Travel Medicine and Infectious Disease最新文献_第8页

Climate change and dengue Fever: A 14-year study of mortality trends during 2010–2023 in Indonesia 气候变化与登革热：印度尼西亚2010-2023年死亡率趋势的14年研究

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-08-23 DOI: 10.1016/j.tmaid.2025.102893

Kurnia Ardiansyah Akbar , Rosa Kumala Fatma , Fauzi Elamouri , Jürgen Kurt Rockstroh

Background

Dengue fever remains a critical public health issue in Indonesia, with a significant increase in mortality cases in recent years. As a vector-borne disease, dengue fever is highly influenced by environmental conditions, making it particularly sensitive to the impacts of climate change. Indonesia, being heavily affected by global climate change, faces increasing challenges in managing dengue fever. This study aims to investigate the association between dengue fever mortality and climate variables, specifically annual rainfall, and temperature, in Indonesia from 2010 to 2023.

Methods

Secondary data on dengue fever cases from 2010 to 2023 were collected from the Ministry of Health of Indonesia. Data on annual rainfall and annual temperature were obtained from the Indonesia Meteorology, Climatology, and Geophysics Council, with information gathered from 116 stations across Indonesia. Linear regression analysis was used to determine the association between these variables and dengue fever mortality.

Results

The analysis revealed a significant association between annual temperature (p = 0.049; R² = 0.212; 95 % CI: 710.85–2.233) and dengue fever mortality. Additionally, annual dengue fever cases were significantly associated with mortality (p < 0.001; R² = 1.075; 95 % CI: 0.007–0.010). However, annual rainfall was not found to be significant in this study.

Conclusion

These findings underscore the importance of monitoring climatic changes and their impact on public health, particularly concerning vector-borne diseases. Enhanced surveillance and targeted interventions could mitigate the adverse effects of these climatic variables on dengue fever mortality in Indonesia.

背景登革热在印度尼西亚仍然是一个严重的公共卫生问题，近年来死亡病例显著增加。作为一种病媒传播疾病，登革热受环境条件的影响很大，使其对气候变化的影响特别敏感。印度尼西亚受到全球气候变化的严重影响，在管理登革热方面面临越来越大的挑战。本研究旨在调查2010年至2023年印度尼西亚登革热死亡率与气候变量（特别是年降雨量和温度）之间的关系。方法收集印度尼西亚卫生部2010 - 2023年登革热病例二级资料。年降雨量和年气温数据来自印度尼西亚气象、气候学和地球物理委员会，信息来自印度尼西亚116个气象站。采用线性回归分析确定这些变量与登革热死亡率之间的关系。结果年气温与登革热病死率有显著相关性（p = 0.049; R2 = 0.212; 95% CI: 710.85 ~ 2.233）。此外，每年登革热病例与死亡率显著相关（p < 0.001; R2 = 1.075; 95% CI: 0.007-0.010）。然而，年降雨量在本研究中没有发现显著性。结论这些发现强调了监测气候变化及其对公共卫生的影响的重要性，特别是对媒介传播疾病的影响。加强监测和有针对性的干预措施可以减轻这些气候变量对印度尼西亚登革热死亡率的不利影响。

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引用次数: 0

Latent tuberculosis infection and sexually transmitted diseases in incoming mobility students at the National Autonomous University of Mexico 墨西哥国立自治大学流动新生的潜伏性肺结核感染和性传播疾病

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-08-20 DOI: 10.1016/j.tmaid.2025.102891

Jorge B. Díaz Ramírez , Luis A. Cortázar Maldonado , Patricia Bautista-Carbajal , Miguel L. García-León , Anna Fomina , Karen Chavarría-Villafuerte , José A. Morales-Fernández , Midori Kato-Maeda , Rosa M. Wong-Chew

Background

Little is known about latent tuberculosis infection and sexually transmitted diseases in international mobility students, due to the limited number of educational institutions that provide care for these types of health problems. The aim of this study was to determine the prevalence of latent tuberculosis infection and the presence of some sexually transmitted diseases in the population of incoming mobility students of the National Autonomous University of Mexico (UNAM), as well as their socio-demographic, migratory and health characteristics; in order to contribute to the design of strategies for the detection of asymptomatic diseases that may have an impact on the health of this population.

