A global study of pathogens and host risk factors associated with infectious gastrointestinal disease in returned international travellers - 07/08/11

Doi : 10.1016/j.jinf.2009.05.008

Ashwin Swaminathan ^a,^{^{n
Data collection, analysis and manuscript preparation.}}, Joseph Torresi ^b,^c,^⁎,^{^{o
Data collection, study design, interpretation of analyses, manuscript preparation.}} , Patricia Schlagenhauf ^d,^{^{p
Data collection, interpretation of analyses, preparation of maps, critical review of manuscript.}}, Karin Thursky ^e,^{^{q
Statistical analyses and critical review of results.}}, Annelies Wilder-Smith ^f,^{^{r
Data collection, interpretation of analyses, critical review of manuscript.}}, Bradley A. Connor ^g,^{^{r
Data collection, interpretation of analyses, critical review of manuscript.}}, Eli Schwartz ^h,^i,^{^{r
Data collection, interpretation of analyses, critical review of manuscript.}}, Frank vonSonnenberg ^j,^{^{r
Data collection, interpretation of analyses, critical review of manuscript.}}, Jay Keystone ^k,^l,^{^{r
Data collection, interpretation of analyses, critical review of manuscript.}}, Daniel P. O’Brien ^e,^m,^{^{o
Data collection, study design, interpretation of analyses, manuscript preparation.}}
for the GeoSentinel Network
^a National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
^b Austin Hospital, Heidelberg, Victoria, Australia
^c The University of Melbourne, Victoria, Australia
^d WHO CC for Travellers’ Health Division of Epidemiology and Communicable Diseases University of Zurich Centre for Travel Medicine, Zurich, Switzerland
^e Victorian Infectious Diseases Service, Royal Melbourne Hospital, Victoria, Australia
^f Department of Medicine, National University Singapore, Singapore
^g Weill Medical College of Cornell University, New York, USA
^h The Center for Geographic Medicine and Tropical Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel
ⁱ Sakler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
^j Department of Infectious Diseases and Tropical Medicine, University of Munich, Germany
^k Center for Travel and Tropical Medicine, Toronto General Hospital, Toronto, Ontario, Canada
^l Department of Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada
^m Geelong Hospital, Victoria, Australia

Corresponding author. Department of Infectious Diseases, Austin Hospital, The University of Melbourne, 145 Studley Road, Heidelberg 3084, VIC, Australia. Tel.: +61 3 9496 6676; fax: +61 3 9496 6677.

Summary

Objectives

Infectious gastrointestinal disease (IGD) is a significant cause of morbidity in returned international travellers. This study aims to elucidate host and travel characteristics associated with IGD presentation, and describe the broad spectrum of aetiological pathogens responsible by geographic region of acquisition and reason for travel.

Methods

We analyzed demographic, clinical and microbiological data recorded for ill, returned international travellers presenting to GeoSentinel Surveillance Network sites globally during the period September 1996–December 2005.

Results

A total of 25,867 returned travellers were analyzed, of whom 7442 (29%) patients had a total of 8273 IGD diagnoses. Multivariate analysis demonstrated that IGD presentation was associated significantly with female sex (OR: 1.11; p=0.001); younger age group; attending a pre-travel medical appointment (OR: 1.28; p<0.0001); and travelling for the reason of tourism. Travelling for longer periods (>28 days) was associated with lower risk (OR: 0.93; p=0.04). Of the 2902 clinically significant pathogens isolated, 65% were parasitic, 31% bacterial and 3% viral. Presentation of IGD by specific pathogen varied markedly dependent on geographic region of recent travel, and reason for travel.

Conclusions

Host characteristics, region of travel and category of traveller, significantly impact on the relative likelihood of presenting with a broad range of pathogen-specific IGD.

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Keywords : Gastrointestinal diseases, Infection, Travel, Diarrhoea

Plan

Host and travel characteristics affecting the likelihood of an IGD diagnosis

Significant pathogens isolated from returned travellers with IGD

All listed authors have given final approval for this manuscript to be submitted, as has the Research Committee of the GeoSentinel Surveillance Network.

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Vol 59 - N° 1

P. 19-27 - juillet 2009 Retour au numéro

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A global study of pathogens and host risk factors associated with infectious gastrointestinal disease in returned international travellers - 07/08/11

Summary

Objectives

Methods

Results

Conclusions

Plan

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