高危儿童的旅行者腹泻：一项来自西班牙数据库的观察性研究。

Travelers' Diarrhea in Children at Risk: An Observational Study From a Spanish Database.

作者信息

Soriano-Arandes Antoni, García-Carrasco Emely, Serre-Delcor Nuria, Treviño-Maruri Begoña, Sulleiro Elena, Ruiz-Giardín José Manuel, Sanmartín Juan Víctor, Torrús Diego, Rojo-Marcos Gerardo, Cuadros Juan, Martín-Echevarría Esteban, López-Vélez Rogelio, Molina Israel, Pérez-Molina José Antonio

机构信息

From the*Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain; †Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; ‡Hospital de Fuenlabrada, Madrid, Spain; §Hospital General Universitario de Alicante, Alicante, Spain; ¶Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain; and ‖Hospital Universitario de Guadalajara, Guadalajara, Spain.

出版信息

Pediatr Infect Dis J. 2016 Apr;35(4):392-5. doi: 10.1097/INF.0000000000001049.

DOI:10.1097/INF.0000000000001049

PMID:26974746

Abstract

BACKGROUND

Gastrointestinal symptoms are a common cause of consultation about children traveling to or coming from developing countries. The aim of this study was to identify the risk factors associated with gastrointestinal syndrome in children who travel.

METHODS

A prospective observational analytical and multicenter study was performed within +Redivi, a Spanish Tropical Medicine network on imported infections, from January 2009 to December 2013. All participants aged 16 years and younger were included in the analysis. Ethical approval was obtained from all the participating centers.

RESULTS

A total of 606 children ≤16 years of age were registered in the +Redivi database during the study period. Median age was 8.7 years (interquartile range, 4.4-12.4 years), 65.8% (399/606) were immigrants, 90% were >2 years old and 54% were male. Median travel duration, excluding immigrants, was 50 days (interquartile range, 30-150 days). Children with gastrointestinal symptoms represented 13.5% (82/606) of total consultations. A significant association was found in bivariate analysis between gastrointestinal disorder and age <2 years (P < 0.01) and travel duration (P = 0.046). Immigrants had less gastrointestinal disorders than tourists (P < 0.05). The most prevalent infection was protozoan in 23.4% (142/606), and Giardia intestinalis was the most common pathogen in 10.1% (61/606) of total children. Independent risk factors for gastrointestinal symptoms were tourist and traveler child visiting friends and relatives (P = 0.03), travel duration <90 days (P = 0.008) and bacterial cause (P < 0.001).

CONCLUSIONS

Traveling children who developed a gastrointestinal syndrome represented 13.5% of the total pediatric consultations in +Redivi. Independent risk factors were tourist or traveler visiting friends and relatives, travel duration <90 days and bacterial infection. G. intestinalis was the most common infectious agent causing a gastrointestinal disorder in the traveler children.

摘要

背景

胃肠道症状是前往或来自发展中国家的儿童就诊的常见原因。本研究的目的是确定旅行儿童胃肠道综合征的相关危险因素。

方法

2009年1月至2013年12月期间，在西班牙热带医学网络+Redivi（一个关于输入性感染的网络）内进行了一项前瞻性观察分析多中心研究。所有16岁及以下的参与者均纳入分析。所有参与中心均获得了伦理批准。

结果

研究期间，+Redivi数据库中共登记了606名16岁及以下儿童。中位年龄为8.7岁（四分位间距，4.4 - 12.4岁），65.8%（399/606）为移民，90%年龄大于2岁，54%为男性。不包括移民，中位旅行时长为50天（四分位间距，30 - 150天）。有胃肠道症状的儿童占总就诊人数的13.5%（82/606）。在双变量分析中，发现胃肠道疾病与年龄<2岁（P < 0.01）和旅行时长（P = 0.046）之间存在显著关联。移民的胃肠道疾病比游客少（P < 0.05）。最常见的感染是原生动物感染，占23.4%（142/606），小肠贾第虫是所有儿童中最常见的病原体，占10.1%（61/606）。胃肠道症状的独立危险因素是游客及探亲访友的旅行儿童（P = 0.03）、旅行时长<90天（P = 0.008）和细菌感染原因（P < 0.001）。