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Travel-related health risks in moderately and severely immunocompromised patients: a case-control study.
J Travel Med. 2016 Mar; 23(3)JT

Abstract

BACKGROUND

The number of immunocompromised persons travelling to tropical countries is increasing. The hypothesis is that this population is at increased risk of travel-related health problems but there are few data to support it. The objective was to assess the risk of travel-related health problems in immunocompromised persons when compared with the general population of travellers.

METHODS

A retrospective matched case-control study was performed. Cases were moderately or severely immunocompromised persons travelling to tropical countries and controls were non-immunocompromised persons, matched for demographic and travel characteristics. All participants responded to a phone questionnaire, asking them about any health problem they may have encountered while travelling or during the month following their return. The primary outcome was the incidence of a significant clinical event defined as repatriation, hospitalization during the travel or during the month following the return if due to a travel-related health problem and medical consultations during the trip.

RESULTS

One hundred and sixteen moderately or severely immunocompromised cases [HIV infection (15), active cancer (25), splenectomized (20), solid organ transplant recipients (4) and use of systemic immunosuppressive medication (52)] and 116 controls were included. Incidence rates of significant clinical events were higher in immunocompromised travellers (9/116, 7.8%) than in controls (2/116, 1.7%) [OR = 4.8 , 95% CI 1.01-22.70; P = 0.048]. Most cases were related to infectious diseases (5/9, 55.5%), others were pulmonary embolism (2/9, 22%), inflammatory disease and trauma (1/9, 11.1% each). There was no significant difference between the two groups regarding common health problems.

CONCLUSION

Moderately and severely immunocompromised travellers are at increased risk of developing a serious health problem during or after a trip in a tropical country. They should be well informed about the specific risks they are particularly prone to. Travel medicine health professionals should favour effective preventive measures for immunocompromised travellers and envisage stand-by antibiotic treatment.

Authors+Show Affiliations

Travel Clinic, Department of Ambulatory Care and Community Medicine, University Hospital, Lausanne, Switzerland souad.dekkiche@gmail.com.Travel Clinic, Department of Ambulatory Care and Community Medicine, University Hospital, Lausanne, Switzerland Infectious Disease Service, University Hospital, Lausanne, Switzerland.Travel Clinic, Department of Ambulatory Care and Community Medicine, University Hospital, Lausanne, Switzerland Swiss Tropical and Public Health Institute, Basel, Switzerland.Travel Clinic, Department of Ambulatory Care and Community Medicine, University Hospital, Lausanne, Switzerland Infectious Disease Service, University Hospital, Lausanne, Switzerland Swiss Tropical and Public Health Institute, Basel, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26929155

Citation

Dekkiche, Souad, et al. "Travel-related Health Risks in Moderately and Severely Immunocompromised Patients: a Case-control Study." Journal of Travel Medicine, vol. 23, no. 3, 2016.
Dekkiche S, de Vallière S, D'Acremont V, et al. Travel-related health risks in moderately and severely immunocompromised patients: a case-control study. J Travel Med. 2016;23(3).
Dekkiche, S., de Vallière, S., D'Acremont, V., & Genton, B. (2016). Travel-related health risks in moderately and severely immunocompromised patients: a case-control study. Journal of Travel Medicine, 23(3). https://doi.org/10.1093/jtm/taw001
Dekkiche S, et al. Travel-related Health Risks in Moderately and Severely Immunocompromised Patients: a Case-control Study. J Travel Med. 2016;23(3) PubMed PMID: 26929155.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Travel-related health risks in moderately and severely immunocompromised patients: a case-control study. AU - Dekkiche,Souad, AU - de Vallière,Serge, AU - D'Acremont,Valérie, AU - Genton,Blaise, Y1 - 2016/02/29/ PY - 2015/12/18/accepted PY - 2016/3/2/entrez PY - 2016/3/2/pubmed PY - 2016/12/15/medline KW - Immunocompromised KW - risk KW - travel JF - Journal of travel medicine JO - J Travel Med VL - 23 IS - 3 N2 - BACKGROUND: The number of immunocompromised persons travelling to tropical countries is increasing. The hypothesis is that this population is at increased risk of travel-related health problems but there are few data to support it. The objective was to assess the risk of travel-related health problems in immunocompromised persons when compared with the general population of travellers. METHODS: A retrospective matched case-control study was performed. Cases were moderately or severely immunocompromised persons travelling to tropical countries and controls were non-immunocompromised persons, matched for demographic and travel characteristics. All participants responded to a phone questionnaire, asking them about any health problem they may have encountered while travelling or during the month following their return. The primary outcome was the incidence of a significant clinical event defined as repatriation, hospitalization during the travel or during the month following the return if due to a travel-related health problem and medical consultations during the trip. RESULTS: One hundred and sixteen moderately or severely immunocompromised cases [HIV infection (15), active cancer (25), splenectomized (20), solid organ transplant recipients (4) and use of systemic immunosuppressive medication (52)] and 116 controls were included. Incidence rates of significant clinical events were higher in immunocompromised travellers (9/116, 7.8%) than in controls (2/116, 1.7%) [OR = 4.8 , 95% CI 1.01-22.70; P = 0.048]. Most cases were related to infectious diseases (5/9, 55.5%), others were pulmonary embolism (2/9, 22%), inflammatory disease and trauma (1/9, 11.1% each). There was no significant difference between the two groups regarding common health problems. CONCLUSION: Moderately and severely immunocompromised travellers are at increased risk of developing a serious health problem during or after a trip in a tropical country. They should be well informed about the specific risks they are particularly prone to. Travel medicine health professionals should favour effective preventive measures for immunocompromised travellers and envisage stand-by antibiotic treatment. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/26929155/full_citation L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/taw001 DB - PRIME DP - Unbound Medicine ER -