Health problems in travellers to Nepal visiting CIWEC clinic in Kathmandu — A GeoSentinel analysis. Issue 40 (March 2021)

• Record Type: Journal Article
• Authors: Pandey, Prativa; Lee, Keun; Amatya, Bhawana; Angelo, Kristina M.; Shlim, David R.; Murphy, Holly
• Is Part Of: Travel medicine and infectious disease. Issue 40(2021)
• Publication Date: 2021-03
• Subjects: Altitude sickness -- Environmental exposure -- Nepal -- Sentinel surveillance -- Travel; CIWEC Canadian International Water and Energy Consultants -- CDC Centers for Disease Control and Prevention -- MRSA methicillin resistant Staphylococcus aureus -- HEENT head/eyes/ears/nose/throat -- GI gastrointestinal -- GU genitourinary -- VBD vector-borne diseases -- VPD vaccine-preventable diseases -- SAS Statistical Analysis Software -- HACE High Altitude Cerebral Oedema -- UTI Urinary Tract Infection -- AMS Acute Mountain Sickness -- HAPE High Altitude Pulmonary Oedema -- FQ fluoroquinolone -- VFR visiting friends or relatives -- JE Japanese Encephalitis -- PEP post-exposure prophylaxis -- RIG rabies immune globulin -- PrEP pre-exposure prophylaxis; Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2021.101999
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: Background: Nepal has always been a popular international travel destination. There is limited published data, however, on the spectrum of illnesses acquired by travellers to Nepal. Methods: GeoSentinel is a global data collection network of travel and tropical medicine providers that monitors travel-related morbidity. Records for ill travellers with at least one confirmed or probable diagnosis, were extracted from the GeoSentinel database for the CIWEC Clinic Kathmandu site from January 1, 2009 to December 31, 2017. Results: A total of 24, 271 records were included. The median age was 30 years (range: 0–91); 54% were female. The top 3 system-based diagnoses in travellers were: gastrointestinal (32%), pulmonary (16%), and dermatologic (9%). Altitude illness comprised 9% of all diagnoses. There were 278 vaccine-preventable diseases, most frequently influenza A (41%) and typhoid fever (19%; S . typhi 52 and S . paratyphi 62). Of 64 vector-borne illnesses, dengue was the most frequent (64%), followed by imported malaria (14%). There was a single traveller with Japanese encephalitis. Six deaths were reported. Conclusions: Travellers to Nepal face a wide spectrum of illnesses, particularly diarrhoea, respiratory disease, and altitude illness. Pre-travel consultations for travellers to Nepal should focus on prevention and treatment of diarrhoea and altitude illness, along with appropriate immunizations and travel advice.