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Shiferaw W, Martin BM, Dean JA, Mills D, Lau C, Paterson D, Koh K, Eriksson L, Furuya-Kanamori L. A systematic review and meta-analysis of sexually transmitted infections and blood-borne viruses in travellers. J Travel Med 2024; 31:taae038. [PMID: 38438164 PMCID: PMC11149723 DOI: 10.1093/jtm/taae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/18/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Sexually transmitted infections (STIs) and blood-borne viruses (BBVs) impose a global health and economic burden. International travellers facilitate the spread of infectious diseases, including STIs. Hence, this review assessed the prevalence/proportionate morbidity of travellers with STIs and sexually transmitted BBVs and factors associated with the infection in this population. METHODS PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Cochrane Library were searched from inception of the databases until November 2022. Published analytical observational studies reporting the prevalence/proportionate morbidity of travellers with STIs and factors associated with STIs by type of traveller [i.e. tourists, business travellers, students, visiting friends or relatives (VFRs), international truck drivers, backpackers, expatriates and men who have sex with men (MSM)] were included. The selection of articles, data extraction and risk of bias assessment were conducted by two independent reviewers. Meta-analyses were conducted for each STI by clinical presentation and type of traveller. RESULTS Thirty-two studies (n = 387 731 travellers) were included; 19 evaluated the proportionate morbidity of STIs among symptomatic travellers, while 13 examined the prevalence of STIs in asymptomatic travellers. The highest proportionate morbidity was found among VFRs (syphilis, 1.67%; 95% CI: 1.03-2.81%), backpackers (Chlamydia trachomatis, 6.58%; 95% CI: 5.96-7.25%) and MSM (HIV [2.50%;95% CI: 0.44-12.88%], gonorrhoea [4.17%; 95% CI: 1.1.5-13.98%], lymphogranuloma venereum [4.17%;95% CI: 1.1.5-13.98%] and HAV [20.0%; 95% CI: 14.99-26.17%]). The highest prevalence of STIs among asymptomatic were found in MSM (HIV [25.94%; 95% CI: 22.21-30.05%] and HBV [24.90%; 95% CI: 21.23-28.96%]) and backpackers (C. trachomatis, 3.92%; 95% CI: 2.72-5.32%). Short duration of the trip (<1 month), not having pre-travel consultation, travelling to Southeast Asia and being unvaccinated for HBV were identified as risk factors for STIs. CONCLUSION Strategies to prevent STIs and sexually transmitted BBVs should be discussed at pre-travel consultations, and recommendations should be prioritized in high-risk groups of travellers, such as backpackers, VFRs and MSMs. Additionally, healthcare providers should tailor recommendations for safe sex practices to individual travellers' unique needs.
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Affiliation(s)
- Wondimeneh Shiferaw
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Asrat Woldeyes Health Science Campus, Debre Berhan University, Ethiopia
| | - Beatris Mario Martin
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Judith A Dean
- UQ Poche Centre for Indigenous Health, Faculty of Health, and Behavioural Sciences, The University of Queensland, Toowong, Australia
| | - Deborah Mills
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Colleen Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - David Paterson
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Kenneth Koh
- Gladstone Road Medical Centre, Brisbane, Australia
| | - Lars Eriksson
- Herston Health Sciences Library, The University of Queensland, Herston, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
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Steffen R, Chen LH, Leggat PA. Travel vaccines-priorities determined by incidence and impact. J Travel Med 2023; 30:taad085. [PMID: 37341307 DOI: 10.1093/jtm/taad085] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Infectious disease epidemiology is continuously shifting. While travel has been disrupted by the COVID-19 pandemic and travel-related epidemiological research experienced a pause, further shifts in vaccine-preventable diseases (VPDs) relevant for travellers have occurred. METHODS We conducted a literature search on the epidemiology of travel-related VPD and synthesized data for each disease with a focus on symptomatic cases and on the impact of the respective infection among travellers, considering the hospitalization rate, disease sequela and case fatality rate. We present new data and revised best estimates on the burden of VPD relevant for decisions on priorities in travel vaccines. RESULTS COVID-19 has emerged to be a top travel-related risk and influenza remains high in the ranking with an estimated incidence at 1% per month of travel. Dengue is another commonly encountered infection among international travellers with estimated monthly incidence of 0.5-0.8% among non-immune exposed travellers; the hospitalized proportion was 10 and 22%, respectively, according to two recent publications. With recent yellow fever outbreaks particularly in Brazil, its estimated monthly incidence has risen to >0.1%. Meanwhile, improvements in hygiene and sanitation have led to some decrease in foodborne illnesses; however, hepatitis A monthly incidence remains substantial in most developing regions (0.001-0.01%) and typhoid remains particularly high in South Asia (>0.01%). Mpox, a newly emerged disease that demonstrated worldwide spread through mass gathering and travel, cannot be quantified regarding its travel-related risk. CONCLUSION The data summarized may provide a tool for travel health professionals to prioritize preventive strategies for their clients against VPD. Updated assessments on incidence and impact are ever more important since new vaccines with travel indications (e.g. dengue) have been licensed or are undergoing regulatory review.
