The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012
Although human African trypanosomiasis (HAT) is uncommon among patients from non-endemic countries (NEC), there has been an increase in the number of cases reported in recent years. A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obta...
Gespeichert in:
| Veröffentlicht in: | PloS one 2014-02, Vol.9 (2), p.e88647-e88647 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e88647 |
|---|---|
| container_issue | 2 |
| container_start_page | e88647 |
| container_title | PloS one |
| container_volume | 9 |
| creator | Neuberger, Ami Meltzer, Eyal Leshem, Eyal Dickstein, Yaakov Stienlauf, Shmuel Schwartz, Eli |
| description | Although human African trypanosomiasis (HAT) is uncommon among patients from non-endemic countries (NEC), there has been an increase in the number of cases reported in recent years.
A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obtained from the United Nations World Tourism Organization. All HAT cases diagnosed in patients from NEC were included. Immigrants and refugees were excluded. We compared patients during and after the colonial period, and analyzed the relationship between the number of incoming travellers and the number of HAT cases.
Between 1902 and 2012, HAT was reported in 244 patients. Most HAT cases were reported before 1920, and after the year 2000. In the colonial era the average age of patients was lower (32.5±7.8 vs. 43.0±16.1 years, P |
| doi_str_mv | 10.1371/journal.pone.0088647 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1500410346</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A478799075</galeid><doaj_id>oai_doaj_org_article_14b388bac1704825bedc9f14574f7996</doaj_id><sourcerecordid>A478799075</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-a09a8338139a44faf082a790183d9b123a134b3d18aac406a52d77a3349a4bbd3</originalsourceid><addsrcrecordid>eNqNk12L1DAUhoso7jr6D0QLguhFx3y1TW6EYfFjYGFBV2_DaZu2GdpkTFpx_r3pTHeZyl5ILhKS533PyTmcKHqJ0RrTHH_Y2dEZ6NZ7a9QaIc4zlj-KLrGgJMkIoo_PzhfRM-93CKWUZ9nT6IKwlGc0o5eRuW1VXLZgGm2aWO11pXptO9scYlvH7diDiTe102XYB3fYg7He9hq89jH0Nmj2MGhlBh_XzvaxCdmYyaOMSzuawWnlkwQLRBKCMHkePamh8-rFvK-iH58_3V59Ta5vvmyvNtdJmQkyJIAEcEo5pgIYq6FGnEAuEOa0EgUmFDBlBa0wBygZyiAlVZ4DpSzwRVHRVfT65LvvrJdzqbzEKUIMI8qyQGxPRGVhJ_dO9-AO0oKWxwvrGglu0GWnJA6hOC-gxDlinKSFqkpRY5bmrM6FmLw-ztHGog-PoRwOuoXp8sXoVjb2t6SCiCx0ZRW9mw2c_TUqP8he-1J1HRhlx2PeDKcMZyigb_5BH_7dTDUQPqBNbUPccjKVG5bzkDXKp7DrB6iwjg0Mnax1uF8I3i8EgRnUn6GB0Xu5_f7t_9mbn0v27RnbKuiG1ttuHLQ1fgmyE1g6671T9X2RMZLTWNxVQ05jIeexCLJX5w26F93NAf0LkCAGqQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1500410346</pqid></control><display><type>article</type><title>The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Neuberger, Ami ; Meltzer, Eyal ; Leshem, Eyal ; Dickstein, Yaakov ; Stienlauf, Shmuel ; Schwartz, Eli</creator><contributor>Arez, Ana Paula</contributor><creatorcontrib>Neuberger, Ami ; Meltzer, Eyal ; Leshem, Eyal ; Dickstein, Yaakov ; Stienlauf, Shmuel ; Schwartz, Eli ; Arez, Ana Paula</creatorcontrib><description>Although human African trypanosomiasis (HAT) is uncommon among patients from non-endemic countries (NEC), there has been an increase in the number of cases reported in recent years.
A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obtained from the United Nations World Tourism Organization. All HAT cases diagnosed in patients from NEC were included. Immigrants and refugees were excluded. We compared patients during and after the colonial period, and analyzed the relationship between the number of incoming travellers and the number of HAT cases.