Methods

Incoming mobility students of the UNAM were invited to participate in the study, underwent a clinical history and physical examination, and informed consent was requested for the collection of blood to determine the presence of TB and some sexually transmitted diseases. Socio-demographic, migration and health characteristics were recorded.

Results

149 incoming mobility students were recruited, with a prevalence of 7.3 % of latent TB. None of the students were positive for HIV and HCV, and only one student was positive for syphilis.

Conclusions

The prevalence of latent TB was 7.3 %. LTB and sexually transmitted diseases in high-risk populations, such as international mobility students, was unknown in our country. It is important to continue with research projects aimed at reducing the burden of disease in this population and to promote the development of strategies that inform educational institutions about their presence, control and prevention.

背景：由于提供这类健康问题护理的教育机构数量有限，人们对国际流动学生中的潜伏性结核病感染和性传播疾病知之甚少。这项研究的目的是确定墨西哥国立自治大学（UNAM）即将入学的流动学生中潜伏性肺结核感染的流行程度和某些性传播疾病的存在情况，以及他们的社会人口、迁徙和健康特征；为了帮助设计检测可能对这一人群健康产生影响的无症状疾病的策略。方法邀请墨西哥国立交通大学即将入学的流动学生参加研究，对其进行临床病史和体格检查，并要求知情同意采血，以确定是否存在结核病和一些性传播疾病。记录了社会人口、移民和健康特征。结果共纳入流动新生149人，潜伏性结核患病率为7.3%。没有一个学生的HIV和HCV呈阳性，只有一个学生的梅毒呈阳性。结论本区潜伏结核检出率为7.3%。在国际流动学生等高危人群中，LTB和性传播疾病在我国尚不清楚。必须继续开展旨在减轻这一人口疾病负担的研究项目，并促进制定战略，使教育机构了解疾病的存在、控制和预防。

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引用次数: 0

Mapping the global risk of chikungunya virus endemicity and autochthonous transmission following importation 绘制输入后基孔肯雅病毒流行和本地传播的全球风险图

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-08-19 DOI: 10.1016/j.tmaid.2025.102892

Yu-Feng Yang , Yun-Bo Qiu , Qiang Xu , Rui-Cheng Gao , Tian Tang , Yao Tian , Yan-He Wang , Sheng-Hong Lin , Yun-Dong Shi , Long-Tao Chen , Yan Zhang , Jun Ma , Chen-Long Lv , Guo-Lin Wang , Hai-Feng Pan , Wei Liu , Li-Qun Fang

Background

Chikungunya virus, emerging as an increasingly significant global health threat, poses significant uncertainty regarding the global risk of its endemicity and autochthonous transmission following importation.

Methods

In this study, we established a multi-source database spanning 70 years (1953–2023), synthesizing 4515 geolocated records of human, vector, and animal infections alongside clinical metadata. Three machine learning algorithms were utilized to analyze the ecological factors associated with CHIKV occurrences in regions characterized by endemic or autochthonous transmission following importation. Subsequently, the respective risk distributions of CHIKV occurrences were projected and used the SHAP method to rank feature importance and interpret model predictions.

Results

Machine learning frameworks that stratifying endemic zones and importation-transmission prone regions have revealed consistent ecological drivers, albeit with significantly discrepant rankings of feature importance. The habitat suitability indices of Aedes aegypti and Aedes albopictus, as indicated by the Shapley values analysis, were identified as the most significant contributing factors for endemic occurrence and autochthonous transmission following importation, respectively. Population density, human footprint index, precipitation, thermal conditions, and the habitat suitability indices of other mosquito vectors also play crucial roles in the transmission within the two regions. Notably, temperate regions with established Ae. albopictus populations, including southern United States, most parts of Western Europe, East Asia, West Asia and Australia, emerged as high-risk hotspots for autochthonous transmission following importation.

