Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study.


Journal

Internal medicine journal
ISSN: 1445-5994
Titre abrégé: Intern Med J
Pays: Australia
ID NLM: 101092952

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 02 05 2018
revised: 29 05 2018
accepted: 29 05 2018
pubmed: 6 6 2018
medline: 21 9 2019
entrez: 6 6 2018
Statut: ppublish

Résumé

Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. To describe the spectrum of illnesses seen in returned travellers from Bali. Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department presentations to a metropolitan health service in Melbourne, from 2011 to 2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses. A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). A total of 110 patients (24%) was admitted to the hospital; those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (odds ratio 3.42, 95% confidence interval 2.02-5.75, P < 0.001). This is the first study to use a text mining approach to identify and describe emergency department presentations related to diseases acquired in Bali by Australian travellers. Although infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to the knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations.

Sections du résumé

BACKGROUND BACKGROUND
Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice.
AIM OBJECTIVE
To describe the spectrum of illnesses seen in returned travellers from Bali.
METHODS METHODS
Using a novel text mining approach, we performed a retrospective, observational study of all adult emergency department presentations to a metropolitan health service in Melbourne, from 2011 to 2015. Outcome measures included demographic, clinical and laboratory features of travel-related illnesses.
RESULTS RESULTS
A total of 464 patients met inclusion criteria. Gastroenteritis (119/464, 26%), systemic febrile illness (88/464, 19%) and respiratory tract infection (51/464, 11%) were the most common diagnoses. Dengue was the most common laboratory-confirmed diagnosis (25/464, 5%). No cases of malaria were identified. Common non-infectious presentations included traumatic injury (47/464, 10%) and animal bites requiring rabies post-exposure prophylaxis (29/464, 6%). A total of 110 patients (24%) was admitted to the hospital; those presenting with systemic febrile illness were more likely to be admitted compared to those presenting with other illnesses (odds ratio 3.42, 95% confidence interval 2.02-5.75, P < 0.001).
CONCLUSION CONCLUSIONS
This is the first study to use a text mining approach to identify and describe emergency department presentations related to diseases acquired in Bali by Australian travellers. Although infections are important causes of illness, trauma and animal bites account for a significant number of hospital presentations. Our findings contribute to the knowledge on the health risks for travellers to Bali, and will assist clinicians in relevant pre- and post-travel evaluations.

Identifiants

pubmed: 29869360
doi: 10.1111/imj.13993
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

34-40

Informations de copyright

© 2018 Royal Australasian College of Physicians.

Auteurs

Asma Sohail (A)

Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.

Sarah L McGuinness (SL)

Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.
Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.

Rachel Lightowler (R)

Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.

Karin Leder (K)

Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Bismi Jomon (B)

AKM-Information Development Division, The Alfred Hospital, Melbourne, Victoria, Australia.

Christopher A Bain (CA)

School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Faculty of Information Technology, Monash University, Melbourne, Victoria, Australia.

Anton Y Peleg (AY)

Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.
Biomedicine Discovery Institute, Department of Microbiology, Monash University, Melbourne, Victoria, Australia.

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