Universidad Peruana Cayetano Heredia

Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru

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dc.contributor.author Jennings, Mary Carol
dc.contributor.author Tilley, Drake H.
dc.contributor.author Ballard, Sarah-Blythe
dc.contributor.author Villanueva, Miguel
dc.contributor.author Maldonado Costa, Fernando
dc.contributor.author Lopez, Martha
dc.contributor.author Steinberg, Hannah E.
dc.contributor.author Luna, C. Giannina
dc.contributor.author Meza, Rina
dc.contributor.author Silva, Maria E.
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Simons, Mark P.
dc.contributor.author Maves, Ryan C.
dc.contributor.author Cabada, Miguel M.
dc.date.accessioned 2019-01-25T15:02:19Z
dc.date.available 2019-01-25T15:02:19Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4616
dc.description.abstract In Cusco, Peru, and South America in general, there is a dearth of travelers' diarrhea (TD) data concerning the clinical features associated with enteropathogen-specific infections and destination-specific risk behaviors. Understanding these factors would allow travel medicine providers to tailor interventions to patients' risk profiles and travel destination. To characterize TD etiology, evaluate region-specific TD risk factors, and examine relationships between preventive recommendations and risk-taking behaviors among medium- to long-term travelers' from high-income countries, we conducted this case-case analysis using 7 years of prospective surveillance data from adult travelers' presenting with TD to a physician in Cusco. At the time of enrollment, participants provided a stool sample and answered survey questions about demographics, risk behaviors, and the clinical features of illness. Stool samples were tested for norovirus (NV), bacteria, and parasites using conventional methods. Data obtained were then analyzed using case-case methods. NV (14%), enterotoxigenic Escherichia coli (11%), and Campylobacter (9%), notably ciprofloxacin-resistant Campylobacter, were the most frequently identified pathogens among adults with TD. Coinfection with multiple enteropathogens occurred in 5% of cases. NV caused severe disease relative to other TD-associated pathogens identified, confining over 90% of infected individuals to bed. Destination-specific risk factors include consumption of the local beverage "chicha," which was associated with Cryptosporidium infection. Preventive interventions, such as vaccines, directed against these pathogens could significantly reduce the burden of TD. en_US
dc.language.iso eng
dc.publisher American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adolescent en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Risk-Taking en_US
dc.subject Travel en_US
dc.subject Peru/epidemiology en_US
dc.subject Public Health Surveillance en_US
dc.subject Travel Medicine en_US
dc.subject Campylobacter Infections/diagnosis/epidemiology/microbiology en_US
dc.subject Campylobacter/isolation & purification en_US
dc.subject Diarrhea/diagnosis/epidemiology/microbiology/virology en_US
dc.subject Enterotoxigenic Escherichia coli/isolation & purification en_US
dc.subject Escherichia coli Infections/diagnosis/epidemiology/microbiology en_US
dc.subject Gastroenteritis/diagnosis/epidemiology/virology en_US
dc.subject Norovirus/isolation & purification en_US
dc.title Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.4269/ajtmh.16-0633
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1476-1645


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