Conclusions

This study assesses the potential risks of endemic occurrence and post-import autochthonous transmission of CHIKV, respectively. The frameworks provide insights for informing vaccine deployment strategies and mitigating globalization-driven arboviral threats.

基孔肯雅病毒作为日益严重的全球健康威胁出现，对其地方性和输入后本地传播的全球风险构成了重大不确定性。方法在本研究中，我们建立了一个跨越70年（1953-2023）的多源数据库，综合了4515份人类、媒介和动物感染的地理记录以及临床元数据。利用三种机器学习算法分析了在以输入后流行或本地传播为特征的地区与CHIKV发生相关的生态因素。随后，分别预测了CHIKV发生的风险分布，并使用SHAP方法对特征重要性进行排序并解释模型预测。结果：对流行区和输入性传播易发地区进行分层的机器学习框架揭示了一致的生态驱动因素，尽管特征重要性排名存在显著差异。Shapley值分析表明，埃及伊蚊和白纹伊蚊的生境适宜性指数分别是导致当地流行和输入后本地传播的最重要因素。人口密度、人类足迹指数、降水、热条件和其他媒介蚊媒生境适宜性指数也在两区传播中发挥重要作用。值得注意的是，温带地区已建立伊蚊。白纹伊蚊种群，包括美国南部、西欧大部分地区、东亚、西亚和澳大利亚，在输入后成为本地传播的高风险热点。结论本研究分别评估了寨卡病毒流行和输入后本地传播的潜在风险。这些框架为通报疫苗部署战略和减轻全球化驱动的虫媒病毒威胁提供了见解。

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引用次数: 0

Serodiagnosis of strongyloidiasis in a low-endemic setting – a two-tiered test approach 在低流行环境下的圆线虫病的血清诊断——两层检测方法

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-08-11 DOI: 10.1016/j.tmaid.2025.102890

Sebastian Albermann , Anne Vischer , Xuan Lan Vu , Anja Horat , Felix Grimm , Beatrice Nickel , Bruno Gottstein , Cédric Hirzel , Alexander Oberli

Background

Previous studies have demonstrated that Strongyloides ELISAs frequently exhibit cross-reactivity with infections caused by other helminths. This may result in false-positive results, especially in low-endemic areas, potentially leading to unwarranted treatment. This study aimed to present a new Western blot for the detection of anti-Strongyloides antibodies such as to enhance the accuracy of distinguishing true-positive from false-positive ELISA results.

Methods

We developed and validated a Western blot to detect anti-S. stercoralis specific antibodies using reference sera from confirmed cases (n = 55), non-infected control patients (n = 20), and patients with other helminth infections (n = 50). Using this sample set, we evaluated the analytical performance of three serologic approaches: an in-house ELISA, the commercially available Bordier-ELISA, and a two-tiered testing procedure combining the in-house ELISA with a confirmatory Western blot. Using receiver operating characteristics (ROC) analysis, setting-specific cut-offs values were determined for both ELISA assays. Further, we conducted a retrospective cohort study using serum samples from solid organ transplant (SOT) candidates (n = 310) tested by ELISA during pre-transplant evaluations at Bern University Hospital (2018–2022).

Results

The Western blot specifically detected human IgG antibodies against S. stercoralis. A two-tier test algorithm (in-house ELISA, followed by confirmatory Western blot) showed a diagnostic sensitivity of 96.4 % (95 %CI:87.5 %–99.6 %) and a diagnostic specificity of 98.6 % (95 %CI:92.3 %–100 %). Out of 310 SOT candidates’ serum samples, 9.3 % (n = 29) exhibited positive, and 5.2 % (n = 16) equivocal ELISA results. Testing by Western blot revealed positive S. stercoralis findings for 11.1 % (n = 5) of these patients. Two of those were initially positive and 3 were equivocal by ELISA.

