Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands.
International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Calle de San Oleguer, 17, 08001 Barcelona, Spain.
J Travel Med. 2024 Aug 3;31(6). doi: 10.1093/jtm/taae067.
BACKGROUND: High-speed global travel, increased trade, world population growth, migration, urbanization and climate change have favoured the emergence and spread of pathogens. We aimed to analyse the evolution of imported infections in Spain during 2012-2022 and the potential impact of some of the abovementioned factors on differential morbidity patterns. METHODS: In this retrospective study (January 2012 to December 2022), we analysed data collected by the +Redivi network across 25 health centres. The network's standardised database records new cases of imported infections, including patient demographics, travel history, pre-travel advice and diagnostic information. To assess outcome rates over time and potential interactions, we constructed penalized weighted models to reduce the bias related to a low event rate and used weighted logistic regression for morbidity outcomes. RESULTS: We recorded 25 632 episodes, comprising 13 913 migrants, 4047 visiting friends and relatives (VFR) immigrants, 392 VFR travellers and 7280 travellers. Most immigrants came from South America (48.3%), Sub-Saharan Africa (28.5%), North Africa (6.6%), South Central Asia (5.4%) and Central America/Caribbean (5.3%). The most common regions visited by travellers were Sub-Saharan Africa (33.5%), South America (24.5%), Central America/Caribbean (13.5%), Southeast Asia (12%) and South Central Asia (10%). The proportion of diagnoses of malaria, strongyloidiasis and unspecified self-limiting febrile syndrome < 3 weeks remained unchanged during the study period. An increased frequency of diagnosis was reported for schistosomiasis, blastocystosis, giardiasis, dengue, diarrhoea, new cases of HIV, latent and pulmonary tuberculosis, whereas a decrease was reported for syphilis, chikungunya fever, Chagas disease and eosinophilia. We detected interactions between time and sex or type of participant across the different diagnoses. CONCLUSIONS: Our study underscores the importance of epidemiological data in understanding infectious diseases dynamics among travellers and migrants, emphasizing how demographic shifts, migration trends and healthcare policies affect disease profiles. Comprehensive data play an essential role in enhancing public health policies and travel advice.
背景：高速全球化旅行、贸易增加、世界人口增长、移民、城市化和气候变化促进了病原体的出现和传播。我们旨在分析 2012-2022 年期间西班牙输入性感染的演变情况，以及上述因素对不同发病模式的潜在影响。
方法：在这项回顾性研究中（2012 年 1 月至 2022 年 12 月），我们分析了 +Redivi 网络在 25 个卫生中心收集的数据。该网络的标准化数据库记录了新的输入性感染病例，包括患者人口统计学特征、旅行史、旅行前咨询和诊断信息。为了评估随时间推移的结果率和潜在的相互作用，我们构建了惩罚加权模型以减少与低事件率相关的偏差，并使用加权逻辑回归进行发病结局分析。
结果：我们记录了 25632 例病例，包括 13913 名移民、4047 名探亲移民、392 名探亲旅行者和 7280 名旅行者。大多数移民来自南美洲（48.3%）、撒哈拉以南非洲（28.5%）、北非（6.6%）、南亚中部（5.4%）和中美洲/加勒比地区（5.3%）。旅行者最常去的地区是撒哈拉以南非洲（33.5%）、南美洲（24.5%）、中美洲/加勒比地区（13.5%）、东南亚（12%）和南亚中部（10%）。研究期间，疟疾、旋毛虫病和未特指的自限性发热综合征<3 周的诊断比例保持不变。血吸虫病、芽囊原虫病、贾第虫病、登革热、腹泻、新诊断的 HIV、潜伏和肺结核的诊断频率增加，而梅毒、基孔肯雅热、恰加斯病和嗜酸性粒细胞增多症的诊断频率降低。我们发现不同诊断之间时间与性别或参与者类型之间存在相互作用。
结论：我们的研究强调了流行病学数据在了解旅行者和移民中传染病动态方面的重要性，强调了人口结构变化、移民趋势和医疗保健政策如何影响疾病谱。全面的数据在加强公共卫生政策和旅行建议方面发挥着至关重要的作用。
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