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Affiliation(s)
- Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Travelers' Health, University of Zurich, Zurich 8001, Switzerland
- Division of Epidemiology, Human Genetics & Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA
- Faculty of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4810, Australia
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
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Du M, Yuan J, Jing W, Liu M, Liu J. The Effect of International Travel Arrivals on the New HIV Infections in 15–49 Years Aged Group Among 109 Countries or Territories From 2000 to 2018. Front Public Health 2022; 10:833551. [PMID: 35252102 PMCID: PMC8888525 DOI: 10.3389/fpubh.2022.833551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The prevalent international travel may have an impact on new HIV infections, but related studies were lacking. We aimed to explore the association between international travel arrivals and new HIV infections in 15–49 years aged group from 2000 to 2018, to make tailored implications for HIV prevention. Methods We obtained the data of new HIV infections from the Joint United Nations Programme on HIV/AIDS and international travel arrivals from the World Bank. Correlation analysis was used to explore the relation briefly. Log-linear models were built to analyze the association between international travel arrivals and new HIV infections. Results International travel arrivals were positively correlated with new HIV infections (correlation coefficients: 0.916, p < 0.001). After controlling population density, the median age of the total population (years), socio-demographic index (SDI), travel-related mandatory HIV testing, HIV-related restrictions, and antiretroviral therapy coverage, there were 6.61% (95% CI: 5.73, 7.50; p < 0.001) percentage changes in new HIV infections of 15–49 years aged group associated with a 1 million increase in international travel arrivals. Conclusions Higher international travel arrivals were correlated with new HIV infections in 15–49 years aged group. Therefore, multipronged structural and effective strategies and management should be implemented and strengthened.
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Mäkelä HMM, Cristea V, Sane JA. Lack of perception regarding risk of dengue and day-active mosquitoes in Finnish travellers. Infect Dis (Lond) 2020; 52:651-658. [PMID: 32538285 DOI: 10.1080/23744235.2020.1775883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background: An increasing number of international travellers are at risk for dengue infection. We analysed the characteristics of Finnish travellers with recently acquired dengue infections.Methods: Notified dengue infections from 2016 to 2019 were obtained from the Finnish National Infectious Disease Register. We developed a questionnaire and invited individuals diagnosed with dengue to provide information on countries and areas of infection, travel characteristics, risk perception and use of protective measures.Results: Almost all infections (94%, 127/135) were acquired in Asian countries, most in Thailand (78/135, 58%). The Maldives had the highest crude risk after adjusting for the number of travellers (55.6/100,000). Most trips were pre-booked holidays (93/111, 84%) and 62% (69/111) had a duration of 14-21 days with time spent mostly on the beach (78/111, 70%). The majority of travellers were not aware of the risk of dengue infection before travelling (67/111, 60%) and had not sought pre-travel advice (72/111, 65%). The majority applied some protective measures (71/111, 64%) but mainly after sunset (64/111, 58%).Conclusions: Most dengue infections in Finnish travellers were acquired at popular destinations in Southeast Asia, especially Thailand. Our study showed that there was low awareness regarding the risk of contracting the infection. In addition, many travellers reported inadequate use of protective measures. This calls for further public health actions, such as raising awareness of day-active mosquitoes, of risk at popular travelling destinations and the correct way of applying anti-vectorial measures.