Conclusions

The new Western blot is a promising tool for clarifying equivocal S. stercoralis ELISA results, and therefore predisposed to reduce false positive Strongyloides ELISA results, especially in low-endemic regions.

以往的研究表明，类圆线虫酶联免疫吸附试验经常与其他蠕虫引起的感染表现出交叉反应性。这可能导致假阳性结果，特别是在低流行地区，可能导致不必要的治疗。本研究旨在建立一种新的Western blot检测抗类圆线虫抗体的方法，以提高ELISA检测结果的真阳性和假阳性的准确性。方法建立并验证了Western blot法检测抗s。使用确诊病例（55例）、未感染对照患者（20例）和其他蠕虫感染患者（50例）的参比血清检测粪虫特异性抗体。使用该样本集，我们评估了三种血清学方法的分析性能：内部ELISA，市售的Bordier-ELISA，以及结合内部ELISA和验证性Western blot的两层检测程序。采用受试者工作特征（ROC）分析，确定两种ELISA检测的设定特异性截止值。此外，我们进行了一项回顾性队列研究，使用了伯尔尼大学医院（2018-2022）在移植前评估期间通过ELISA检测的实体器官移植（SOT）候选者（n = 310）的血清样本。结果Western blot特异检测到人抗粪球菌IgG抗体。两层检测算法（内部ELISA，然后是验证性Western blot）显示诊断敏感性为96.4% (95% CI: 87.5% - 99.6%)，诊断特异性为98.6% （95% CI: 92.3% - 100%）。在310例SOT候选血清样本中，9.3% （n = 29）表现出阳性，5.2% （n = 16）表现出模棱两可的ELISA结果。Western blot检测显示，11.1% （n = 5）患者的粪球菌阳性。其中2例最初呈阳性，3例ELISA结果不明确。结论新的Western blot是一种很有前途的工具，可以澄清模棱两可的粪球菌ELISA结果，因此易于减少假阳性的类圆线虫ELISA结果，特别是在低流行地区。

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引用次数: 0

Scabies: An updated review from epidemiology to current controversies and future perspectives 疥疮：从流行病学到当前争议和未来观点的最新综述

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-08-05 DOI: 10.1016/j.tmaid.2025.102878

Gianluca Tavoletti , Gianluca Avallone , Andrea Sechi , Elisa Cinotti , Stefano Veraldi , Giuseppe Micali , Francesco Lacarrubba , Angelo Valerio Marzano , Gianluca Nazzaro

Scabies is a highly contagious parasitic dermatosis caused by the mite Sarcoptes scabiei var. hominis, affecting over 200 million individuals globally and imposing a significant health burden. Traditionally linked to low socioeconomic status and overcrowding, its prevalence is rising globally, especially among urban and institutional settings. Beyond its cutaneous manifestations, secondary bacterial complications contribute to significant morbidity, particularly in endemic areas.

Advances in non-invasive imaging techniques including ultraviolet dermoscopy, reflectance confocal microscopy and line-field confocal optical coherence tomography, have improved diagnostic accuracy, while molecular assays show promise for enhanced sensitivity. Conventional diagnostics remain dependent on clinical evaluation and microscopic identification of mites, eggs, or scybala.

First-line treatment involves topical and systemic therapies, and topical permethrin, benzyl benzoate, and oral ivermectin are commonly recommended in international guidelines. Emerging drug resistance has prompted research toward optimizing drug regimens and novel therapies, including moxidectin and combination treatments. Outbreaks of scabies in institutional settings, as well as endemic disease in those with limited resources, demonstrate the importance of coordinated public health efforts in the form of early case detection, simultaneous treatment of contacts and other environmental control measures.