Between 1902 and 2012, HAT was reported in 244 patients. Most HAT cases were reported before 1920, and after the year 2000. In the colonial era the average age of patients was lower (32.5±7.8 vs. 43.0±16.1 years, P<0.001), the proportion of females was lower (10.0% vs. 23.9%, P<0.01], most cases were diagnosed in expatriates, missionaries and soldiers (74.3%), and Gambian trypanosomiasis accounted for 86/110, (78%) of cases. In the post-colonial era most patients 91/125 (72.8%) were short-term tourists to game parks in Eastern and South-Eastern Africa (mainly in Tanzania); Rhodesian trypanosomiasis accounted for 94/123 (76.4%) of cases. Between 1995 and 2010 there has been a constant linear increase in the number of incoming tourists to Tanzania, and HAT cases occurred in small outbreaks rather than following a similar linear pattern.
In recent decades HAT patients from NEC are older, and more likely to be tourists who acquired the disease while visiting game-parks in Eastern and South-Eastern Africa. While Rhodesian trypanosomiasis is relatively uncommon among Africans, it now accounts for most cases reported among patients from NEC. Returning febrile travellers without an alternative diagnosis should be evaluated for HAT. Cases among travellers may serve as sentinels for Rhodesian trypanosomiasis "hot spots" in Africa.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0088647</identifier><identifier>PMID: 24586363</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; African trypanosomiasis ; Aged ; Animals ; Child ; Child, Preschool ; Comparative analysis ; Disease ; Disease hot spots ; Disease Outbreaks - statistics & numerical data ; Endemic Diseases - statistics & numerical data ; Epidemics ; Epidemiology ; Female ; Females ; Humans ; Immigrants ; Infant ; Infections ; Internal medicine ; Literature reviews ; Male ; Medical diagnosis ; Medicine ; Middle Aged ; Outbreaks ; Parks ; Patients ; Protozoa ; Refugees ; Soldiers ; Tourism ; Tourists ; Travel ; Travelers ; Travellers ; Trypanosoma brucei ; Trypanosomiasis ; Trypanosomiasis, African - epidemiology ; Vector-borne diseases ; Young Adult</subject><ispartof>PloS one, 2014-02, Vol.9 (2), p.e88647-e88647</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Neuberger et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Neuberger et al 2014 Neuberger et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-a09a8338139a44faf082a790183d9b123a134b3d18aac406a52d77a3349a4bbd3</citedby><cites>FETCH-LOGICAL-c692t-a09a8338139a44faf082a790183d9b123a134b3d18aac406a52d77a3349a4bbd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929605/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929605/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24586363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Arez, Ana Paula</contributor><creatorcontrib>Neuberger, Ami</creatorcontrib><creatorcontrib>Meltzer, Eyal</creatorcontrib><creatorcontrib>Leshem, Eyal</creatorcontrib><creatorcontrib>Dickstein, Yaakov</creatorcontrib><creatorcontrib>Stienlauf, Shmuel</creatorcontrib><creatorcontrib>Schwartz, Eli</creatorcontrib><title>The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Although human African trypanosomiasis (HAT) is uncommon among patients from non-endemic countries (NEC), there has been an increase in the number of cases reported in recent years.
A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obtained from the United Nations World Tourism Organization. All HAT cases diagnosed in patients from NEC were included. Immigrants and refugees were excluded. We compared patients during and after the colonial period, and analyzed the relationship between the number of incoming travellers and the number of HAT cases.
Between 1902 and 2012, HAT was reported in 244 patients. Most HAT cases were reported before 1920, and after the year 2000. In the colonial era the average age of patients was lower (32.5±7.8 vs. 43.0±16.1 years, P<0.001), the proportion of females was lower (10.0% vs. 23.9%, P<0.01], most cases were diagnosed in expatriates, missionaries and soldiers (74.3%), and Gambian trypanosomiasis accounted for 86/110, (78%) of cases. In the post-colonial era most patients 91/125 (72.8%) were short-term tourists to game parks in Eastern and South-Eastern Africa (mainly in Tanzania); Rhodesian trypanosomiasis accounted for 94/123 (76.4%) of cases. Between 1995 and 2010 there has been a constant linear increase in the number of incoming tourists to Tanzania, and HAT cases occurred in small outbreaks rather than following a similar linear pattern.
