Business travel-associated illness: a GeoSentinel analysis.
Business travel-associated illness: a GeoSentinel analysis.
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DOI：
10.1093/jtm/tax097
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发表时间：
2018-01-01
影响因子：
25.7
通讯作者：
Wilson, Mary E
中科院分区：
文献类型：
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作者：
Chen, Lin H;Leder, Karin;Wilson, Mary E
背景：对一大批商务旅行者的分析将有助于临床医生专注于常见和严重的疾病。我们的目的是描述商务旅行者中与旅行相关的健康问题。方法：地理哨兵监测网络由29个国家的旅行和热带医学诊所组成；对1997年1月1日至2014年12月31日期间国际旅行后评估的患病商务旅行者进行描述性分析。结果：1997-2014年间，在12203名商务旅行者中(14045例合格诊断)，大多数(97%)是20-岁的成年人；大多数(74%)报告来自西欧或北美；三分之二是男性。大多数(86%)是门诊患者。不到一半(45%)的人报告了旅行前的医疗保健遭遇。经常暴露的地区是撒哈拉以南非洲(37%)、东南亚(15%)和南亚(14%)。最常见的诊断是疟疾(9%)、急性不明原因腹泻(8%)、病毒综合征(6%)、急性细菌性腹泻(5%)和慢性腹泻(4%)。在1079名疟疾患者中，有973人(90%)报告了疟疾种类，主要是在撒哈拉以南非洲获得的恶性疟原虫。在获得疟疾化学预防信息的584人(54%)中，92%的人没有参加任何疗程或未完成疗程。报告死亡13人，其中一半以上死于疟疾，其他死于肺炎、伤寒、狂犬病、类鼻疽和化脓性脓肿。疟疾导致了相当大的发病率和死亡率，特别是在前往撒哈拉以南非洲的商务旅行者中。未充分使用或未使用化学预防是导致疟疾病例的原因。通过加强对疟疾化学预防的坚持和对疫苗可预防疾病的有针对性的疫苗接种，可以减少商务旅行者的死亡。旅行前建议是为商务旅行者提供的，目前没有得到充分利用，需要改进。
Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers.Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014.Results: Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess.Conclusions: Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.