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Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru.

Authors :
Jennings MC
Tilley DH
Ballard SB
Villanueva M
Costa FM
Lopez M
Steinberg HE
Luna CG
Meza R
Silva ME
Gilman RH
Simons MP
Maves RC
Cabada MM
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.

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