In recent decades HAT patients from NEC are older, and more likely to be tourists who acquired the disease while visiting game-parks in Eastern and South-Eastern Africa. While Rhodesian trypanosomiasis is relatively uncommon among Africans, it now accounts for most cases reported among patients from NEC. Returning febrile travellers without an alternative diagnosis should be evaluated for HAT. Cases among travellers may serve as sentinels for Rhodesian trypanosomiasis "hot spots" in Africa.</description><subject>Adolescent</subject><subject>Adult</subject><subject>African trypanosomiasis</subject><subject>Aged</subject><subject>Animals</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Comparative analysis</subject><subject>Disease</subject><subject>Disease hot spots</subject><subject>Disease Outbreaks - statistics & numerical data</subject><subject>Endemic Diseases - statistics & numerical data</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Females</subject><subject>Humans</subject><subject>Immigrants</subject><subject>Infant</subject><subject>Infections</subject><subject>Internal medicine</subject><subject>Literature reviews</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Outbreaks</subject><subject>Parks</subject><subject>Patients</subject><subject>Protozoa</subject><subject>Refugees</subject><subject>Soldiers</subject><subject>Tourism</subject><subject>Tourists</subject><subject>Travel</subject><subject>Travelers</subject><subject>Travellers</subject><subject>Trypanosoma brucei</subject><subject>Trypanosomiasis</subject><subject>Trypanosomiasis, African - epidemiology</subject><subject>Vector-borne diseases</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7jr6D0QLguhFx3y1TW6EYfFjYGFBV2_DaZu2GdpkTFpx_r3pTHeZyl5ILhKS533PyTmcKHqJ0RrTHH_Y2dEZ6NZ7a9QaIc4zlj-KLrGgJMkIoo_PzhfRM-93CKWUZ9nT6IKwlGc0o5eRuW1VXLZgGm2aWO11pXptO9scYlvH7diDiTe102XYB3fYg7He9hq89jH0Nmj2MGhlBh_XzvaxCdmYyaOMSzuawWnlkwQLRBKCMHkePamh8-rFvK-iH58_3V59Ta5vvmyvNtdJmQkyJIAEcEo5pgIYq6FGnEAuEOa0EgUmFDBlBa0wBygZyiAlVZ4DpSzwRVHRVfT65LvvrJdzqbzEKUIMI8qyQGxPRGVhJ_dO9-AO0oKWxwvrGglu0GWnJA6hOC-gxDlinKSFqkpRY5bmrM6FmLw-ztHGog-PoRwOuoXp8sXoVjb2t6SCiCx0ZRW9mw2c_TUqP8he-1J1HRhlx2PeDKcMZyigb_5BH_7dTDUQPqBNbUPccjKVG5bzkDXKp7DrB6iwjg0Mnax1uF8I3i8EgRnUn6GB0Xu5_f7t_9mbn0v27RnbKuiG1ttuHLQ1fgmyE1g6671T9X2RMZLTWNxVQ05jIeexCLJX5w26F93NAf0LkCAGqQ</recordid><startdate>20140219</startdate><enddate>20140219</enddate><creator>Neuberger, Ami</creator><creator>Meltzer, Eyal</creator><creator>Leshem, Eyal</creator><creator>Dickstein, Yaakov</creator><creator>Stienlauf, Shmuel</creator><creator>Schwartz, Eli</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20140219</creationdate><title>The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012</title><author>Neuberger, Ami ; Meltzer, Eyal ; Leshem, Eyal ; Dickstein, Yaakov ; Stienlauf, Shmuel ; Schwartz, Eli</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-a09a8338139a44faf082a790183d9b123a134b3d18aac406a52d77a3349a4bbd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>African trypanosomiasis</topic><topic>Aged</topic><topic>Animals</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Comparative analysis</topic><topic>Disease</topic><topic>Disease hot spots</topic><topic>Disease Outbreaks - statistics & numerical data</topic><topic>Endemic Diseases - statistics & numerical data</topic><topic>Epidemics</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Females</topic><topic>Humans</topic><topic>Immigrants</topic><topic>Infant</topic><topic>Infections</topic><topic>Internal medicine</topic><topic>Literature reviews</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Outbreaks</topic><topic>Parks</topic><topic>Patients</topic><topic>Protozoa</topic><topic>Refugees</topic><topic>Soldiers</topic><topic>Tourism</topic><topic>Tourists</topic><topic>Travel</topic><topic>Travelers</topic><topic>Travellers</topic><topic>Trypanosoma brucei</topic><topic>Trypanosomiasis</topic><topic>Trypanosomiasis, African - epidemiology</topic><topic>Vector-borne diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neuberger, Ami</creatorcontrib><creatorcontrib>Meltzer, Eyal</creatorcontrib><creatorcontrib>Leshem, Eyal</creatorcontrib><creatorcontrib>Dickstein, Yaakov</creatorcontrib><creatorcontrib>Stienlauf, Shmuel</creatorcontrib><creatorcontrib>Schwartz, Eli</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neuberger, Ami</au><au>Meltzer, Eyal</au><au>Leshem, Eyal</au><au>Dickstein, Yaakov</au><au>Stienlauf, Shmuel</au><au>Schwartz, Eli</au><au>Arez, Ana Paula</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-02-19</date><risdate>2014</risdate><volume>9</volume><issue>2</issue><spage>e88647</spage><epage>e88647</epage><pages>e88647-e88647</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Although human African trypanosomiasis (HAT) is uncommon among patients from non-endemic countries (NEC), there has been an increase in the number of cases reported in recent years.
