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Travelers' Diarrhea in Children at Risk: An Observational Study From a Spanish Database
Antoni Soriano-Arandes1, Emely García-Carrasco, Nuria Serre-Delcor
1From the*Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain; †Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; ‡Hospital de Fuenlabrada, Madrid, Spain; §Hospital General Universitario de Alicante, Alicante, Spain; ¶Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain; and ‖Hospital Universitario de Guadalajara, Guadalajara, Spain.
Insights
Pediatric gastrointestinal illnesses are common in children traveling to developing countries. Key risk factors include being a tourist, shorter travel durations, and bacterial infections, with Giardia intestinalis being a frequent cause.
Area of Science:
- Pediatric infectious diseases
- Travel medicine
- Global health
Background:
- Gastrointestinal symptoms are a frequent reason for pediatric consultations, particularly for children traveling to or from developing countries.
- Identifying risk factors for gastrointestinal illness in traveling children is crucial for prevention and management.
Purpose of the Study:
- To identify independent risk factors associated with gastrointestinal syndrome in children undertaking international travel.
- To determine the prevalence of gastrointestinal disorders among pediatric travelers.
Main Methods:
- A prospective, observational, analytical, multicenter study was conducted within the +Redivi Spanish Tropical Medicine network.
- Data were collected from January 2009 to December 2013, including 606 children aged 16 years and younger.
- Statistical analysis identified associations between demographic factors, travel characteristics, and gastrointestinal symptoms.
Main Results:
- Gastrointestinal symptoms accounted for 13.5% of total pediatric consultations for traveling children.
- Independent risk factors identified included being a tourist or visiting friends and relatives, travel duration under 90 days, and bacterial infections.
- Protozoan infections were most prevalent (23.4%), with Giardia intestinalis being the most common pathogen (10.1%).
Conclusions:
- Gastrointestinal syndromes affect a significant proportion of traveling children, necessitating targeted public health interventions.
- Risk factors such as travel type, duration, and causative agent (bacterial vs. protozoan) inform clinical practice and travel advisories.
- Giardia intestinalis remains a primary cause of infectious gastrointestinal illness in pediatric travelers, highlighting the need for awareness and preventive measures.
Background:
Gastrointestinal symptoms are a common cause of consultation about children traveling to or coming from developing countries. The aim of this study was to identify the risk factors associated with gastrointestinal syndrome in children who travel.
Methods:
A prospective observational analytical and multicenter study was performed within +Redivi, a Spanish Tropical Medicine network on imported infections, from January 2009 to December 2013. All participants aged 16 years and younger were included in the analysis. Ethical approval was obtained from all the participating centers.
Results:
A total of 606 children ≤16 years of age were registered in the +Redivi database during the study period. Median age was 8.7 years (interquartile range, 4.4-12.4 years), 65.8% (399/606) were immigrants, 90% were >2 years old and 54% were male. Median travel duration, excluding immigrants, was 50 days (interquartile range, 30-150 days). Children with gastrointestinal symptoms represented 13.5% (82/606) of total consultations. A significant association was found in bivariate analysis between gastrointestinal disorder and age <2 years (P < 0.01) and travel duration (P = 0.046). Immigrants had less gastrointestinal disorders than tourists (P < 0.05). The most prevalent infection was protozoan in 23.4% (142/606), and Giardia intestinalis was the most common pathogen in 10.1% (61/606) of total children. Independent risk factors for gastrointestinal symptoms were tourist and traveler child visiting friends and relatives (P = 0.03), travel duration <90 days (P = 0.008) and bacterial cause (P < 0.001).
Conclusions:
Traveling children who developed a gastrointestinal syndrome represented 13.5% of the total pediatric consultations in +Redivi. Independent risk factors were tourist or traveler visiting friends and relatives, travel duration <90 days and bacterial infection. G. intestinalis was the most common infectious agent causing a gastrointestinal disorder in the traveler children.
