Regional Variation in Travel-related Illness acquired in Africa, March 1997–May 2011

Abstract

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.

Ebola virus disease

“…Because malaria is still the most common cause of febrile illness in returning travellers, the presence of risk factors for acquiring malaria should be assessed (for example, living or working in, or arriving from, an endemic area; inadequate or absent chemoprophylaxis; not using insecticides or bed nets). 36 Infection control risk should be assessed. Having determined that a patient may be infected, the doctor needs to determine how infectious the patient currently is.…”

Conference Report from International Congress on Infectious Diseases 2014: Part 2

“…In north Africa, gastrointestinal illnesses and bites requiring postrabies prophylaxis were the two most common conditions seen. Southern Africa has a high incidence of rickettsias, and malaria is most prevalent in west and central Africa [5]. Mendelson highlighted how this emphasizes the need for an accurate, evidence-based pretravel consultation, as the profile of travel-related illnesses differs with that of the resident populations within these regions.…”

“…There are approximately 50 million travelers to Africa each year [5]. Marc Mendelson (Cape Town, South Africa) presented data from a recent analysis of illnesses in travelers returning from Africa, who visited one of the 54 international GeoSentinel Travel Surveillance Network clinics over the past 14 years [5].…”

“…Marc Mendelson (Cape Town, South Africa) presented data from a recent analysis of illnesses in travelers returning from Africa, who visited one of the 54 international GeoSentinel Travel Surveillance Network clinics over the past 14 years [5]. The findings demonstrate that Africa does not present a homogenous risk to these travelers in terms of acquisition of infections, and geographic profiling may expedite diagnosis in those returning ill as well as facilitating targeted pretravel advice [5]. He cited the example of the significant differences between the types of illness acquired in northern and sub-Saharan Africa.…”

“…In the low income setting, one in four people have therapy initiated at CD4 levels of <100. This is thought to impact mortality usually within the first 3-6 months of ART as many patients with advanced immunosuppression have undiagnosed opportunistic infections [5,6]. Disseminated tuberculosis is the most common cause of mortality, followed by cryptococcal meningitis.…”