TY - JOUR
T1 - A global study of pathogens and host risk factors associated with infectious gastrointestinal disease in returned international travellers
AU - Swaminathan, Ashwin
AU - Torresi, Joseph
AU - Schlagenhauf, Patricia
AU - Thursky, Karin
AU - Wilder-Smith, Annelies
AU - Connor, Bradley A.
AU - Schwartz, Eli
AU - vonSonnenberg, Frank
AU - Keystone, Jay
AU - O'Brien, Daniel P.
N1 - Funding Information:
GeoSentinel, the Global Surveillance Network of the International Society of Travel Medicine, is supported by Cooperative Agreement U50/CI000359 from the Centers for Disease Control and Prevention.
PY - 2009/7
Y1 - 2009/7
N2 - 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.
AB - 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.
KW - Diarrhoea
KW - Gastrointestinal diseases
KW - Infection
KW - Travel
UR - http://www.scopus.com/inward/record.url?scp=67649995353&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2009.05.008
DO - 10.1016/j.jinf.2009.05.008
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C2 - 19552961
AN - SCOPUS:67649995353
SN - 0163-4453
VL - 59
SP - 19
EP - 27
JO - Journal of Infection
JF - Journal of Infection
IS - 1
ER -