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Affiliation(s)
- Henna M M Mäkelä
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Veronica Cristea
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jussi A Sane
- Infectious Disease Control and Vaccinations Unit, Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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Knowledge, Attitudes, and Practices towards Infectious Diseases Related to Travel of Community Pharmacists in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062147. [PMID: 32213832 PMCID: PMC7143491 DOI: 10.3390/ijerph17062147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/06/2023]
Abstract
Pharmacists should be educated about travel medicine, since they could influence their own choices and those of the individuals they encounter. This study aims to investigate the knowledge, attitudes, and behaviors towards infectious diseases related to travel among community pharmacists in Italy. The data was collected from September 2018 to September 2019 using semi-structured telephone interviews. Only 1.8% answered correctly to all seven questions regarding the infectious diseases related to travel. Community pharmacists who had heard about travel medicine and those who had received information were more likely to have good knowledge. More than two-thirds of the respondents believed that it is important to provide information to the public about travel medicine. Pharmacists who worked a higher number of hours per week, were more knowledgeable about the more frequent infectious diseases related to travel, believed that travel medicine was a pharmacist competency, believed that they could give advice to the public, and had received information from scientific journals and educational activities were more likely to have this positive attitude. More than two-thirds often/always informed the public about the importance of having travel health center counseling. Pharmacists who had heard about travel medicine and those who believed that they could give advice to the public were more likely to inform. Interventions are needed to improve knowledge in order that community pharmacists can play an active role in counseling the public.
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Abstract
PURPOSE OF REVIEW The present review considers recent evidence on travel-associated sexual intercourse and sexually transmitted infection (STI) risks and travel with regards to risk behavior and implications of travel on communities. It highlights the lack of research in this area and topics for consideration. RECENT FINDINGS A population-based study, and others, shows significant levels of sex abroad and risk behavior with inconsistent condom use despite increasing travel advice about risks. There is an increasing association of STIs in military personnel from local rather than deployment-associated sex contacts shown in United States and French studies, probably related to deployment of women. Innovative studies are showing the effect of female sex-tourism on the communities involved, and the sexual interaction and risk for tourism employees from tourists. New social networking apps require evaluation as to both their potential to increase and decrease risks. Travel sex continues to be a vector for the global spread of multidrug resistant gonorrhoeae. SUMMARY New research challenges previous perspectives with changes to risk behavior in the military, female sex tourism, the change in social networks and ongoing risk behavior research and evidence of increased cross-country partnerships. The lack of high-quality studies evaluating travel advice to reduce risk is a key area for future work.
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Shaban RZ, Sotomayor-Castillo CF, Jakrot H, Jiang P. Passenger travel health advice regarding infection control and the prevention of infectious diseases: What's in airline inflight magazines? Travel Med Infect Dis 2020; 33:101453. [DOI: 10.1016/j.tmaid.2019.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023]
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Shaban RZ, Sotomayor-Castillo CF, Malik J, Li C. Global commercial passenger airlines and travel health information regarding infection control and the prevention of infectious disease: What's in a website? Travel Med Infect Dis 2020; 33:101528. [PMID: 31760126 PMCID: PMC7110852 DOI: 10.1016/j.tmaid.2019.101528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Air travel has never been easier, cheaper or faster, with large volumes of people travelling around the world. These factors increase the risk of the spread of infectious diseases by air travel. Little is known, however, about the extent to which airlines provide information to passengers on infection control and measures to prevent the spread of infectious diseases. This study examined the websites of the global commercial passenger airlines to see if they contained information about infection control and prevention of infectious diseases and appraised the clinical usefulness of that information. METHOD A cross-sectional text-based analysis of the 73 airline websites from the six global commercial passenger airline conglomerates was performed to identify information about infection control and prevention of infectious between July and August 2019. RESULTS Of the 73 airline websites, less than half (n = 35, 28.6%) contained information deemed useful for passengers. While there was a range of general health advice within the websites, there was limited information about infection control and preventing infectious diseases. A minority of websites contained information about vaccination status prior to travel, and to a lesser extent handwashing and hand hygiene, with very few including disease-specific advice or preventive measures. CONCLUSIONS Airline websites are an underutilised source of information for infection control and the prevention of infectious diseases. Providing passengers with information on basic infection control and prevention measures may support the global efforts against the spread of infectious diseases.
