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Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study.
Intern Med J. 2019 Jan; 49(1):34-40.IM

Abstract

BACKGROUND

Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice.

AIM

To describe the spectrum of illnesses seen in returned travellers from Bali.

METHODS

Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department presentations to a metropolitan health service in Melbourne, from 2011 to 2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses.

RESULTS

A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). A total of 110 patients (24%) was admitted to the hospital; those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (odds ratio 3.42, 95% confidence interval 2.02-5.75, P < 0.001).

CONCLUSION

This is the first study to use a text mining approach to identify and describe emergency department presentations related to diseases acquired in Bali by Australian travellers. Although infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to the knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations.

Authors+Show Affiliations

Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia. Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia. Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.AKM-Information Development Division, The Alfred Hospital, Melbourne, Victoria, Australia.School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Faculty of Information Technology, Monash University, Melbourne, Victoria, Australia.Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia. Biomedicine Discovery Institute, Department of Microbiology, Monash University, Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29869360

Citation

Sohail, Asma, et al. "Spectrum of Illness Among Returned Australian Travellers From Bali, Indonesia: a 5-year Retrospective Observational Study." Internal Medicine Journal, vol. 49, no. 1, 2019, pp. 34-40.
Sohail A, McGuinness SL, Lightowler R, et al. Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study. Intern Med J. 2019;49(1):34-40.
Sohail, A., McGuinness, S. L., Lightowler, R., Leder, K., Jomon, B., Bain, C. A., & Peleg, A. Y. (2019). Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study. Internal Medicine Journal, 49(1), 34-40. https://doi.org/10.1111/imj.13993
Sohail A, et al. Spectrum of Illness Among Returned Australian Travellers From Bali, Indonesia: a 5-year Retrospective Observational Study. Intern Med J. 2019;49(1):34-40. PubMed PMID: 29869360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study. AU - Sohail,Asma, AU - McGuinness,Sarah L, AU - Lightowler,Rachel, AU - Leder,Karin, AU - Jomon,Bismi, AU - Bain,Christopher A, AU - Peleg,Anton Y, PY - 2018/05/02/received PY - 2018/05/29/revised PY - 2018/05/29/accepted PY - 2018/6/6/pubmed PY - 2019/9/21/medline PY - 2018/6/6/entrez KW - Bali KW - Indonesia KW - text mining KW - travel KW - tropical medicine SP - 34 EP - 40 JF - Internal medicine journal JO - Intern Med J VL - 49 IS - 1 N2 - BACKGROUND: Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. AIM: To describe the spectrum of illnesses seen in returned travellers from Bali. METHODS: Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department presentations to a metropolitan health service in Melbourne, from 2011 to 2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses. RESULTS: A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). A total of 110 patients (24%) was admitted to the hospital; those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (odds ratio 3.42, 95% confidence interval 2.02-5.75, P < 0.001). CONCLUSION: This is the first study to use a text mining approach to identify and describe emergency department presentations related to diseases acquired in Bali by Australian travellers. Although infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to the knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/29869360/Spectrum_of_illness_among_returned_Australian_travellers_from_Bali_Indonesia:_a_5_year_retrospective_observational_study_ L2 - https://doi.org/10.1111/imj.13993 DB - PRIME DP - Unbound Medicine ER -