Expatriates ill after travel: Results from the Geosentinel Surveillance Network

BMC Infectious Diseases

David O Freedman⁶  Xiaohong M Davis^1,10  Annelies Wilder-Smith⁴  Louis Loutan⁵  Patricia Schlagenhauf¹  DeVon Hale⁷  Prativa Pandey²  Susan MacDonald⁸  Lin H Chen⁹  Pauline Han^1,10  Poh-Lian Lim³ 

[1] University of Zurich Centre for Travel Medicine, WHO Collaborating Centre for Travellers’ Health, University of Zurich, Zurich, Switzerland;CIWEC Clinic Travel Medicine Center, Katmandu, Nepal;Department of Infectious Diseases, Institute of Infectious Disease & Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore;Institute of Public Health, University of Heidelberg, Heidelberg, Germany;University of Geneva, Geneva, Switzerland;Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA;Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA;University Hospital of Northern British Columbia, Prince George, Canada;Harvard Medical School, Boston, Massachusetts, USA;Centers for Disease Control and Prevention, Atlanta, Georgia, USA

关键词: Malaria;    GeoSentinel;    Travelers;    Expatriate;   

Others  :  1158627
DOI  :  10.1186/1471-2334-12-386

 received in 2012-05-18, accepted in 2012-12-13,  发布年份 2012

【 摘 要 】

Background

Expatriates are a distinct population at unique risk for health problems related to their travel exposure.

Methods

We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM) for travel-related illness.

Results

Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months), and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM) for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis). Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea) compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue) and vaccine-preventable infections (hepatitis A), and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness.

Conclusions

Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

【 授权许可】

   
2012 Lim et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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