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. 2021 Mar-Apr:40:101999.
doi: 10.1016/j.tmaid.2021.101999. Epub 2021 Feb 24.

Health problems in travellers to Nepal visiting CIWEC clinic in Kathmandu - A GeoSentinel analysis

Prativa Pandey  1 , Keun Lee  2 , Bhawana Amatya  3 , Kristina M Angelo  4 , David R Shlim  5 , Holly Murphy  6
Affiliations

Health problems in travellers to Nepal visiting CIWEC clinic in Kathmandu - A GeoSentinel analysis

Prativa Pandey et al. Travel Med Infect Dis. 2021 Mar-Apr.

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.

Keywords: Altitude sickness; Environmental exposure; Nepal; Sentinel surveillance; Travel.

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Figures

Fig. 1.
Fig. 1.
Distribution of Cyclospora cases at CIWEC, 2009–2017 (n = 191).
Fig. 2.
Fig. 2.
Altitude illness from various trekking regions of Nepal, 2009–2017 (n = 1920).
Fig. 3.
Fig. 3.
Antibiotic sensitivity in typhoid fever cases at CIWEC (2009–2017) with resistance patterns available (n = 45).
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References

    1. Ministry of Culture, Tourism and Civil Aviation. Nepal tourism statistics 2017. Singha Durbar, Kathmandu: Government of Nepal; 2018.
    1. Ministry of Culture, Tourism and Civil Aviation. Nepal tourism statistics 2018. Kathmandu, Nepal: Government of Nepal; 2019.
    1. Taylor DN, Houston R, Shlim DR, Bhaibulaya M, Ungar BL, Echeverria P. Etiology of diarrhea among travelers and foreign residents in Nepal. J Am Med Assoc 1988; 260(9):1245–8. - PubMed
    1. CIWEC Hospital Travel Medicine Center, Kathmandu, Nepal. Available from: http://www.ciwec-clinic.com.
    1. CIWEC Hospital Travel Medicine Center. About Us [Internet]. [cited 2019 November 12]. Available from: http://ciwec-clinic.com/about-us/.

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