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Affiliation(s)
- Ramon Z Shaban
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
| | - Cristina F Sotomayor-Castillo
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
| | - Jeremy Malik
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia
| | - Cecilia Li
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
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Frost I, Van Boeckel TP, Pires J, Craig J, Laxminarayan R. Global geographic trends in antimicrobial resistance: the role of international travel. J Travel Med 2019; 26:5496989. [PMID: 31115466 DOI: 10.1093/jtm/taz036] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Rising antimicrobial resistance (AMR) is a threat to modern medicine, and increasing international mobility facilitates the spread of AMR. Infections with resistant organisms have higher morbidity and mortality, are costlier to treat, result in longer hospital stays and place a greater burden on health systems than infections caused by susceptible organisms. Here we review the role of travel in the international dissemination of AMR and consider actions at the levels of travelers, travel medicine practitioners and policymakers that would mitigate this threat. RESULTS Resistant pathogens do not recognize international borders; travelers to areas with high AMR prevalence are likely to be exposed to resistant bacteria and return to their home countries colonized. Medical tourists go between health facilities with drastically different rates of AMR, potentially transmitting highly resistant strains.Drug-resistant bacteria have been found in every continent; however, differences between countries in the prevalence of AMR depend on multiple factors. These include levels of antibiotic consumption (including inappropriate use), access to clean water, adequate sanitation, vaccination coverage, the availability of quality healthcare and access to high-quality medical products. CONCLUSIONS Travelers to areas with high levels of AMR should have vaccines up to date, be aware of ways of treating and preventing travelers' diarrhea (other than antibiotic use) and be informed on safe sexual practices. The healthcare systems of low- and middle-income countries require investment to reduce the transmission of resistant strains by improving access to clean water, sanitation facilities and vaccines. Efforts are needed to curb inappropriate antibiotic use worldwide. In addition, more surveillance is needed to understand the role of the movement of humans, livestock and food products in resistance transmission. The travel medicine community has a key role to play in advocating for the recognition of AMR as a priority on the international health agenda. KEY POLICY RECOMMENDATIONS AMR is a threat to modern medicine, and international travel plays a key role in the spread of highly resistant strains. It is essential that this is addressed at multiple levels. Individual travelers can reduce antibiotic consumption and the likelihood of infection. Travelers should have up-to-date vaccines and be informed on methods of preventing and treating travelers' diarrhea, other than use of antibiotics and on safe sexual practices, such as condom use. Healthcare facilities need to be aware of the travel history of patients to provide appropriate treatment to those who are at high risk of exposure and to prevent further spread. Internationally, in countries without reliable and universal access to clean water, sanitation and hygiene, investment is needed to reduce the emergence and spread of resistance and ensure the antimicrobials available are of assured quality. High-income countries must ensure their use of antimicrobials is appropriate to reduce selection for AMR. Surveillance across all countries is needed to monitor and respond to this emerging threat.
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Affiliation(s)
- Isabel Frost
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Amity Institute of Public Health, Amity University, Noida, India
| | - Thomas P Van Boeckel
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Swiss Federal Institute of Technology Zurich, Department of Earth Systems Science, Institute for Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - João Pires
- Swiss Federal Institute of Technology Zurich, Department of Earth Systems Science, Institute for Integrative Biology, ETH Zurich, Zurich, Switzerland
| | - Jessica Craig
- Center for Disease Dynamics, Economics & Policy, New Delhi, India
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,Princeton Environmental Institute, Princeton University, New Jersey, USA
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Meurs L, Lempp FS, Lippmann N, Trawinski H, Rodloff AC, Eckardt M, Klingeberg A, Eckmanns T, Walter J, Lübbert C. Intestinal colonization with extended-spectrum beta-lactamase producing Enterobacterales (ESBL-PE) during long distance travel: A cohort study in a German travel clinic (2016-2017). Travel Med Infect Dis 2019; 33:101521. [PMID: 31770602 DOI: 10.1016/j.tmaid.2019.101521] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/14/2019] [Accepted: 11/18/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intercontinental travel contributes to the spread of extended-spectrum beta-lactamase producing Enterobacterales (ESBL-PE). We assessed risk factors for intestinal ESBL-PE colonization in people travelling to low and middle income countries in the tropics and subtropics to better understand how travel affects ESBL-PE spread. METHOD This prospective cohort study in travellers attending a travel clinic in Leipzig, Germany was conducted in 2016-2017. Information on risk factors related to travel, symptoms, antibiotic use, health care usage, accommodation, destination, diet and hygiene was collected by questionnaire after travel. Stools were phenotypically tested for ESBL-PE before and after travel. Risk factors for ESBL-PE colonization were identified using logistic regression. RESULTS Of the 230 travellers that were ESBL-PE negative before travelling, 23% (n = 53) travellers returned positive. Multivariable analyses showed that age, type of accommodation and travelling to Asia were associated with ESBL-PE colonization. CONCLUSIONS Given that a considerable amount of travellers returned with ESBL-PE, we recommend raising awareness in returning high-risk travellers, e.g. those returning from high-risk areas. They should be aware that they may carry antimicrobial-resistant bacteria after travel, and how they can prevent its spread. The role of the type of accommodation as a factor favouring intestinal colonization with ESBL-PE requires further investigation.
