Itzkowitz Eyal, Alpert Evan A, Farojeh Abdulhadi Z, Zimmerman Deena R, Schwartz Eli, Lachish Tamar
Nephrology Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel.
Department of Emergency Medicine, Shaare Zedek Medical Center, Jerusalem 9103102, Israel.
Trop Med Infect Dis. 2023 Jun 13;8(6):319. doi: 10.3390/tropicalmed8060319.
Information regarding post-travel morbidity is usually reported via dedicated post-travel clinics and mainly relates to travelers returning from low-middle-income countries (LMIC), however, the spectrum of morbidity seen within the community setting is scarcely reported. This prospective observational study among visitors to 17 community Urgent Care Centers (UCC) was designed to evaluate the reasons for post-travel community clinic visits and to compare travelers returning from LMIC to high-income countries (HIC). All visitors within one-month post-travel to all destinations were included. A total of 1580 post-travel visits were analyzed during 25 months. Travelers to LMICs were younger (mean 36.8 years old vs. 41.4 in the HIC group) and stayed longer periods abroad (30.1 ± 41.2 vs. 10.0 ± 10.6 in the HIC group) but more of them had pre-travel vaccines (35.5% vs. 6.6%). Travel-related morbidity was significantly more common in the LMIC group 58.3% (253/434) vs. 34.1% (391/1146) in the HIC group, ( < 0.001). Acute diarrhea was the leading cause of morbidity after visiting LMIC (28.8%) and was significantly more common than in the HIC (6.6%, < 0.001). Other common morbidities in the LMIC cohort were respiratory (23.3%), cutaneous (15.8%), and injuries (9.9%). In the HIC group, the common morbidities were respiratory (37.3%), and diarrhea composed only 6.6% of the complaints. Our study group represents a less biased sample of travelers to LMIC as well as HIC, therefore, data from the UCC setting and at the specialized travel clinics complete each other in understanding the true extent of morbidity in travelers.
关于旅行后发病情况的信息通常通过专门的旅行后诊所报告，且主要涉及从中低收入国家（LMIC）返回的旅行者，然而，社区环境中所见到的发病谱却鲜有报道。这项针对17家社区紧急护理中心（UCC）访客的前瞻性观察研究旨在评估旅行后前往社区诊所就诊的原因，并比较从中低收入国家返回的旅行者与从高收入国家（HIC）返回的旅行者。纳入了所有在旅行后一个月内前往所有目的地的访客。在25个月期间共分析了1580次旅行后就诊情况。前往中低收入国家的旅行者更年轻（平均36.8岁，而高收入国家组为41.4岁），在国外停留时间更长（30.1±41.2天，而高收入国家组为10.0±10.6天），但他们中更多人在旅行前接种了疫苗（35.5%对6.6%）。与旅行相关的发病情况在中低收入国家组中明显更常见，为58.3%（253/434），而高收入国家组为34.1%（391/1146），（P<0.001）。急性腹泻是访问中低收入国家后发病的主要原因（28.8%），且明显比高收入国家组更常见（6.6%，P<0.001）。中低收入国家队列中的其他常见发病情况为呼吸道疾病（23.3%）、皮肤疾病（15.8%）和损伤（9.9%）。在高收入国家组中，常见发病情况为呼吸道疾病（37.3%），腹泻仅占主诉的6.6%。我们的研究组代表了前往中低收入国家以及高收入国家的旅行者中偏差较小的样本，因此，来自社区紧急护理中心环境和专门旅行诊所的数据在理解旅行者发病的真实程度方面相互补充。