In this review, we present an updated and thorough description of scabies, covering the relevant epidemiology, clinical picture and the new diagnostic methods. In summary, by combining new updates and essential unanswered questions, this review describes the current dilemma and covers the latest data in the field.

疥疮是一种由人疥疥螨引起的高度传染性寄生虫皮肤病，影响全球2亿多人，造成重大健康负担。其传统上与低社会经济地位和过度拥挤有关，但在全球范围内，特别是在城市和机构环境中，其患病率正在上升。除皮肤表现外，继发性细菌并发症可导致显著的发病率，特别是在流行地区。非侵入性成像技术的进步，包括紫外线皮肤镜、反射共聚焦显微镜和线场共聚焦光学相干断层扫描，提高了诊断的准确性，而分子检测显示出提高灵敏度的希望。传统的诊断仍然依赖于临床评估和显微镜鉴定的螨虫，卵，或scscbala。一线治疗包括局部和全身治疗，国际指南通常推荐外用氯菊酯、苯甲酸苄酯和口服伊维菌素。新出现的耐药性促使研究朝着优化药物方案和新疗法，包括莫西菌素和联合治疗。机构环境中疥疮的爆发以及资源有限的地方的地方病表明，必须通过早期发现病例、同时治疗接触者和采取其他环境控制措施来协调公共卫生工作。在这篇综述中，我们提出了疥疮的最新和全面的描述，包括相关的流行病学，临床图片和新的诊断方法。总之，通过结合新的更新和基本未解问题，本综述描述了当前的困境，并涵盖了该领域的最新数据。

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引用次数: 0

Content analysis of malaria-related health information published in online travel blogs 在线旅游博客发布的疟疾相关健康信息内容分析

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-07-30 DOI: 10.1016/j.tmaid.2025.102879

Shayan Din , Ramy Bishay , Usama Asad , Gerard T. Flaherty

Introduction

It is not known whether travellers consult travel blogs for malaria preventive advice. This study aimed to characterise information about travellers’ malaria across a sample of online travel blogs.

Methods

A search of online travel blogs was conducted using the Google search engine for reference to malaria. Blogs were analysed across 35 variables and usage statistics were recorded.

Results

Of 100 blogs retrieved, 92 contained malaria-related information. Ten different drugs were mentioned in this series, five of which were not appropriate for prevention of falciparum malaria. Pre-travel consultation was recommended by almost a third of blogs. Most blogs were supported by commercial sponsors, related to either the travel industry or travel health products.

Conclusion

Given the inconsistency of the malaria preventive advice provided, there is scope for the travel medicine community to produce reliable material suitable for the lay traveller to be shared with prominent bloggers.

导言：目前尚不清楚旅行者是否会向旅游博客咨询疟疾预防建议。这项研究旨在通过一个在线旅游博客样本来描述旅行者疟疾的特征信息。方法：利用谷歌搜索引擎对在线旅游博客进行疟疾相关内容搜索。博客通过35个变量进行分析，并记录使用统计数据。结果：在检索到的100个博客中，有92个包含与疟疾相关的信息。本系列中提到了10种不同的药物，其中5种不适合预防恶性疟疾。近三分之一的博客推荐旅行前咨询。大多数博客都有商业赞助者的支持，这些赞助者要么与旅游业有关，要么与旅行保健产品有关。结论：鉴于所提供的疟疾预防建议的不一致性，旅行医学界有空间制作适合外行旅行者的可靠材料，并与知名博客分享。

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引用次数: 0

Redefining outpatient dengue management 18 years on: lessons from a national tertiary centre 重新定义门诊登革热管理18年：来自国家三级医疗中心的经验教训。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-07-28 DOI: 10.1016/j.tmaid.2025.102882

Jinghao Nicholas Ngiam , Matthew Chung Yi Koh , Brenda Mae Alferez Salada , Dale Fisher , Sophia Archuleta , Jolene Ee Ling Oon

Background

Dengue fever places a substantial burden on healthcare systems in endemic areas. Traditional inpatient management places strain on hospital capacity during seasonal surges. This study evaluates an expanded nurse-led Dengue Outpatient Management (DOM) program at a tertiary centre in Singapore.

