Sensitivity of a point of care tick-test for the development of Lyme borreliosis

Abstract

BackgroundA commercially available self-test for the detection of Borrelia burgdorferi sensu lato in ticks was evaluated for its ability to predict erythema migrans formation.FindingsThe self-test was performed on 127 Ixodes ricinus from 122 humans that reported tick bites at enrolment and occurrence of symptoms during follow-up. The self-test gave negative results on all the 122 individuals, 14 of whom reported erythema migrans (EM) at follow-up of which 10 were confirmed by their GP. The estimated sensitivity of the self-test for prediction of EM formation is 0% (95% CI: 0%-28%).ConclusionsThis self-test is not suitable for reducing the number needed to treat in a post-exposure prophylaxis setting as it already missed all the obvious early Lyme borreliosis cases.

Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model

“…Currently, we are analyzing the data from a randomized controlled intervention study through our tick bite notification website www.tekenradar.nl[18, 19], investigating the efficacy of prophylactic antibiotic treatment after a tick bite within the European setting. With our model, we aimed to identify patients with high risk of developing Lyme borreliosis.…”

“…As an alternative to the recommended standard practice of watchful waiting after tick removal, prophylactic antibiotic treatment of tick bites can potentially play an important role in the prevention of Lyme borreliosis[ 17 ]. Currently, we are analyzing the data from a randomized controlled intervention study through our tick bite notification website www.tekenradar.nl [ 18 , 19 ], investigating the efficacy of prophylactic antibiotic treatment after a tick bite within the European setting. With our model, we aimed to identify patients with high risk of developing Lyme borreliosis.…”

“…To our knowledge, commercially available easy to use and affordable assays for testing of ticks for DNA of Borrelia at point of care currently do not provide suitable sensitivity or specificity for early detection of individuals with a higher risk of Lyme borreliosis. [ 19 ] To assess the duration of the tick’s blood meal, specific knowledge and skills of the physicians in general practice would be required. To differentiate between low engorgement (1.4% risk) and substantial engorgement (5.5% risk), physicians training and education would be instrumental.…”

“…Study TR1213 was a web-based national survey on www.tekenradar.nl , through which civilians reported 3,191 tick bites between March 2012 and March 2013, with 42 reports of Lyme borreliosis within three months follow-up. [ 18 , 19 ] Study GP0708 was a nationwide prospective study among 260 patients with tick bites who consulted one of 307 enrolling general practitioners in 2007 and 2008, with 3 reports of Lyme borreliosis within three months follow-up[ 12 ]. Study EP0911 was a prospective study performed among 244 patients with tick bites who visited one of fourteen medical emergency posts for consultation of a general practitioner outside office hours from 2009 to 2011, with 5 reports of Lyme borreliosis within two months follow-up.…”

Das Angebot von medizinisch-diagnostischen Selbsttests auf deutschsprachigen Internetseiten: Ergebnisse einer systematischen Recherche

“…So wurde in einigen Studien eine geringe Sensitivität der Selbsttests zur Diagnostik von z. B. HIV [18], Darmkrebs [7], Humane Papillomviren [19] oder Lyme-Borreliose [6] festgestellt. Weiterhin warnte 2011 die World Health Organization vor der Anwendung von kommerziellen Tuberkulose-Tests, da diese inkonsistente und unpräzise Schätzungen lieferten [20].…”