Mapping the distribution of Lyme disease at a mid-Atlantic site in the United States using electronic health data.

dc.contributor.author

Lantos, Paul M

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Janko, Mark

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Nigrovic, Lise E

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Ruffin, Felicia

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Kobayashi, Takaaki

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Higgins, Yvonne

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Auwaerter, Paul G

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Jacobs, Jon M

dc.date.accessioned

2024-06-29T14:47:27Z

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2024-06-29T14:47:27Z

dc.date.issued

2024-01

dc.description.abstract

Lyme disease is a spatially heterogeneous tick-borne infection, with approximately 85% of US cases concentrated in the mid-Atlantic and northeastern states. Surveillance for Lyme disease and its causative agent, including public health case reporting and entomologic surveillance, is necessary to understand its endemic range, but currently used case detection methods have limitations. To evaluate an alternative approach to Lyme disease surveillance, we have performed a geospatial analysis of Lyme disease cases from the Johns Hopkins Health System in Maryland. We used two sources of cases: a) individuals with both a positive test for Lyme disease and a contemporaneous diagnostic code consistent with a Lyme disease-related syndrome; and b) individuals referred for a Lyme disease evaluation who were adjudicated to have Lyme disease. Controls were individuals from the referral cohort judged not to have Lyme disease. Residential address data were available for all cases and controls. We used a hierarchical Bayesian model with a smoothing function for a coordinate location to evaluate the probability of Lyme disease within 100 km of Johns Hopkins Hospital. We found that the probability of Lyme disease was greatest in the north and west of Baltimore, and the local probability that a subject would have Lyme disease varied by as much as 30-fold. Adjustment for demographic and ecological variables partially attenuated the spatial gradient. Our study supports the suitability of electronic medical record data for the retrospective surveillance of Lyme disease.

dc.identifier

PONE-D-23-21983

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1932-6203

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1932-6203

dc.identifier.uri

https://hdl.handle.net/10161/31223

dc.language

eng

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Public Library of Science (PLoS)

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PloS one

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10.1371/journal.pone.0301530

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https://creativecommons.org/licenses/by-nc/4.0

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Humans

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Lyme Disease

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Bayes Theorem

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Adolescent

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Adult

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Aged

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Middle Aged

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Child

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United States

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Maryland

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Mid-Atlantic Region

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Female

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Male

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Young Adult

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Electronic Health Records

dc.title

Mapping the distribution of Lyme disease at a mid-Atlantic site in the United States using electronic health data.

dc.type

Journal article

duke.contributor.orcid

Janko, Mark|0000-0002-4099-3081

duke.contributor.orcid

Ruffin, Felicia|0000-0003-2176-6462

pubs.begin-page

e0301530

pubs.issue

5

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Duke

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School of Medicine

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Duke University

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Staff

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Clinical Science Departments

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Family Medicine and Community Health

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Medicine

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Pediatrics

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Medicine, General Internal Medicine

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Medicine, Infectious Diseases

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Pediatrics, Infectious Diseases

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University Institutes and Centers

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Duke Global Health Institute

pubs.publication-status

Published

pubs.volume

19

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