Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics

Belderok, Sanne-Meike; Hoek, Anneke van den; Kint, Joan A; Loeff, Maarten F. Schim van der; Sonder, Gerard J.B.

doi:10.1186/1471-2334-11-295

Cited by 45 publications

(36 citation statements)

References 22 publications

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“…Their proportion appears higher than reported elsewhere, yet the criteria for severe disease vary between studies [18,19]. The severity of the clinical picture presumably explains the comparatively high (15%) use of antimicrobials for TD over the journey and also afterwards (18% for TD).…”

Section: Discussionmentioning

confidence: 87%

High number of diarrhoeal co-infections in travellers to Benin, West Africa

et al. 2014

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BackgroundTravellers’ diarrhoea (TD) is the most frequent health problem among travellers to the tropics. Using routine techniques, the aetiology mostly remains unresolved, whereas modern molecular methods enable reducing the number of equivocal cases considerably. While many studies address the aetiology of TD in Asian, Central American and North African tourist resorts, only few focus on Western Africa.MethodsStool samples from 45 travellers travelling in Benin, West Africa, were analyzed by a new multiplex qPCR assay for Salmonella, Yersinia, Campylobacter, Vibrio cholerae, Shigella or enteroinvasive (EIEC), enterohaemorrhagic (EHEC), enterotoxigenic (ETEC), enteroaggregative (EAEC), and enteropathogenic Escherichia coli (EPEC).ResultsAll 18 pre-travel samples proved negative for bacterial pathogens. Of the 39/45 (87%) travellers having had TD, EPEC was detected in post-travel samples in 30 (77%) cases, EAEC in 23 (59%), ETEC in 22 (56%), Shigella or EIEC in 7 (18%), EHEC in two (5%), and Salmonella in one (3%). In 31(79%) of the TD cases two or more bacterial pathogens were identified. Two (8%) samples remained negative: both patients had taken antimicrobials for TD.ConclusionsEPEC, EAEC and ETEC were the most common findings. 79% of the cases had a co-infection. As modern diagnostics reveals in most patients a multitude of pathogens, the role of each pathogen should be re-evaluated.

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Section: Discussionmentioning

confidence: 87%

High number of diarrhoeal co-infections in travellers to Benin, West Africa

et al. 2014

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“…Lunetta [37] analysed the causes of death of Finnish travellers abroad during 1969e2007 finding that infections covered only 1.3%. Infections did not often cause changes in travel plans either, which in part reflects the benign course of the most common disease, TD, usually resolving spontaneously within a few days [38,39].…”

Section: Repatriation and Deathsmentioning

confidence: 93%

A closer look at travellers' infections abroad: Finnish nationwide data with incidences, 2010 to 2012

Siikamäki

Kivelä

Fotopoulos³

2017

Travel Medicine and Infectious Disease

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“…The majority of patients with STEI have a brief self-limiting illness and can be managed conservatively (253,(287)(288)(289)(290).…”

Section: Further Investigations and Treatmentmentioning

confidence: 99%

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

et al. 2018

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This guideline is intended for use in UK Genitourinary medicine clinics and sexual health services but is likely to be of relevance in all sexual health settings, including general practice and Contraception and Sexual Health (CASH) services, where men who have sex with men (MSM) seek sexual health care or where addressing the sexual health needs of MSM may have public health benefits. For the purposes of this document, MSM includes all gay, bisexual and all other males who have sex with other males and both cis and trans men. This document does not provide guidance on the treatment of particular conditions where this is covered in other British Association for Sexual Health and HIV (BASHH) Guidelines but outlines best practice in multiple aspects of the sexual health care of MSM. Where prevention of sexually transmitted infections including HIV can be addressed as an integral part of clinical care, this is consistent with the concept of combination prevention and is included. The document is designed primarily to provide guidance on the direct clinical care of MSM but also makes reference to the design and delivery of services with the aim of supporting clinicians and commissioners in providing effective services. Methodology This document was produced in accordance with the guidance set out in the BASHH CEG’s document ‘Framework for guideline development and assessment’ published in 2010 at http://www.bashh.org/guidelines and with reference to the Agree II instrument. Following the production of the updated framework in April 2015, the GRADE system for assessing evidence was adopted and the draft recommendations were regraded. Search strategy (see also Appendix 1) Ovid Medline 1946 to December 2014, Medline daily update, Embase 1974 to December 2014, Pubmed NeLH Guidelines Database, Cochrane library from 2000 to December 2014. Search language English only. The search for Section 3 was conducted on PubMed to December 2014. Priority was given to peer-reviewed papers published in scientific journals, although for many issues evidence includes conference abstracts listed on the Embase database. In addition, for ‘Identification of problematic recreational drug and alcohol use’ section and ‘Sexual problems and dysfunctions in MSM’ section, searches included PsycINFO. Methods Article titles and abstracts were reviewed and if relevant the full text article was obtained. Priority was given to randomised controlled trial and systematic review evidence, and recommendations made and graded on the basis of best available evidence. Piloting and feedback The first draft of the guideline was circulated to the writing group and to a small group of relevant experts, third sector partners and patient representatives who were invited to comment on the whole document and specifically on particular sections. The revised draft was reviewed by the CEG and then reviewed by the BASHH patient/public panel and posted on the BASHH website for public consultation. The final draft was piloted before publication. Guideline update The guidelines will be reviewed and revised in five years’ time, 2022.

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Incidence, risk factors and treatment of diarrhoea among Dutch travellers: reasons not to routinely prescribe antibiotics

Cited by 45 publications

References 22 publications

High number of diarrhoeal co-infections in travellers to Benin, West Africa

High number of diarrhoeal co-infections in travellers to Benin, West Africa

A closer look at travellers' infections abroad: Finnish nationwide data with incidences, 2010 to 2012

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

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