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全球旅行者疾病监测网络:为国际旅行者提供医疗服务的全国性诊所联盟——2009-2011 年美国高危国际旅行者人口统计学特征、旅行目的地和旅行前医疗保健分析。

Global TravEpiNet: a national consortium of clinics providing care to international travelers--analysis of demographic characteristics, travel destinations, and pretravel healthcare of high-risk US international travelers, 2009-2011.

机构信息

Travelers' Advice and Immunization Center, Massachusetts General Hospital, Boston, USA.

出版信息

Clin Infect Dis. 2012 Feb 15;54(4):455-62. doi: 10.1093/cid/cir839. Epub 2011 Dec 5.

Abstract

BACKGROUND

International travel poses a risk of destination-specific illness and may contribute to the global spread of infectious diseases. Despite this, little is known about the health characteristics and pretravel healthcare of US international travelers, particularly those at higher risk of travel-associated illness.

METHODS

We formed a national consortium (Global TravEpiNet) of 18 US clinics registered to administer yellow fever vaccination. We collected data regarding demographic and health characteristics, destinations, purpose of travel, and pretravel healthcare from 13235 international travelers who sought pretravel consultation at these sites from January 2009 through January 2011.

RESULTS

The destinations and itineraries of Global TravEpiNet travelers differed from those of the overall population of US international travelers. The majority of Global TravEpiNet travelers were visiting low- or lower-middle-income countries, and Africa was the most frequently visited region. Seventy-five percent of travelers were visiting malaria-endemic countries, and 38% were visiting countries endemic for yellow fever. Fifty-nine percent of travelers reported ≥1 medical condition. Atovaquone/proguanil was the most commonly prescribed antimalarial drug, and most travelers received an antibiotic for self-treatment of travelers' diarrhea. Hepatitis A and typhoid were the most frequently administered vaccines.

CONCLUSIONS

Data from Global TravEpiNet provide insight into the characteristics and pretravel healthcare of US international travelers who are at increased risk of travel-associated illness due to itinerary, purpose of travel, or existing medical conditions. Improved understanding of this epidemiologically significant population may help target risk-reduction strategies and interventions to limit the spread of infections related to global travel.

摘要

背景

国际旅行存在目的地特有疾病的风险,可能导致传染病在全球范围内传播。尽管如此,人们对美国国际旅行者的健康特征和旅行前医疗保健知之甚少,尤其是那些旅行相关疾病风险较高的旅行者。

方法

我们成立了一个由 18 家美国诊所组成的国家联盟(全球 TravEpiNet),这些诊所注册为黄热病疫苗接种机构。我们从 2009 年 1 月至 2011 年 1 月期间在这些地点寻求旅行前咨询的 13235 名国际旅行者那里收集了有关人口统计学和健康特征、目的地、旅行目的和旅行前医疗保健的数据。

结果

Global TravEpiNet 旅行者的目的地和行程与美国国际旅行者的总体人群不同。大多数 Global TravEpiNet 旅行者前往低收入或中下收入国家,非洲是最常去的地区。75%的旅行者前往疟疾流行国家,38%的旅行者前往黄热病流行国家。59%的旅行者报告有≥1种疾病。阿托伐醌/普喹胺是最常开的抗疟药物,大多数旅行者接受抗生素治疗旅行者腹泻。甲型肝炎和伤寒疫苗接种最频繁。

结论

来自 Global TravEpiNet 的数据提供了有关因行程、旅行目的或现有医疗条件而增加旅行相关疾病风险的美国国际旅行者的特征和旅行前医疗保健的见解。更好地了解这一具有重要流行病学意义的人群,可能有助于确定降低风险的策略和干预措施,以限制与全球旅行相关的感染传播。

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