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Geographical and temporal trends in imported infections from the tropics requiring inpatient care at the Hospital for Tropical Diseases, London - a 15 year study.
Trans R Soc Trop Med Hyg. 2016 08; 110(8):456-63.TR

Abstract

BACKGROUND

Understanding geographic and temporal trends in imported infections is key to the management of unwell travellers. Many tropical infections can be managed as outpatients, with admission reserved for severe cases.

METHODS

We prospectively recorded the diagnosis and travel history of patients admitted between 2000 and 2015. We describe the common tropical and non-tropical infectious diseases and how these varied based on region, reason for travel and over time.

RESULTS

A total of 4362 admissions followed an episode of travel. Falciparum malaria was the most common diagnosis (n=1089). Among individuals who travelled to Africa 1206/1724 (70.0%) had a tropical diagnosis. The risk of a tropical infection was higher among travellers visiting friends and relatives than holidaymakers (OR 2.8, p<0.001). Among travellers to Asia non-tropical infections were more common than tropical infections (349/782, 44.6%), but enteric fever (117, 33.5%) of the tropical infections and dengue (70, 20.1%) remained important. The number of patients admitted with falciparum malaria declined over the study but those of enteric fever and dengue did not.

CONCLUSIONS

Most of those arriving from sub-Saharan Africa with an illness requiring admission have a classical tropical infection, and malaria still predominates. In contrast, fewer patients who travelled to Asia have a tropical diagnosis but enteric fever and dengue remain relatively common. Those visiting friends and relatives are most likely to have a tropical infection.

Authors+Show Affiliations

Hospital for Tropical Diseases, London, UK Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK michael.marks@lshtm.ac.uk.Hospital for Tropical Diseases, London, UK.Hospital for Tropical Diseases, London, UK Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.Hospital for Tropical Diseases, London, UK.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27618924

Citation

Marks, Michael, et al. "Geographical and Temporal Trends in Imported Infections From the Tropics Requiring Inpatient Care at the Hospital for Tropical Diseases, London - a 15 Year Study." Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 110, no. 8, 2016, pp. 456-63.
Marks M, Armstrong M, Whitty CJ, et al. Geographical and temporal trends in imported infections from the tropics requiring inpatient care at the Hospital for Tropical Diseases, London - a 15 year study. Trans R Soc Trop Med Hyg. 2016;110(8):456-63.
Marks, M., Armstrong, M., Whitty, C. J., & Doherty, J. F. (2016). Geographical and temporal trends in imported infections from the tropics requiring inpatient care at the Hospital for Tropical Diseases, London - a 15 year study. Transactions of the Royal Society of Tropical Medicine and Hygiene, 110(8), 456-63. https://doi.org/10.1093/trstmh/trw053
Marks M, et al. Geographical and Temporal Trends in Imported Infections From the Tropics Requiring Inpatient Care at the Hospital for Tropical Diseases, London - a 15 Year Study. Trans R Soc Trop Med Hyg. 2016;110(8):456-63. PubMed PMID: 27618924.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Geographical and temporal trends in imported infections from the tropics requiring inpatient care at the Hospital for Tropical Diseases, London - a 15 year study. AU - Marks,Michael, AU - Armstrong,Margaret, AU - Whitty,Christopher J M, AU - Doherty,Justin F, Y1 - 2016/09/12/ PY - 2016/06/13/received PY - 2016/07/29/accepted PY - 2016/9/14/entrez PY - 2016/9/14/pubmed PY - 2017/12/28/medline KW - Enteric fever KW - Febrile illness KW - Imported infections KW - Malaria KW - Travellers SP - 456 EP - 63 JF - Transactions of the Royal Society of Tropical Medicine and Hygiene JO - Trans. R. Soc. Trop. Med. Hyg. VL - 110 IS - 8 N2 - BACKGROUND: Understanding geographic and temporal trends in imported infections is key to the management of unwell travellers. Many tropical infections can be managed as outpatients, with admission reserved for severe cases. METHODS: We prospectively recorded the diagnosis and travel history of patients admitted between 2000 and 2015. We describe the common tropical and non-tropical infectious diseases and how these varied based on region, reason for travel and over time. RESULTS: A total of 4362 admissions followed an episode of travel. Falciparum malaria was the most common diagnosis (n=1089). Among individuals who travelled to Africa 1206/1724 (70.0%) had a tropical diagnosis. The risk of a tropical infection was higher among travellers visiting friends and relatives than holidaymakers (OR 2.8, p<0.001). Among travellers to Asia non-tropical infections were more common than tropical infections (349/782, 44.6%), but enteric fever (117, 33.5%) of the tropical infections and dengue (70, 20.1%) remained important. The number of patients admitted with falciparum malaria declined over the study but those of enteric fever and dengue did not. CONCLUSIONS: Most of those arriving from sub-Saharan Africa with an illness requiring admission have a classical tropical infection, and malaria still predominates. In contrast, fewer patients who travelled to Asia have a tropical diagnosis but enteric fever and dengue remain relatively common. Those visiting friends and relatives are most likely to have a tropical infection. SN - 1878-3503 UR - https://www.unboundmedicine.com/medline/citation/27618924/Geographical_and_temporal_trends_in_imported_infections_from_the_tropics_requiring_inpatient_care_at_the_Hospital_for_Tropical_Diseases_London___a_15_year_study_ L2 - https://academic.oup.com/trstmh/article-lookup/doi/10.1093/trstmh/trw053 DB - PRIME DP - Unbound Medicine ER -