Department of Infectious Diseases, Public Health Service, GGD, Amsterdam, Amsterdam, The Netherlands.
J Travel Med. 2011 Sep-Oct;18(5):318-26. doi: 10.1111/j.1708-8305.2011.00543.x. Epub 2011 Aug 15.
Immunocompromised travelers to developing countries are thought to have symptomatic infectious diseases more often and longer than non-immunocompromised travelers. Evidence for this is lacking. This study evaluates whether immunocompromised short-term travelers are at increased risk of diseases.
A prospective study was performed between October 2003 and May 2010 among adult travelers using immunosuppressive agents (ISA) and travelers with inflammatory bowel disease (IBD), with their non-immunocompromised travel companions serving as matched controls with comparable exposure to infection. Data on symptoms of infectious diseases were recorded by using a structured diary.
Among 75 ISA, the incidence of travel-related diarrhea was 0.76 per person-month, and the number of symptomatic days 1.32 per month. For their 75 controls, figures were 0.66 and 1.50, respectively (p > 0.05). Among 71 IBD, the incidence was 1.19, and the number of symptomatic days was 2.48. For their 71 controls, figures were 0.73 and 1.31, respectively (p > 0.05). These differences also existed before travel. ISA had significantly more and longer travel-related signs of skin infection and IBD suffered more and longer from vomiting. As for other symptoms, no significant travel-related differences were found. Only 21% of immunocompromised travelers suffering from diarrhea used their stand-by antibiotics.
ISA and IBD did not have symptomatic infectious diseases more often or longer than non-immunocompromised travelers, except for signs of travel-related skin infection among ISA. Routine prescription of stand-by antibiotics for these immunocompromised travelers to areas with good health facilities is probably not more useful than for healthy travelers.
与非免疫抑制旅行者相比，前往发展中国家的免疫抑制旅行者出现症状性传染病的频率更高，持续时间更长。目前尚缺乏相关证据。本研究旨在评估免疫抑制短期旅行者是否存在更高的患病风险。
2003 年 10 月至 2010 年 5 月期间，对使用免疫抑制药物（ISA）的成年旅行者和炎症性肠病（IBD）旅行者进行了前瞻性研究，其非免疫抑制旅行者同伴作为具有相似感染暴露的匹配对照。通过使用结构化日记记录感染性疾病症状的数据。
在 75 例 ISA 中，旅行相关腹泻的发病率为 0.76 人/月，症状天数为 1.32 天/月。而他们的 75 名对照者，相应的发病率和症状天数分别为 0.66 和 1.50（p＞0.05）。在 71 例 IBD 中，发病率为 1.19，症状天数为 2.48。而他们的 71 名对照者，发病率和症状天数分别为 0.73 和 1.31（p＞0.05）。这些差异在旅行前就已经存在。ISA 旅行者有更多且更长的旅行相关皮肤感染症状，IBD 旅行者有更多且更长的呕吐症状。至于其他症状，未发现与旅行相关的显著差异。只有 21%的腹泻免疫抑制旅行者使用了备用抗生素。
除了 ISA 旅行者有更多且更长的旅行相关皮肤感染迹象外，ISA 和 IBD 旅行者出现症状性传染病的频率和持续时间并不长，与非免疫抑制旅行者相比。对于前往卫生设施良好的地区的这些免疫抑制旅行者，常规开具备用抗生素可能并不比健康旅行者更有用。
