Travel-related respiratory symptoms and infections in travellers 2000-2022: a systematic review and meta- analysis
Poster presentation
Event details
18th Conference of the International Society of Travel Medicine (CISTM18)
May 14th, 2023
10:30-11:15 EEST
Congress Center Basel, Basel, Switzerland
Poster
Overview
Travel-related Respiratory Infections in Travellers (2000-2022): a Systematic Review and Meta-analysis
T. Lovey1, R. Hasler2, P. Gautret3, P. Schlagenhauf1,4
1 University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland
2 HFR Fribourg - Cantonal Hospital, Fribourg, Switzerland
3 |HU-Méditerranée Infection, Marseille, France, WHO Collaborating Centre for Travellers’ Health
4 Department of Global and Public Health, MilMedBiol Competence Centre, Epidemiology, Biostatistics and Prevention Institute (EBPI), Zürich, Switzerland
Topic: EMERGING INFECTIONS
Background: Travellers are susceptible to respiratory tract infections (RTIs) because they come into close contact with numerous individuals and respiratory pathogens are present year-round in most areas visited. No study has systematically examined the burden of these infections among travellers. We examined the incidence of RTIs and also the incidence of symptoms suggestive of RTIs among travellers stratified by risk groups and/or geographic regions and evaluated the spectrum of RTIs.
Methods: Our systematic review and meta-analysis (PRISMA 2020 guidelines) was registered in PROSPERO (CRD42022311261). We searched Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Science Direct, and preprint servers MedRxiv, BioRxiv, SSRN, and IEEE Xplore on February 1, 2022. We included articles reporting at least one RTI or symptom suggestive of RTIs in international travellers after January 1, 2000. Deduplication, inclusion and exclusion criteria, title and abstract screening, full-text assessment, and bias assessment were performed by two reviewers. Data extraction was performed manually twice for each study and merged. Descriptive analyzes and maps were used to represent RTIs cases, respiratory symptoms, and their distribution. Two proportional meta-analyzes were utilized to obtain estimates of the incidence of respiratory symptoms and RTIs in travellers and predefined risk groups.
Results: Our search yielded 2,042 articles, and a total of 429 articles were included of which 268 were found by screening and 161 by a citation search of included studies. 78% of reported symptoms suggestive of RTIs and 60% of RTIs with available location data were acquired at mass gathering events. Cough was the most common symptom suggestive of respiratory infections, and the upper respiratory tract was the most common site for RTIs in travellers. We found an incidence proportion of respiratory symptoms and RTIs of 0.38 [0.28; 0.49] and 0.12 [0.09; 0.16], respectively among travellers. We found that the incidence of RTIs in travellers was closely correlated to global waves of emerging respiratory infections.
Conclusions: These results demonstrate the high burden of RTIs in travellers regardless of traveller group. This is the first meta-analysis to estimate the incidence proportion of RTIs among travellers by specific area of acquisition.