Stoney Rhett J, Han Pauline V, Barnett Elizabeth D, Wilson Mary E, Jentes Emily S, Benoit Christine M, MacLeod William B, Hamer Davidson H, Chen Lin H
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia.
Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Am J Trop Med Hyg. 2017 Jun;96(6):1388-1393. doi: 10.4269/ajtmh.16-0447.
AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic regression models. Of 628 travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms. Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin, azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of 108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took loperamide during travel. Of 172 with TD during travel, 24% stopped planned activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during travel, six (13%) stopped planned activities. International travelers continue to experience diarrhea and other GI symptoms, resulting in disruption of planned activities and healthcare visits for some. Although these illnesses resulted in interruption of travel plans, a relatively small proportion took prescribed antibiotics.
摘要
这项前瞻性队列研究描述了来自波士顿地区的国际旅行者的旅行者腹泻（TD）和非TD胃肠道（GI）症状，TD与旅行者特征和饮食习惯的关联，处方止泻药物的使用，以及TD和非TD GI症状对旅行期间和旅行后计划活动的影响。我们纳入了在波士顿地区三家旅行诊所接受旅行前咨询并完成三部分调查的成年人：旅行前、旅行期间和旅行后（返回后2 - 4周）。TD被定义为自我报告的腹泻，伴有或不伴有恶心/呕吐、腹痛或发热。通过χ检验评估分类变量的人口统计学和旅行特征，通过Wilcoxon秩和检验评估连续变量。饮食习惯分析使用逻辑广义估计方程模型或逻辑回归模型。在628名旅行者中，208人（33%）经历了TD，45人（7%）经历了非TD GI症状。在208名患有TD的旅行者中，分别有128人（64%）、71人（36%）和123人（62%）在旅行前被开了环丙沙星、阿奇霉素和/或洛哌丁胺。在旅行期间，108人中有39人（36%）服用了环丙沙星，55人中有20人（38%）服用了阿奇霉素，99人中有28人（28%）服用了洛哌丁胺。在旅行期间患有TD的172人中，24%停止了计划活动，2%住院治疗。在旅行期间有非TD GI症状的31人中，6人（13%）停止了计划活动。国际旅行者继续经历腹泻和其他GI症状，导致一些人的计划活动中断并需要就医。尽管这些疾病导致旅行计划中断，但服用处方抗生素的比例相对较小。
