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. 2024 Oct 25;19(10):e0312703.
doi: 10.1371/journal.pone.0312703. eCollection 2024.

Incidence of hospitalizations related to Lyme disease and other tick-borne diseases using Discharge Abstract Database, Canada, 2009-2021

Salima Gasmi  1   2 , Nicholas H Ogden  2   3   4 , Annie-Claude Bourgeois  5 , Maria Elizabeth Mitri  5 , Peter Buck  5 , Jules K Koffi  1   2
Affiliations

Incidence of hospitalizations related to Lyme disease and other tick-borne diseases using Discharge Abstract Database, Canada, 2009-2021

Salima Gasmi et al. PLoS One. .

Abstract

To estimate rates of hospitalizations for tick-borne diseases (TBDs) in Canada, retrospective analysis was conducted to determine the incidence of patients diagnosed with TBDs during their hospital stay in Canada, and describe demographic characteristics, temporal trends and geographic distributions, from 2009 through 2021. Codes from the International Classification of Diseases, Tenth Revision (ICD-10-CA) were used to capture diagnoses of TBDs in the Discharge Abstract Database (DAD) in Canadian hospitals. From 2009 through 2021, 1,626 patients were diagnosed with TBDs during their hospital stay. Of these, 1,457 were diagnosed with Lyme disease (LD), 162 with other TBDs, and seven were diagnosed with more than one TBD. Annual hospitalization counts for LD showed a significant increase from 50 in 2009 to 259 in 2021 (incidence rate per 100,000 population of 0.1 and 0.7, respectively). Epidemiologic patterns for hospitalized LD cases, including increases and variation in annual incidences, seasonality, demographics and geographic distribution, are consistent with those elucidated in national LD surveillance data. Amongst 162 patients diagnosed with other tick-borne diseases, discharge diagnoses were: rickettsiosis (32.7%), spotted fever due to rickettsia rickettsii (23.5%), tularemia (21.0%), babesiosis (8.6%), other tick-borne viral encephalitis (6.2%), tick-borne relapsing fever (4.9%), and Colorado tick fever (0.6%). Annual incidence increased only for rickettsiosis from 3 to 12 patients over the study period. Monitoring the data of hospitalizations using the DAD provided insights into the burden of emerging TBDs, the severity of illnesses and the population most at risk.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Annual incidence per 100,000 population of Lyme disease diagnosed patients in Discharge Abstract Database (DAD) and Lyme disease cases in national surveillance data, Canada, 2009−2021.
The ratio of hospitalized patients with a diagnosis of Lyme disease to the number of cases reported in national surveillance data is shown as a percentage.
Fig 2
Fig 2. Annual tick-borne diseases hospitalizations, other than Lyme disease, from the Discharge Abstract Database using the International Classification of Diseases Codes, 10th Revision (ICD-10-CA), Canada, 2009−2021.
Fig 3
Fig 3. Seasonal distribution of Lyme disease cases reported in national surveillance data and other tick-borne disease hospitalizations (dates of onset or admission), from the Discharge Abstract Database (DAD) using the International Classification of Diseases Codes, 10th Revision (ICD-10-CA), Canada, 2009−2021.
The percentage of patients was calculated by dividing the monthly patient count by the total number of patients.
Fig 4
Fig 4. Regional distribution of incidence of hospitalizations (per 100,000 population) with diagnoses of tick-borne diseases, in data from the Discharge Abstract Database using the International Classification of Diseases Codes, 10th Revision (ICD-10-CA), Canada, 2009−2021.
Fig 5
Fig 5. Cumulative incidence rates of hospitalizations related to tick-borne diseases, by age group, Canada, 2009−2021.
Graph A shows cumulative incidence for Lyme disease hospitalizations with cumulative incidence of cases reported in national surveillance data. Graph B presents hospitalizations related to non-Lyme disease Ixodes scapularis/pacificus-borne diseases (babesiosis, tick-borne viral encephalitis and rickettsiosis). Graph C presents hospitalizations related to the other tick-borne diseases transmitted by other vectors (Colorado tick fever, tick-borne relapsing fever, RMSF, and tularemia). Hospitalization data from the Discharge Abstract Database (DAD) using the International Classification of Diseases Codes, 10th Revision (ICD-10-CA).
See this image and copyright information in PMC

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