+Redivi 网络中移民和旅行者的病毒性肝炎的临床流行病学特征。

Clinicoepidemiological characteristics of viral hepatitis in migrants and travellers of the +Redivi network.

机构信息

National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Carretera de Colmenar Km 9, 1, 28034, Madrid, Spain.

Unitat Medicina Tropical I Salut Internacional Vall d´Hebron-Drassanes, PROSICS, Av de Drassanes 17-21, 08001, Barcelona, Spain.

出版信息

Travel Med Infect Dis. 2019 May-Jun;29:51-57. doi: 10.1016/j.tmaid.2019.02.001. Epub 2019 Feb 6.

DOI:10.1016/j.tmaid.2019.02.001

PMID:30738196

Abstract

BACKGROUND

Continuous growth of mobile populations has influenced the global epidemiology of infectious diseases, including chronic and acute viral hepatitis.

METHOD

A prospective observational multicentre study was performed in a Spanish network of imported infections. Viral hepatitis cases from January 2009 to September 2017 were included.

RESULTS

Of 14,546 records, 723 (4.97%) had imported viral hepatitis, including 48 (6.64%) acute cases and 675 (93.36%) chronic cases. Of the 48 acute cases, 31 were travellers and immigrants returning from visiting friends or relatives (VFR), while 19 (61%) were acute Hepatitis A or Hepatitis B. Only 18.2% of VFR immigrants and 35% of travellers received pre-travel advice. Acute hepatitis was more frequent in VFR immigrants (AOR 2.59, CI95% 1.20-5.60) and travellers (AOR 2.83, CI95% 1.46-5.50) than immigrants. Of the 675 Chronic cases, 570 were immigrants, and 439 (77%) had chronic Hepatitis B. Chronic hepatitis was more frequent in immigrants (AOR 20.22, CI95% 11.64-35.13) and VFR immigrants (AOR 11.12, CI95% 6.20-19.94) than travellers.

CONCLUSIONS

Chronic viral hepatitis was typical of immigrants, acute viral hepatitis was common among travellers, and VFR immigrants had mixed risk. Improving pre-travel consultation and screening of immigrants may contribute to preventing new cases of viral hepatitis and avoiding community transmission.

摘要

背景

流动人口的持续增长影响了传染病的全球流行病学，包括慢性和急性病毒性肝炎。

方法

在西班牙输入性感染网络中进行了一项前瞻性观察性多中心研究。纳入 2009 年 1 月至 2017 年 9 月期间的病毒性肝炎病例。

结果

在 14546 份记录中，有 723 例（4.97%）为输入性病毒性肝炎，包括 48 例（6.64%）急性病例和 675 例（93.36%）慢性病例。在 48 例急性病例中，有 31 例是旅行者和移民，他们是探亲访友（VFR）返回，其中 19 例（61%）为急性甲型肝炎或乙型肝炎。只有 18.2%的 VFR 移民和 35%的旅行者接受了旅行前咨询。VFR 移民（AOR 2.59，95%CI 1.20-5.60）和旅行者（AOR 2.83，95%CI 1.46-5.50）患急性肝炎的风险高于移民。在 675 例慢性病例中，有 570 例为移民，其中 439 例（77%）患有慢性乙型肝炎。移民（AOR 20.22，95%CI 11.64-35.13）和 VFR 移民（AOR 11.12，95%CI 6.20-19.94）患慢性肝炎的风险高于旅行者。