboratory tests allowed us to note the following changes in general blood analysis: lymphocytosis is above the normal range and is up to 60%, ESR is increased up to 12-50 mm/h. After examination of all the patients using ELISA serological test, the following results were obtained: primary stage - 33 patients, the secondary stage - 18 patients, the third stage - 6 patients. Conclusions: 1. The rate of addressing increases during the warm seasons, especially in June and July-34% 2. There is an increase of the number of patients diagnosed since 2008, with Lyme’s disease that were treated in DDVR hospital, with a predominance of females over males, at an ratio of 3:1 3. Efficiency of the treatment is 100% when the disease is diagnosed at primary stage, but it is less efficient when the disease is diagnosed in the secondary or tertiary stage 4. Most of the patients were admitted to the hospital in the primary stage of the disease, which denotes an increased change of the population on the pathology. 5. In Republic of Moldova the disease is recorded more frequently in patients with habitat in forests, alongside the rivers Nistru and Prut in rural population - 40%, in urban - 60%.