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从加勒比地区返回的加拿大旅行者中的皮肤幼虫移行症:来自加拿大旅行网络(CanTravNet)的10年监测分析。

Cutaneous larva migrans in Canadian travellers returning from the Caribbean: A 10-year surveillance analysis from CanTravNet.

作者信息

Boggild Andrea, Bierbrier Rachel, Libman Michael, Yansouni Cedric, McCarthy Anne, Hajek Jan, Ghesquiere Wayne, Mirzanejad Yazdan, Plewes Katherine, Vincelette Jean, Kuhn Susan, Plourde Pierre, Greenaway Christina, Kain Kevin, Morris Shaun, Barkati Sapha

机构信息

Division of Infectious Diseases, Department of Medicine, University Health Network and the University of Toronto, Toronto, ON.

Institute of Medical Science, University of Toronto, Toronto, ON.

出版信息

Can Commun Dis Rep. 2025 May 1;51(5):179-186. doi: 10.14745/ccdr.v51i05a04. eCollection 2025 May.

Abstract

BACKGROUND

Cutaneous larva migrans (CLM) is one of the most common dermatoses affecting travellers to the tropics.

OBJECTIVE

To describe demographic and travel correlates of travellers returning to Canada from the Caribbean with CLM over a 10-year pre-pandemic period.

METHODS

Demographic and travel-related data on ill travellers encountered either during or after completion of their travel/migration and seen in any of eight CanTravNet sites from January 1, 2009, to December 31, 2018, with a final diagnosis of CLM were extracted and analyzed. During this time, access to first-line therapy, ivermectin, was available via Health Canada's Special Access Programme.

RESULTS

Of 17,644 travellers presenting to CanTravNet over the enrolment period, 328 (1.9%) returned from the Caribbean with CLM. The median age of travellers with CLM was 34 years (interquartile range: 25-50 years), with females accounting for 58% of cases. Ninety-five percent (n=313) travelled for tourism. Jamaica was the most common source country, with 216 cases (67%), followed by Barbados (n=27, 8%) and the Dominican Republic (n=23, 7%). Cases in 2018 were imported predominantly from Jamaica (n=58, 73%) and the Dominican Republic (n=12, 15%). Age, sex and purpose of travel were similar across years. The percentage of all imported cases of CLM that originated from the Caribbean increased from 9% in 2016 to 24.5% in 2018.

CONCLUSION

Proportions and absolute numbers of CLM in travellers returning to Canada from the Caribbean are increasing. Improved awareness of this common dermatosis among physicians and travellers, as well as improved access to effective therapies, will reduce associated morbidity.

摘要

背景

皮肤幼虫移行症(CLM)是影响前往热带地区旅行者的最常见皮肤病之一。

目的

描述在大流行前10年期间从加勒比地区返回加拿大且患有CLM的旅行者的人口统计学特征及旅行相关因素。

方法

提取并分析了2009年1月1日至2018年12月31日期间在八个加拿大旅行网络(CanTravNet)站点中遇到的患病旅行者的人口统计学和旅行相关数据,这些旅行者在旅行/迁徙期间或结束后被诊断为CLM。在此期间,通过加拿大卫生部的特殊准入计划可获得一线治疗药物伊维菌素。

结果

在登记期间前往CanTravNet的17644名旅行者中,328人(1.9%)从加勒比地区返回且患有CLM。患有CLM的旅行者的中位年龄为34岁(四分位间距:25 - 50岁),女性占病例的58%。95%(n = 313)的旅行者是去旅游。牙买加是最常见的来源国,有216例(67%),其次是巴巴多斯(n = 27,8%)和多米尼加共和国(n = 23,7%)。2018年的病例主要从牙买加(n = 58,73%)和多米尼加共和国(n = 12,15%)输入。各年份的年龄、性别和旅行目的相似。源自加勒比地区的所有CLM输入病例的百分比从2016年的9%增加到2018年的24.5%。

结论

从加勒比地区返回加拿大的旅行者中CLM的比例和绝对数量正在增加。提高医生和旅行者对这种常见皮肤病的认识,以及改善获得有效治疗的机会,将降低相关发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d2/12360410/5e96ddca1e5d/510504-f1.jpg

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