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Mapping review

Laboratory diagnosis of tick-borne infections: A systematic literature search with a sorted reference list

  • Year: 2019
  • By: Norwegian Institute of Public Health
  • Authors Kirkehei I, Flottorp S, Aaberge I, Aase A.
  • ISBN (digital): 978-82-8406-013-2
Forside flåttbårne infeksjoner.jpg

The Norwegian Directorate of Health and The Norwegian National Advisory Unit on Tick-borne diseases asked the Norwegian Institute of Public Health to perform a systematic literature search followed by an overview of available research on laboratory diagnosis and co-infections of tick-borne diseases.

Downloadable as PDF. In English. Norwegian summary.



Key message


The objective of part one was to identify research on laboratory diagnosis of people with long-term complaints after borrelia infection, including seven tick-born infections other than Lyme borreliosis (Borrelia) and tick-borne encephalitis (TBE): anaplasmosis (Anaplasma phagocytophilium), rickettsiosis (Rickettsia helvetica or Rickettsia conorii), neoehrlichiosis (Candidatus Neoehrlichia mikurensis), babesiosis (Babesia spp, hard tick-borne relapsing fever (Borrelia miyamotoi), tularemia (Francisella tularensis) and cat scratch disease (Bartonella spp). The objective of part two was to identify research on tick-borne co-infections, also including Lyme borreliosis (Borrelia) and tick-borne encephalitis (TBE).


We performed a systematic literature search for research published between 2007 and 2018, and categorised potentially relevant references according to the studied infections and study design.


Part 1: Laboratory diagnostics:

We included and sorted 458 references by type of tick-borne infection and by study design (diagnostic studies, case studies or case series).

Part 2: Co-infections:

We found four systematic reviews, eleven non-systematic reviews, 15 diagnostic studies, 50 prevalence studies and 25 case-studies on Lyme borreliosis co-infections.

We did not read the papers in full text, and we did not assess the methodological quality of the studies, nor did we summarise the results. We present references to the studies with links to the studies’ abstracts or full text.