旅行者中可能接触狂犬病的预测因素：一项病例对照研究。
Predictors of possible exposure to rabies in travellers: A case-control study.
作者信息
Bantjes S E, Ruijs W L M, van den Hoogen G A L, Croughs M, Pijtak-Radersma A H, Sonder G J B, Swaan C M, Haverkate M R
机构信息
National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands.
Infectious Disease Control, Public Health Service West-Brabant, PO Box 3024, 5003 DA, Tilburg, the Netherlands.
出版信息
Travel Med Infect Dis. 2022 May-Jun;47:102316. doi: 10.1016/j.tmaid.2022.102316. Epub 2022 Mar 27.
BACKGROUND
Timely administration of post-exposure prophylaxis (PEP) can prevent rabies. For non-vaccinated persons, PEP consists of multiple vaccinations and rabies immunoglobulin (RIG) on indication. Since RIG is scarce, the need for PEP could be restricted through preventing animal contact and pre-exposure vaccination. We aimed to identify determinants for possible rabies exposure among travellers to provide more targeted pre-travel advice.
METHOD
A case-control study was performed. Cases were defined as persons with a possible rabies exposure (category II or III injury according to WHO classification guidelines) in a rabies endemic country. Controls did not report exposure during travel. Multivariable logistic regression was performed.
RESULTS
229 cases and 1427 controls were included. Predictors (p < 0.05) of possible rabies exposure were young age, male sex, travelling to Western or Southeastern Asia, visiting a monkey park, pet ownership, previously visited the same country and considering oneself an experienced traveller. Negative predictors were travelling for business, visiting friends and relatives, and fear of animals.
CONCLUSIONS
Pre-travel advice should take the identified predictors into account to provide better targeted information and pre-exposure prophylaxis.
背景
及时进行暴露后预防（PEP）可预防狂犬病。对于未接种疫苗的人，PEP包括多次接种疫苗以及根据指征使用狂犬病免疫球蛋白（RIG）。由于RIG稀缺，可通过预防动物接触和暴露前接种疫苗来限制对PEP的需求。我们旨在确定旅行者中可能感染狂犬病的决定因素，以提供更具针对性的旅行前建议。
方法
进行了一项病例对照研究。病例定义为在狂犬病流行国家有可能感染狂犬病的人（根据世界卫生组织分类指南为II级或III级损伤）。对照组在旅行期间未报告暴露情况。进行了多变量逻辑回归分析。
结果
纳入了229例病例和1427例对照。可能感染狂犬病的预测因素（p < 0.05）为年龄较小、男性、前往西亚或东南亚、参观猴园、拥有宠物、曾访问过同一国家以及自认为是经验丰富的旅行者。负面预测因素为商务旅行、探亲访友以及害怕动物。
结论
旅行前建议应考虑已确定的预测因素，以提供更具针对性的信息和暴露前预防措施。
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