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Soleng A.,Norwegian Institute of Public Health | Kjelland V.,University of Agder | Kjelland V.,Sorlandet Hospital Health Enterprise
Ticks and Tick-borne Diseases | Year: 2013

Ticks are important vectors of disease for both humans and animals. In Europe, Lyme borreliosis is the most abundant tick-borne human disease, whereas anaplasmosis, or tick-borne fever, is the most widespread tick-borne infection in domestic animals. However, knowledge about the prevalence of the causative disease agents in questing ticks in the northern range of their distribution in Norway is missing. Ixodes ricinus ticks were therefore collected by flagging vegetation in Brønnøysund, an area near the Arctic Circle in Norway where ticks have been abundant for decades. Ticks were analysed for infection with Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum by real-time PCR amplification of the 16S rRNA gene of B. burgdorferi and the msp2 gene of A. phagocytophilum. B. burgdorferi s.l. were subsequently genotyped by conducting a melt curve analysis of the PCR-amplified hbb gene or by directly sequencing the PCR-amplified rrs (16S)-rrl (23S) intergenetic spacer. A. phagocytophilum was genotyped by msp2 gene sequencing. B. burgdorferi s.l. isolates were detected in 11.3% (15/133) of the nymphal ticks and in 33.3% (29/87) of the adult ticks. Of the 44 Borrelia-infected ticks collected, B. afzelii was identified in 42 ticks (95.5%), whereas B. garinii was detected in only 2 ticks (4.5%). A. phagocytophilum was detected in 0.8% of nymphal ticks (1/133) and in 4.6% of adult ticks (4/87). Mixed infections of more than one B. burgdorferi genospecies were not observed. One adult tick was co-infected with B. afzelii and A. phagocytophilum. © 2013 Elsevier GmbH.


Haugen A.J.,Ostfold Hospital Trust | Grovle L.,Ostfold Hospital Trust | Brox J.I.,University of Oslo | Natvig B.,National Resource Center for Rehabilitation in Rheumatology | And 5 more authors.
European Spine Journal | Year: 2011

The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much better on a 7-point global change scale as external criterion for success. The cut-off values (references in brackets) at 12 months were leg pain VAS 17.5 (0-100), back pain VAS 22.5 (0-100), Sciatica Bothersomeness Index 6.5 (0-24), Maine-Seattle Back Questionnaire 4.5 (0-12), and the SF-36 subscales bodily pain 51.5, and physical functioning 81.7 (0-100, higher values indicate better health). In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies. © The Author(s) 2011.


Kjelland V.,University of Agder | Ytrehus B.,National Veterinary Institute | Skarpaas T.,Sorlandet Hospital Health Enterprise | Slettan A.,University of Agder
Ticks and Tick-borne Diseases | Year: 2011

As part of a larger survey, ears from 18 roe deer (Capreolus capreolus) and 52 moose (Alces alces) shot in the 2 southernmost counties in Norway were collected and examined for Ixodes ricinus ticks. Seventy-two adult ticks, 595 nymphs, and 267 larvae from the roe deer, and 182 adult ticks, 433 nymphs, and 70 larvae from the moose were investigated for infection with Borrelia burgdorferi sensu lato (s.l.). The results showed the presence of B. burgdorferi s.l. DNA in 2.9% of the nymphs collected from roe deer and in 4.4% of the nymphs and 6.0% of the adults collected from moose. The spirochetes were not detected in adult ticks from roe deer, or in larvae feeding on roe deer or moose. In comparison, the mean infection prevalences in questing I. ricinus collected from the same geographical area were 0.5% infection in larvae, 24.5% in nymphs, and 26.9% in adults. The most prevalent B. burgdorferi genospecies identified in ticks collected from roe deer was B. afzelii (76.5%), followed by B. garinii (17.6%), and B. burgdorferi sensu stricto (5.9%). Only B. afzelii (76.7%) and B. garinii (23.3%) were detected in ticks collected from moose. The present study indicates a lower prevalence of B. burgdorferi infection in I. ricinus ticks feeding on roe deer and moose compared to questing ticks. This is the first study to report B. burgdorferi s.l. prevalence in ticks removed from cervids in Norway. © 2011 Elsevier GmbH.


Kjelland V.,University of Agder | Kjelland V.,Sorlandet Hospital Health Enterprise | Rollum R.,University of Agder | Korslund L.,University of Agder | And 2 more authors.
Ticks and Tick-borne Diseases | Year: 2015

From April to October 2007, host-seeking Ixodes ricinus ticks were collected from four locations in southern Norway; Farsund, Mandal, Søgne and Tromøy, respectively. Larvae (n = 210), nymphs (n = 1130) and adults (n = 449) were investigated for infection with Borrelia miyamotoi by real-time polymerase chain reaction (PCR) amplification of part of the 16S rRNA gene. Results were verified by direct sequencing of the PCR amplicon generated from the rrs (16S)-rrl (23S) intergenetic spacer. B. miyamotoi was detected at all sites and throughout the period of questing activity, with infection prevalence (≤1.26%) similar to what has been seen in other European countries. Detection of the relapsing fever spirochete at all locations indicates a wide distribution in southern Norway. This is the first report of B. miyamotoi prevalence in ticks collected from Norway. As not much is known about the spatiotemporal dynamics of this relatively recently discovered pathogen, the conclusions of this study significantly add to the knowledge regarding B. miyamotoi in this region. © 2015 Elsevier GmbH.


Haugen A.J.,Ostfold Hospital Trust | Brox J.I.,University of Oslo | Grovle L.,Ostfold Hospital Trust | Keller A.,University of Oslo | And 5 more authors.
BMC Musculoskeletal Disorders | Year: 2012

Background: Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2years of follow-up and to test the prognostic value of surgical treatment for sciatica. Methods. The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine-Seattle Back Questionnaire score of 5 (0-12) (primary outcome) and Sciatica Bothersomeness Index 7 (0-24) (secondary outcome). Results: Rates of non-success were at 1 and 2years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1year was significantly associated with being male (OR 1.70 [95% CI; 1.062.73]), smoker (2.06 [1.313.25]), more back pain (1.0 [1.011.02]), more comorbid subjective health complaints (1.09 [1.031.15]), reduced tendon reflex (1.62 [1.032.56]), and not treated surgically (2.97 [1.755.04]). Further, factors significantly associated with non-success at 2years were duration of back problems>;1year (1.92 [1.113.32]), duration of sciatica>;3months (2.30 [1.403.80]), more comorbid subjective health complaints (1.10 [1.031.17]) and kinesiophobia (1.04 [1.001.08]). For the secondary outcome variable, in the final multivariate model, more comorbid subjective health complaints, more back pain, muscular weakness at clinical examination, and not treated surgically, were independent prognostic factors for non-success at both 1 and 2years. Conclusions: The results indicate that the prognosis for sciatica referred to secondary care is not that good and only slightly better after surgery and that comorbidity should be assessed in patients with sciatica. This calls for a broader assessment of patients with sciatica than the traditional clinical assessment in which mainly the physical symptoms and signs are investigated. © 2012 Haugen et al.; licensee BioMed Central Ltd.

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