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Incidence and risk factors of diarrhoea in Dutch travellers: consequences for priorities in pre-travel health advice.
Trop Med Int Health. 1998 Nov; 3(11):896-903.TM

Abstract

A cohort of 743 Dutch short-term travellers (1-6 weeks) to various (sub)tropical areas was studied to assess incidences of travellers' diarrhoea (TD) and risk factors to guide prevention policies. The occurrence of TD was ascertained retrospectively by questionnaire; independent risk factors were identified by logistic regression analysis. The overall attack rate (AR, 95% CI) of TD was 52% (49-56); 11% (9-14) reported two or more episodes. The overall incidence rate (IR) per 100 person weeks of travel (pwt) (95% CI) was 22 (20-24). IRs were highest for travellers to the Middle East (48, 33-71), lowest for South-east Asia (17, 15-20) and East Africa (18, 14-24) and intermediate for South America and West Africa (both 26, 19-36), Central America (29, 23-37) and the Indian subcontinent (32, 26-39). Compared to first episodes of TD, subsequent episodes were of longer duration and more frequently accompanied by faecal blood loss, abdominal cramps or systemic symptoms. After adjustment for travel duration and destination, independent risk factors (OR, 95% CI) for TD were recent treatment for gastrointestinal (GI) disorders (4.6, 1.2-17.2), history of GI surgery (3.9, 1.4-11.1) and, possibly, current use of medication reducing gastric acidity (6.9, 0.7-67.4). The risk was reduced for extensive travel experience (0.4, 0.3-0.7) and organized travel (0.7, 0.5-0.9). Regarding prevention and/or antibiotic self-treatment of TD, priority should be given to travellers who may suffer major health or other consequences from TD and to those with pre-existing GI disorders, particularly when visiting a high or intermediate-risk area on individual journeys with limited travel experience.

Authors+Show Affiliations

Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, The Netherlands. kvb@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9855403

Citation

Cobelens, F G., et al. "Incidence and Risk Factors of Diarrhoea in Dutch Travellers: Consequences for Priorities in Pre-travel Health Advice." Tropical Medicine & International Health : TM & IH, vol. 3, no. 11, 1998, pp. 896-903.
Cobelens FG, Leentvaar-Kuijpers A, Kleijnen J, et al. Incidence and risk factors of diarrhoea in Dutch travellers: consequences for priorities in pre-travel health advice. Trop Med Int Health. 1998;3(11):896-903.
Cobelens, F. G., Leentvaar-Kuijpers, A., Kleijnen, J., & Coutinho, R. A. (1998). Incidence and risk factors of diarrhoea in Dutch travellers: consequences for priorities in pre-travel health advice. Tropical Medicine & International Health : TM & IH, 3(11), 896-903.
Cobelens FG, et al. Incidence and Risk Factors of Diarrhoea in Dutch Travellers: Consequences for Priorities in Pre-travel Health Advice. Trop Med Int Health. 1998;3(11):896-903. PubMed PMID: 9855403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and risk factors of diarrhoea in Dutch travellers: consequences for priorities in pre-travel health advice. AU - Cobelens,F G, AU - Leentvaar-Kuijpers,A, AU - Kleijnen,J, AU - Coutinho,R A, PY - 1998/12/17/pubmed PY - 1998/12/17/medline PY - 1998/12/17/entrez SP - 896 EP - 903 JF - Tropical medicine & international health : TM & IH JO - Trop. Med. Int. Health VL - 3 IS - 11 N2 - A cohort of 743 Dutch short-term travellers (1-6 weeks) to various (sub)tropical areas was studied to assess incidences of travellers' diarrhoea (TD) and risk factors to guide prevention policies. The occurrence of TD was ascertained retrospectively by questionnaire; independent risk factors were identified by logistic regression analysis. The overall attack rate (AR, 95% CI) of TD was 52% (49-56); 11% (9-14) reported two or more episodes. The overall incidence rate (IR) per 100 person weeks of travel (pwt) (95% CI) was 22 (20-24). IRs were highest for travellers to the Middle East (48, 33-71), lowest for South-east Asia (17, 15-20) and East Africa (18, 14-24) and intermediate for South America and West Africa (both 26, 19-36), Central America (29, 23-37) and the Indian subcontinent (32, 26-39). Compared to first episodes of TD, subsequent episodes were of longer duration and more frequently accompanied by faecal blood loss, abdominal cramps or systemic symptoms. After adjustment for travel duration and destination, independent risk factors (OR, 95% CI) for TD were recent treatment for gastrointestinal (GI) disorders (4.6, 1.2-17.2), history of GI surgery (3.9, 1.4-11.1) and, possibly, current use of medication reducing gastric acidity (6.9, 0.7-67.4). The risk was reduced for extensive travel experience (0.4, 0.3-0.7) and organized travel (0.7, 0.5-0.9). Regarding prevention and/or antibiotic self-treatment of TD, priority should be given to travellers who may suffer major health or other consequences from TD and to those with pre-existing GI disorders, particularly when visiting a high or intermediate-risk area on individual journeys with limited travel experience. SN - 1360-2276 UR - https://www.unboundmedicine.com/medline/citation/9855403/Incidence_and_risk_factors_of_diarrhoea_in_Dutch_travellers:_consequences_for_priorities_in_pre_travel_health_advice_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1360-2276&date=1998&volume=3&issue=11&spage=896 DB - PRIME DP - Unbound Medicine ER -