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Affiliation(s)
- Lynn Meurs
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Gustav III:s Boulevard 40, 16973, Solna, Sweden; Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany.
| | - Felix S Lempp
- Division of Infectious Diseases and Tropical Medicine, Department of Gastroenterology, Leipzig University Hospital, Liebigstraße 20, 04103, Leipzig, Germany
| | - Norman Lippmann
- Interdisciplinary Centre for Infectious Diseases, Leipzig University Hospital, Liebigstraße 20, 04103, Leipzig, Germany
| | - Henning Trawinski
- Division of Infectious Diseases and Tropical Medicine, Department of Gastroenterology, Leipzig University Hospital, Liebigstraße 20, 04103, Leipzig, Germany
| | - Arne C Rodloff
- Interdisciplinary Centre for Infectious Diseases, Leipzig University Hospital, Liebigstraße 20, 04103, Leipzig, Germany
| | | | | | - Tim Eckmanns
- Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany
| | - Jan Walter
- Robert Koch Institute, Seestraße 10, 13353, Berlin, Germany
| | - Christoph Lübbert
- Division of Infectious Diseases and Tropical Medicine, Department of Gastroenterology, Leipzig University Hospital, Liebigstraße 20, 04103, Leipzig, Germany; Interdisciplinary Centre for Infectious Diseases, Leipzig University Hospital, Liebigstraße 20, 04103, Leipzig, Germany
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Adou AA, Napolitano F, Vastola A, Angelillo IF. Travelers' knowledge, attitudes, and behavior related to infectious diseases in Italy. PLoS One 2019; 14:e0215252. [PMID: 30978211 PMCID: PMC6461267 DOI: 10.1371/journal.pone.0215252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/29/2019] [Indexed: 01/04/2023] Open
Abstract
The objectives of this investigation were to examine the travelers’ knowledge, attitudes, and behavior about travel-related diseases and to evaluate the factors that influence their knowledge, attitudes, and behavior. A cross-sectional study was performed between May and September 2018 among a random sample of individuals attending randomly selected travel agencies in the geographical areas of Caserta and Naples, Italy. One fourth of participants (25.6%) had a poor level of knowledge, 50.2% a moderate, and only 24.2% a good level about the most common infectious diseases in the destination country. Those who had received information from physicians about the most common infectious diseases in the destination country and who do not need additional information were significantly more likely to have a good level of knowledge. A large majority (91%) showed no concern about the risk of getting an infectious disease during the travel. Almost half of the respondents had received information concerning the most common infectious diseases in the destination country and the related prevention measures. This information was more likely acquired by those graduated, those who know the foods that can cause the infectious diseases, and those who self-perceived a well health status, and less likely by those who had a poor level of knowledge about the most common infectious diseases in the destination country and who were going to Asia and South America. Education and communication activities regarding all aspects of travel-related diseases are needed to increase the knowledge and the access to preventive measures.
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Affiliation(s)
- Abdoulkader Ali Adou
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni, Naples, Italy
| | - Francesco Napolitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni, Naples, Italy
| | - Alessandra Vastola
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni, Naples, Italy
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via Luciano Armanni, Naples, Italy
- * E-mail:
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Terrorism and Travel medicine: Where do we go from here? Travel Med Infect Dis 2018; 22:1-2. [DOI: 10.1016/j.tmaid.2018.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 02/23/2018] [Accepted: 03/14/2018] [Indexed: 11/21/2022]
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