Herbinger K-H, Metzner M, Schmidt V, Beissner M, Nothdurft H D, von Sonnenburg F, Löscher T
Department of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München, Leopoldstraße 5, 80802, Munich, Germany,
Infection. 2013 Dec;41(6):1079-87. doi: 10.1007/s15010-013-0528-6. Epub 2013 Sep 8.
Anaemia is a frequently diagnosed condition which can develop as a consequence of numerous factors, including infectious diseases (IDs). Travelling, especially in sub-/tropical regions, leads to an elevated risk of contracting IDs. The aim of our study was to assess the epidemiological significance of IDs in inducing anaemia among a large cohort of returned travellers.
This was a cross-sectional study in which data on 17,009 returned travellers aged 20-49 years who consulted the travel medicine clinic of the University of Munich between 1999 and 2011 were retrieved and analysed.
Of the returned travellers, 8.3 % (6.0 % of males/10.4 % of females) were diagnosed with anaemia. The prevalence of anaemia was significantly elevated among patients of African (21.4/28.3 %) and Asian (11.6/15.7 %) origin. When the study population was restricted to the 14,636 travellers of German origin, 7.1 % of the returned travellers (4.6/9.6 %) were diagnosed with anaemia. The prevalence was significantly elevated among patients who travelled for >30 days (5.7 of males/10.6 % of females) and for male travellers visiting friends and relatives (7.7 %). However, these correlations were confounded by malaria. The prevalence of anaemia was significantly elevated only among returned travellers diagnosed with malaria (36.1 of males/26.9 % of females) and with symptomatic intestinal Entamoeba histolytica infections (30.0/33.3 %).
Following the exclusion of confounding by malaria from the statistical analysis, the prevalence of anaemia was found to be significantly elevated among patients of African and Asian origin, and among patients of German origin who had travelled for >30 days, it could be mainly attributable to chronic, long-lasting causes. Although more than 550 travel-associated IDs were assessed in our study, only symptomatic intestinal Entamoeba histolytica infections and, to an even larger extent, malaria were determined to be of epidemiological significance for inducing anaemia among travellers.
贫血是一种常见的诊断疾病，其可由多种因素引起，包括传染病（IDs）。旅行，尤其是在亚热带/热带地区旅行，会增加感染IDs的风险。我们研究的目的是评估IDs在一大群归国旅行者中诱发贫血的流行病学意义。
这是一项横断面研究，收集并分析了1999年至2011年间在慕尼黑大学旅行医学诊所就诊的17009名20至49岁归国旅行者的数据。
在归国旅行者中，8.3%（男性占6.0%/女性占10.4%）被诊断为贫血。非洲（21.4%/28.3%）和亚洲（11.6%/15.7%）血统的患者贫血患病率显著升高。当研究人群仅限于14636名德国血统的旅行者时，7.1%的归国旅行者（男性占4.6%/女性占9.6%）被诊断为贫血。旅行超过30天的患者（男性占5.7%/女性占10.6%）以及探亲访友的男性旅行者（7.7%）中患病率显著升高。然而，这些相关性因疟疾而混淆。仅在被诊断为疟疾（男性占36.1%/女性占26.9%）和有症状的肠道溶组织内阿米巴感染（30.0%/33.3%）的归国旅行者中，贫血患病率显著升高。
在从统计分析中排除疟疾的混杂因素后，发现非洲和亚洲血统的患者以及旅行超过30天的德国血统患者中贫血患病率显著升高，这可能主要归因于慢性、长期的病因。尽管我们的研究评估了550多种与旅行相关的IDs，但仅发现有症状的肠道溶组织内阿米巴感染以及在更大程度上疟疾对旅行者中诱发贫血具有流行病学意义。
