过去一年内在旅行者腹泻高风险地区的既往暴露与旅行者腹泻有显著的保护作用相关：一项针对前往南亚旅行者的前瞻性观察性队列研究。

Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia.

机构信息

Swiss Tropical and Public Health Institute Basel, University of Basel, Socinstrasse 57, Basel, Switzerland.

Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, Zürich, Switzerland.

出版信息

J Travel Med. 2017 Sep 1;24(5). doi: 10.1093/jtm/tax056.

DOI:10.1093/jtm/tax056

PMID:28931148

Abstract

BACKGROUND

Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian subcontinent.

METHODS

An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression.

RESULTS

Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel destination is a key risk factor for the occurrence of TD. Travelling to India or Nepal vs Bhutan is associated with an increased risk for TD (OR 6.68 and 6.62, respectively). A length of stay of more than 3 weeks compared to less than 2 weeks is also associated with a significantly increased risk (OR 5.45). Having stayed in a high-risk area for travellers' diarrhoea within the past year before the current trip is associated with a significantly decreased risk (OR 0.19). No association was found between consumption of high risk food (i.e. tap water, ice cream, raw meat and hamburgers) and travellers' diarrhoea.

CONCLUSION

Travellers' diarrhoea is a frequent problem in travellers to the Indian subcontinent. Previous exposure in a high-risk area for travellers' diarrhoea within the past year appears to have a significant protective effect. Furthermore, an association between the occurrence of travellers' diarrhoea and travel destination and length of stay, respectively, was observed. Consumption of risk food did not confer a TD risk in our study.

摘要

背景

旅行者腹泻是旅行者中最常见的健康问题。根据所访问的地区不同，多达 40%的旅行者在两周的旅行中会出现腹泻。本研究旨在评估前往印度次大陆旅行者中旅行者腹泻的危险因素。

方法

一项观察性前瞻性多中心队列研究调查了前往印度次大陆的旅行者。参与者填写了评估旅行者腹泻发生率和确定潜在危险因素的问卷。对协变量进行单变量评估，然后进行多变量回归。

结果

共有 226 名旅行者参加了这项研究，其中 178 名旅行者填写了旅行前后的问卷。总的来说，旅行者腹泻的发病率为 38.2%。旅行目的地是旅行者腹泻发生的关键危险因素。前往印度或尼泊尔与前往不丹相比，旅行者腹泻的风险增加（OR 分别为 6.68 和 6.62）。与停留不到 2 周相比，停留超过 3 周也与显著增加的风险相关（OR 5.45）。与本次旅行前过去 1 年内曾在旅行者腹泻高风险地区停留相比，旅行者腹泻的风险显著降低（OR 0.19）。在我们的研究中，未发现食用高危食物（即自来水、冰淇淋、生肉和汉堡）与旅行者腹泻之间存在关联。