Markwalder K, Altwegg M, Kehl O
Schweiz Med Wochenschr. 1986 Jul 26;116(30):999-1002.
Diarrhea is not only the most common health hazard during travel in the tropics but also the most frequent condition which prompts returning travellers to see a physician. The prevalence of bacterial and parasitic enteropathogens in people attending our outpatient department after returning from the tropics has been studied and the laboratory results of stool examinations have been compared with clinical symptoms. Of the 173 persons enrolled, 19 (11%) harboured bacterial pathogens and pathogenic protozoans (Giardia lamblia and Entamoeba histolytica) were found in 26 (15%). The data of 156 patients were evaluated. Enteropathogenic bacteria and/or protozoa were found in 29 (46%) of the 63 patients presenting with diarrhea at the time of investigation. In contrast, 10 (11%) of the 93 asymptomatic subjects had enteropathogenic organisms in the feces (p less than 0.01). The results appear to confirm that bacteriological stool examinations of travellers returning from the tropics without diarrhea are not usually indicated, even if a history of transient travellers' diarrhea is reported. Parasitological investigations are justified in this group only if asymptomatic carriage of Giardia or E. histolytica is considered an indication for specific treatment.
腹泻不仅是热带地区旅行期间最常见的健康危害，也是促使回国旅行者就医的最常见病症。我们对从热带地区回国后到门诊就诊的人群中细菌和寄生虫肠道病原体的流行情况进行了研究，并将粪便检查的实验室结果与临床症状进行了比较。在纳入研究的173人中，19人（11%）携带细菌性病原体，26人（15%）检测出致病性原生动物（蓝氏贾第鞭毛虫和溶组织内阿米巴）。对156例患者的数据进行了评估。在调查时出现腹泻的63例患者中，29例（46%）发现有肠道致病细菌和/或原生动物。相比之下，93例无症状受试者中有10例（11%）粪便中存在肠道致病生物（p<0.01）。结果似乎证实，对于从热带地区回国且无腹泻症状的旅行者，通常无需进行粪便细菌学检查，即使有短期旅行者腹泻史报告。仅当认为贾第虫或溶组织内阿米巴的无症状携带是特定治疗的指征时，对该组人群进行寄生虫学调查才是合理的。
