University of Zürich Centre for Travel Medicine, World Health Organisation Collaborating Centre for Travellers' Health, University of Zürich, Zürich, Switzerland.
Clin Infect Dis. 2010 Mar 15;50(6):826-32. doi: 10.1086/650575.
No systematic studies exist on sex and gender differences across a broad range of travel-associated diseases.
Travel and tropical medicine GeoSentinel clinics worldwide contributed prospective, standardized data on 58,908 patients with travel-associated illness to a central database from 1 March 1997 through 31 October 2007. We evaluated sex and gender differences in health outcomes and in demographic characteristics. Statistical significance for crude analysis of dichotomous variables was determined using chi2 tests with calculation of odds ratios (ORs) and 95% confidence intervals (CIs). The main outcome measure was proportionate morbidity of specific diagnoses in men and women. The analyses were adjusted for age, travel duration, pretravel encounter, reason for travel, and geographical region visited.
We found statistically significant (P < .001) differences in morbidity by sex. Women are proportionately more likely than men to present with acute diarrhea (OR, 1.13; 95% CI, 1.09-1.38), chronic diarrhea (OR, 1.28; 95% CI, 1.19-1.37), irritable bowel syndrome (OR, 1.39; 95% CI, 1.24-1.57), upper respiratory tract infection (OR, 1.23; 95% CI, 1.14-1.33); urinary tract infection (OR, 4.01; 95% CI, 3.34-4.71), psychological stressors (OR, 1.3; 95% CI, 1.14-1.48), oral and dental conditions, or adverse reactions to medication. Women are proportionately less likely to have febrile illnesses (OR, 0.15; 95% CI, 0.10-0.21); vector-borne diseases, such as malaria (OR, 0.46; 95% CI, 0.41-0.51), leishmaniasis, or rickettsioses (OR, 0.57; 95% CI, 0.43-0.74); sexually transmitted infections (OR, 0.68; 95% CI 0.58-0.81); viral hepatitis (OR, 0.34; 95% CI, 0.21-0.54); or noninfectious problems, including cardiovascular disease, acute mountain sickness, and frostbite. Women are statistically significantly more likely to obtain pretravel advice (OR, 1.28; 95% CI, 1.23-1.32), and ill female travelers are less likely than ill male travelers to be hospitalized (OR, 0.45; 95% CI, 0.42-0.49).
Men and women present with different profiles of travel-related morbidity. Preventive travel medicine and future travel medicine research need to address gender-specific intervention strategies and differential susceptibility to disease.
目前尚无系统研究涵盖广泛旅行相关疾病的性别和性别差异。
全球旅行和热带医学 GeoSentinel 诊所从 1997 年 3 月 1 日至 2007 年 10 月 31 日通过中央数据库前瞻性地、标准化地收集了 58908 例旅行相关疾病患者的数据。我们评估了健康结果和人口统计学特征方面的性别和性别差异。使用卡方检验（计算比值比[OR]和 95%置信区间[CI]）对二项变量的粗分析进行了统计学显著性检验。主要观察指标为男性和女性特定诊断的发病率比例。对年龄、旅行时间、旅行前遭遇、旅行原因和旅行地点进行了调整。
我们发现发病率存在统计学显著差异（P<.001）。与男性相比，女性更可能出现急性腹泻（OR，1.13；95%CI，1.09-1.38）、慢性腹泻（OR，1.28；95%CI，1.19-1.37）、肠易激综合征（OR，1.39；95%CI，1.24-1.57）、上呼吸道感染（OR，1.23；95%CI，1.14-1.33）；尿路感染（OR，4.01；95%CI，3.34-4.71）、心理压力源（OR，1.3；95%CI，1.14-1.48）、口腔和牙齿状况或药物不良反应。女性发热性疾病（OR，0.15；95%CI，0.10-0.21）、虫媒病（如疟疾（OR，0.46；95%CI，0.41-0.51）、利什曼病或立克次体病（OR，0.57；95%CI，0.43-0.74）；性传播感染（OR，0.68；95%CI 0.58-0.81）；病毒性肝炎（OR，0.34；95%CI，0.21-0.54）；或非传染性疾病，包括心血管疾病、急性高原病和冻伤的发病率比例较低。女性获得旅行前建议的可能性统计学上显著更高（OR，1.28；95%CI，1.23-1.32），与男性旅行者相比，生病的女性旅行者住院的可能性较低（OR，0.45；95%CI，0.42-0.49）。
男性和女性表现出不同的旅行相关发病率特征。预防性旅行医学和未来的旅行医学研究需要解决针对特定性别的干预策略和对疾病的不同易感性。
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