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Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers.

Abstract AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ(2) test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic regression models. Of 628 travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms. Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin, azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of 108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took loperamide during travel. Of 172 with TD during travel, 24% stopped planned activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during travel, six (13%) stopped planned activities. International travelers continue to experience diarrhea and other GI symptoms, resulting in disruption of planned activities and healthcare visits for some. Although these illnesses resulted in interruption of travel plans, a relatively small proportion took prescribed antibiotics.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american journal of tropical medicine and hygiene
Publication Year Start




PMID- 28719282
OWN - NLM
STAT- In-Process
DA  - 20170718
LR  - 20170723
IS  - 1476-1645 (Electronic)
IS  - 0002-9637 (Linking)
VI  - 96
IP  - 6
DP  - 2017 Jun
TI  - Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area
      International Travelers.
PG  - 1388-1393
LID - 10.4269/ajtmh.16-0447 [doi]
AB  - AbstractThis prospective cohort study describes travelers' diarrhea (TD) and
      non-TD gastrointestinal (GI) symptoms among international travelers from the
      Boston area, the association of TD with traveler characteristics and dietary
      practices, use of prescribed antidiarrheal medications, and the impact of TD and 
      non-TD GI symptoms on planned activities during and after travel. We included
      adults who received a pre-travel consultation at three Boston-area travel clinics
      and who completed a three-part survey: pre-travel, during travel, and post-travel
      (2-4 weeks after return). TD was defined as self-reported diarrhea with or
      without nausea/vomiting, abdominal pain, or fever. Demographic and travel
      characteristics were evaluated by chi2 test for categorical and Wilcoxon rank-sum
      test for continuous variables. Analysis of dietary practices used logistic
      generalized estimating equation models or logistic regression models. Of 628
      travelers, 208 (33%) experienced TD and 45 (7%) experienced non-TD GI symptoms.
      Of 208 with TD, 128 (64%), 71 (36%), and 123 (62%) were prescribed ciprofloxacin,
      azithromycin, and/or loperamide before travel, respectively. Thirty-nine (36%) of
      108 took ciprofloxacin, 20 (38%) of 55 took azithromycin, and 28 (28%) of 99 took
      loperamide during travel. Of 172 with TD during travel, 24% stopped planned
      activities, and 2% were hospitalized. Of 31 with non-TD GI symptoms during
      travel, six (13%) stopped planned activities. International travelers continue to
      experience diarrhea and other GI symptoms, resulting in disruption of planned
      activities and healthcare visits for some. Although these illnesses resulted in
      interruption of travel plans, a relatively small proportion took prescribed
      antibiotics.
FAU - Stoney, Rhett J
AU  - Stoney RJ
AD  - Division of Global Migration and Quarantine, Centers for Disease Control and
      Prevention, Atlanta, Georgia.
FAU - Han, Pauline V
AU  - Han PV
AD  - Division of Global Migration and Quarantine, Centers for Disease Control and
      Prevention, Atlanta, Georgia.
FAU - Barnett, Elizabeth D
AU  - Barnett ED
AD  - Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center,
      Boston, Massachusetts.
FAU - Wilson, Mary E
AU  - Wilson ME
AD  - Department of Global Health and Population, Harvard T. H. Chan School of Public
      Health, Boston, Massachusetts.
FAU - Jentes, Emily S
AU  - Jentes ES
AD  - Division of Global Migration and Quarantine, Centers for Disease Control and
      Prevention, Atlanta, Georgia.
FAU - Benoit, Christine M
AU  - Benoit CM
AD  - Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center,
      Boston, Massachusetts.
FAU - MacLeod, William B
AU  - MacLeod WB
AD  - Department of Global Health, BUSPH, Boston, Massachusetts.
AD  - Center for Global Health and Development, Boston University School of Public
      Health (BUSPH), Boston, Massachusetts.
FAU - Hamer, Davidson H
AU  - Hamer DH
AD  - Section of Infectious Diseases, Boston University School of Medicine, Boston,
      Massachusetts.
AD  - Department of Global Health, BUSPH, Boston, Massachusetts.
AD  - Center for Global Health and Development, Boston University School of Public
      Health (BUSPH), Boston, Massachusetts.
FAU - Chen, Lin H
AU  - Chen LH
AD  - Department of Medicine, Harvard Medical School, Boston, Massachusetts.
AD  - Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital,
      Cambridge, Massachusetts.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Trop Med Hyg
JT  - The American journal of tropical medicine and hygiene
JID - 0370507
PMC - PMC5462577
EDAT- 2017/07/19 06:00
MHDA- 2017/07/19 06:00
CRDT- 2017/07/19 06:00
PMCR- 2018/06/07
AID - 10.4269/ajtmh.16-0447 [doi]
PST - ppublish
SO  - Am J Trop Med Hyg. 2017 Jun;96(6):1388-1393. doi: 10.4269/ajtmh.16-0447.