A systematic review of the literature was performed. The number of incoming tourists to HAT endemic countries was obtained from the United Nations World Tourism Organization. All HAT cases diagnosed in patients from NEC were included. Immigrants and refugees were excluded. We compared patients during and after the colonial period, and analyzed the relationship between the number of incoming travellers and the number of HAT cases.
Between 1902 and 2012, HAT was reported in 244 patients. Most HAT cases were reported before 1920, and after the year 2000. In the colonial era the average age of patients was lower (32.5±7.8 vs. 43.0±16.1 years, P<0.001), the proportion of females was lower (10.0% vs. 23.9%, P<0.01], most cases were diagnosed in expatriates, missionaries and soldiers (74.3%), and Gambian trypanosomiasis accounted for 86/110, (78%) of cases. In the post-colonial era most patients 91/125 (72.8%) were short-term tourists to game parks in Eastern and South-Eastern Africa (mainly in Tanzania); Rhodesian trypanosomiasis accounted for 94/123 (76.4%) of cases. Between 1995 and 2010 there has been a constant linear increase in the number of incoming tourists to Tanzania, and HAT cases occurred in small outbreaks rather than following a similar linear pattern.
In recent decades HAT patients from NEC are older, and more likely to be tourists who acquired the disease while visiting game-parks in Eastern and South-Eastern Africa. While Rhodesian trypanosomiasis is relatively uncommon among Africans, it now accounts for most cases reported among patients from NEC. Returning febrile travellers without an alternative diagnosis should be evaluated for HAT. Cases among travellers may serve as sentinels for Rhodesian trypanosomiasis "hot spots" in Africa.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24586363</pmid><doi>10.1371/journal.pone.0088647</doi><tpages>e88647</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2014-02, Vol.9 (2), p.e88647-e88647 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1500410346 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult African trypanosomiasis Aged Animals Child Child, Preschool Comparative analysis Disease Disease hot spots Disease Outbreaks - statistics & numerical data Endemic Diseases - statistics & numerical data Epidemics Epidemiology Female Females Humans Immigrants Infant Infections Internal medicine Literature reviews Male Medical diagnosis Medicine Middle Aged Outbreaks Parks Patients Protozoa Refugees Soldiers Tourism Tourists Travel Travelers Travellers Trypanosoma brucei Trypanosomiasis Trypanosomiasis, African - epidemiology Vector-borne diseases Young Adult |
| title | The changing epidemiology of human African trypanosomiasis among patients from nonendemic countries--1902-2012 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T22%3A27%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20changing%20epidemiology%20of%20human%20African%20trypanosomiasis%20among%20patients%20from%20nonendemic%20countries--1902-2012&rft.jtitle=PloS%20one&rft.au=Neuberger,%20Ami&rft.date=2014-02-19&rft.volume=9&rft.issue=2&rft.spage=e88647&rft.epage=e88647&rft.pages=e88647-e88647&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0088647&rft_dat=%3Cgale_plos_%3EA478799075%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1500410346&rft_id=info:pmid/24586363&rft_galeid=A478799075&rft_doaj_id=oai_doaj_org_article_14b388bac1704825bedc9f14574f7996&rfr_iscdi=true |