Back to Search
Start Over
Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2017 May; Vol. 96 (5), pp. 1097-1106. Date of Electronic Publication: 2017 Feb 06. - Publication Year :
- 2017
-
Abstract
- AbstractIn Cusco, Peru, and South America in general, there is a dearth of travelers' diarrhea (TD) data concerning the clinical features associated with enteropathogen-specific infections and destination-specific risk behaviors. Understanding these factors would allow travel medicine providers to tailor interventions to patients' risk profiles and travel destination. To characterize TD etiology, evaluate region-specific TD risk factors, and examine relationships between preventive recommendations and risk-taking behaviors among medium- to long-term travelers' from high-income countries, we conducted this case-case analysis using 7 years of prospective surveillance data from adult travelers' presenting with TD to a physician in Cusco. At the time of enrollment, participants provided a stool sample and answered survey questions about demographics, risk behaviors, and the clinical features of illness. Stool samples were tested for norovirus (NV), bacteria, and parasites using conventional methods. Data obtained were then analyzed using case-case methods. NV (14%), enterotoxigenic Escherichia coli (11%), and Campylobacter (9%), notably ciprofloxacin-resistant Campylobacter , were the most frequently identified pathogens among adults with TD. Coinfection with multiple enteropathogens occurred in 5% of cases. NV caused severe disease relative to other TD-associated pathogens identified, confining over 90% of infected individuals to bed. Destination-specific risk factors include consumption of the local beverage "chicha," which was associated with Cryptosporidium infection. Preventive interventions, such as vaccines, directed against these pathogens could significantly reduce the burden of TD.
- Subjects :
- Adolescent
Adult
Aged
Campylobacter isolation & purification
Campylobacter Infections diagnosis
Campylobacter Infections microbiology
Diarrhea diagnosis
Diarrhea microbiology
Diarrhea virology
Enterotoxigenic Escherichia coli isolation & purification
Escherichia coli Infections diagnosis
Escherichia coli Infections microbiology
Female
Gastroenteritis diagnosis
Gastroenteritis virology
Humans
Middle Aged
Norovirus isolation & purification
Peru epidemiology
Risk-Taking
Travel
Campylobacter Infections epidemiology
Diarrhea epidemiology
Escherichia coli Infections epidemiology
Gastroenteritis epidemiology
Public Health Surveillance
Travel Medicine
Subjects
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 96
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 28167602
- Full Text :
- https://doi.org/10.4269/ajtmh.16-0633