reference : Effect of latitude on the rate of change in incidence of Lyme disease in the United States

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Bibliographic fields
reftype Journal Article
Abstract BACKGROUND: Tick-borne illnesses represent an important class of emerging zoonoses, with climate change projected to increase the geographic range within which tick-borne zoonoses might become endemic. We evaluated the impact of latitude on the rate of change in the incidence of Lyme disease in the United States, using publicly available data. METHODS: We estimated state-level year-on-year incidence rate ratios (IRRs) for Lyme disease for the period 1993 to 2007 using Poisson regression methods. We evaluated between-state heterogeneity in IRRs using a random-effects meta-analytic approach. We identified state-level characteristics associated with increasing incidence using random-effects meta-regression. RESULTS: The incidence of Lyme disease in the US increased by about 80% between 1993 and 2007 (IRR per year 1.049, 95% CI [confidence interval] 1.048 to 1.050). There was marked between-state heterogeneity in the average incidence of Lyme disease, ranging from 0.008 per 100 000 person-years in Colorado to 75 per 100 000 in Connecticut, and significant between-state heterogeneity in temporal trends (p < 0.001). In multivariable meta-regression models, increasing incidence showed a linear association with state latitude and population density. These 2 factors explained 27% of the between-state variation in IRRs. No independent association was identified for other state-level characteristics. INTERPRETATION: Lyme disease incidence increased in the US as a whole during the study period, but the changes were not uniform. Marked increases were identified in northern-most states, whereas southern states experienced stable or declining rates of Lyme disease.
Author Tuite, A. R.; Greer, A. L.; Fisman, D. N.
DOI 10.9778/cmajo.20120002
Date Jan
ISSN 2291-0026
Issue 1
Journal CMAJ Open
Notes Tuite, Ashleigh R Greer, Amy L Fisman, David N eng Canada 2013/01/01 00:00 CMAJ Open. 2013 Apr 16;1(1):E43-7. doi: 10.9778/cmajo.20120002. eCollection 2013 Jan.
Pages E43-E47
Title Effect of latitude on the rate of change in incidence of Lyme disease in the United States
Volume 1
Year 2013
Bibliographic identifiers
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_record_number 18040
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