Methods

A prospective observational study was conducted from January 2023 to August 2024. DOM inclusion criteria were broadened to include older adults and patients with comorbidities, if clinically stable. Patients received physician evaluation, a nurse-led symptom-based assessment and vital signs monitoring.

Results

There were 167 patients managed in DOM in the study period. The model saved an average of 3.3 bed-days per patient, amounting to approximately 231 bed-days saved in 2023.

Conclusion

This expanded nurse-led outpatient dengue management model demonstrates safety, feasibility, and resource efficiency. With structured patient selection and monitoring protocols, DOM significantly reduces hospital bed occupancy while offering a scalable solution for dengue-endemic regions.

背景：登革热对流行地区的卫生保健系统造成重大负担。传统的住院管理在季节性高峰期间对医院的能力造成压力。本研究评估了新加坡三级医疗中心扩大护士主导的登革热门诊管理（DOM）项目。方法：于2023年1月至2024年8月进行前瞻性观察研究。DOM纳入标准扩大到包括老年人和有合并症的患者，如果临床稳定。患者接受医生评估、护士主导的基于症状的评估和生命体征监测。结果：167例患者在研究期间接受了DOM治疗。该模型平均为每位患者节省了3.3个住院日，到2023年将节省约231个住院日。结论：这种扩大护士主导的登革热门诊管理模式具有安全性、可行性和资源效率。通过结构化的患者选择和监测协议，DOM大大减少了医院床位占用，同时为登革热流行地区提供了可扩展的解决方案。

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引用次数: 0

Measles importations by international travelers, GeoSentinel 2019–2025 2019-2025年国际旅行者麻疹输入情况，GeoSentinel。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-07-28 DOI: 10.1016/j.tmaid.2025.102885

Ralph Huits , Dora Buonfrate , Kevin O'Laughlin , Davidson H. Hamer , Michael Libman

Background

The global resurgence of measles is a threat to measles elimination campaigns. Measles importations by international travelers have been identified as a risk factor for outbreaks.

Methods

We reviewed measles cases among international travelers and migrants reported to the GeoSentinel network.

Results

From May 2019 through June 2025, GeoSentinel recorded 53 measles cases among travelers imported into 15 different countries. Travelers of all age groups were affected, and 74 % were 21 years or older. Thirty-three travelers (61 %) were hospitalized. Seventy-nine percent of cases reported no or unknown history of vaccination against measles.

Conclusions

Against a background of increasing numbers of measles cases and outbreaks globally, GeoSentinel observed a stable trend of measles importations by international travelers. Measles caused considerable morbidity among travelers. Immunization effectively prevents measles in more than 97 % of individuals. Pretravel consultations provide an important opportunity to promote vaccination coverage for all vaccine-preventable diseases, including measles.

背景：全球麻疹死灰复燃对消除麻疹运动构成威胁。国际旅行者输入麻疹已被确定为疫情的一个风险因素。方法：我们回顾了报告给GeoSentinel网络的国际旅行者和移民的麻疹病例。结果：从2019年5月到2025年6月，gesentinel在15个不同国家输入的旅行者中记录了53例麻疹病例。所有年龄组的旅行者都受到影响，其中74%的人年龄在21岁或以上。33名旅行者（61%）住院。79%的病例报告没有或未知的麻疹疫苗接种史。结论：在全球麻疹病例和疫情不断增加的背景下，gesentinel观察到国际旅行者麻疹输入呈稳定趋势。麻疹在旅行者中引起相当大的发病率。免疫接种可在97%以上的人群中有效预防麻疹。旅行前咨询为促进包括麻疹在内的所有疫苗可预防疾病的疫苗接种覆盖率提供了重要机会。

