Locals get travellers' diarrhoea too: risk factors for diarrhoeal illness and pathogenic Escherichia coli infection across an urban-rural gradient in Ecuador.
Locals get travellers' diarrhoea too: risk factors for diarrhoeal illness and pathogenic Escherichia coli infection across an urban-rural gradient in Ecuador.
复制标题
当地人也会患上旅行者腹泻：厄瓜多尔城乡梯度地区腹泻病和致病性大肠杆菌感染的危险因素。
DOI：
10.1111/tmi.13183
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Levy,Karen
中科院分区：
文献类型：
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作者：
Smith,ShanonM;Montero,Lorena;Paez,Maritza;Ortega,Estefania;Hall,Eric;Bohnert,Kate;Sanchez,Xavier;Puebla,Edison;Endara,Pablo;Cevallos,William;Trueba,Gabriel;Levy,Karen
ObjectivesDiarrhoea is a common and well‐studied cause of illness afflicting international travellers. However, traveller's diarrhoea can also result from travel between high and low disease transmission regions within a country, which is the focus of this study.MethodsWe recruited participants for a case‐control study of diarrhoea at four sites along an urban‐rural gradient in Northern Ecuador: Quito, Esmeraldas, Borbón and rural communities outside of Borbón. At each of these sites, approximately 100 subjects with diarrhoea (cases) were recruited from Ministry of Health clinics and were age‐matched with subjects visiting the same clinics for other complaints (controls).ResultsTravellers to urban destinations had higher risk of diarrhoea and diarrhoeagenicEscherichia coli(DEC) infections. Travel to Quito was associated with diarrhoea (aOR = 2.01, 95% CI = 1.10–3.68) and travel to Guayaquil (another urban centre in Ecuador) was associated with Diffuse AdherentE. coliinfection (OR = 2.09, 95% CI = 1.01–4.33). Compared to those not travelling, urban origins were also associated with greater risk of diarrhoea in Esmeraldas (aOR = 2.28, 95% CI = 1.20–4.41), and with higher risk of diarrhoeagenicE. coliinfections in Quito (aOR = 2.61, 95% CI = 1.16–5.86), with >50% of travel from Quito and Esmeraldas specified to another urban destination.ConclusionsThis study suggests that individuals travelling from lower‐transmission regions (rural areas) to higher transmission regions (urban centres) within a single country are at a greater risk of acquiring a diarrhoea‐related illness. Investments to improve water, sanitation and hygiene conditions in urban areas could have impacts on outlying rural areas within a given country.