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引用次数: 0

Assessing yellow fever and arboviral risks during the 2025 jubilee in Rome: A mass gathering and global mobility perspective 评估2025年罗马禧年期间的黄热病和虫媒病毒风险：大规模聚集和全球流动的视角

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-07-26 DOI: 10.1016/j.tmaid.2025.102884

Giancarlo Ceccarelli , Francesco Branda , Fabio Scarpa , Marta Giovanetti , Massimo Ciccozzi

引用次数: 0

Imported fascioliasis in non-endemic countries: a case series and review of the literature 非地方性片形吸虫病国家的输入性片形吸虫病：病例系列和文献回顾。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Travel Medicine and Infectious Disease

Pub Date : 2025-07-26 DOI: 10.1016/j.tmaid.2025.102883

Paola Rodari, Maria Luca D'Errico, Andrea Angheben, Leonardo Motta, Veronica Andrea Fittipaldo, Dora Buonfrate, Federico Giovanni Gobbi

Background

Fascioliasis is one of the most neglected foodborne zoonotic infectious disease, caused by the trematodes Fasciola hepatica and Fasciola gigantica. In last decades, it emerged as a public health problem worldwide, due to the substantial number of human infections. Fascioliasis has also been described in travellers and migrants, with relevance in Travel Medicine.

Methods

We reported four cases of imported human fascioliasis diagnosed in our Department between 2011 and 2023. Literature search was performed on MEDLINE and Embase. We included case reports and case series on patients diagnosed with imported fascioliasis in non-endemic countries to summarize diagnostic and therapeutic approaches.

Results

We retrieved 46 cases of imported fascioliasis, mostly acquired after stay in countries of South East Asia (41.3 %) and Africa (34.8 %). Forty patients (86.9 %) presented with symptoms, particularly low-grade fever and abdominal pain. Eosinophilia was found in 94.4 %. When performed, serology was positive in almost all patients (36/37, 97.3 %), while parasitological stool examination was positive only in a few cases (5/32, 15.6 %). In 12 cases, adult worm was removed by endoscopic technique, while in six cases fascioliasis was diagnosed after liver biopsy or resection. Triclabendazole was administered 33 cases, with excellent outcome.

Discussion

Diagnosis of fascioliasis is complex in non-endemic settings, and a high index of suspicion is crucial. The presence of eosinophilia, fever and hepatic lesions in travellers or migrants should rise suspicion, and serological tests may confirm the diagnosis. Triclabendazole remains the drug of choice, despite unavailability in many countries.

背景：片形吸虫病是由肝片形吸虫和巨型片形吸虫引起的最容易被忽视的食源性人畜共患传染病之一。在过去的几十年里，由于大量的人类感染，它成为一个全球性的公共卫生问题。在旅行者和移民中也有片吸虫病的描述，与旅行医学相关。方法：报告2011 - 2023年我科确诊的4例输入性人片吸虫病病例。在MEDLINE和Embase上进行文献检索。我们纳入了在非流行国家诊断为输入性筋膜吸虫病的病例报告和病例系列，以总结诊断和治疗方法。结果：共检获输入性片形吸虫病46例，以东南亚（41.3%）和非洲（34.8%）为主要病例。40例（86.9%）患者出现症状，特别是低烧和腹痛。嗜酸性粒细胞增多占94.4%。血清学检查几乎全部阳性（36/37,97.3%），而粪便寄生虫学检查仅有少数阳性（5/32,15.6%）。12例经内镜摘除成虫，6例经肝活检或肝切除诊断为片吸虫病。应用三氯咪唑治疗33例，疗效良好。讨论：在非流行环境中，片吸虫病的诊断是复杂的，高度的怀疑指数是至关重要的。旅行者或移民中出现嗜酸性粒细胞增多、发热和肝脏病变应引起怀疑，血清学检测可证实诊断。尽管在许多国家无法获得，但三氯咪唑仍然是首选药物。

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引用次数: 0