Predictors of aetiology and outcomes of acute gastrointestinal illness in returning travellers: a retrospective cohort analysis

Abstract Background Gastrointestinal illness is a major cause of morbidity in travellers and common reason for presentation to healthcare services on return. Whilst the aetiology imported gastrointestinal disease predominantly infectious, outcomes are variable due range phenomena such as post-infectious irritable bowel syndrome, drug resistance occult pathology (both infectious non-infectious). Previous studies have focussed predictors travellers; we present retrospective study combining both aetiological early outcome data large cohort returned travellers. Method We identified 1450 patients who attended our post-travel walk-in clinic with symptoms between 2010 2016. Demographic, travel, clinical laboratory was collected through case note review. Logistic regression analysis examine correlates were performed R (CRAN Project 2017). Results Of 153 reported bloody diarrhoea 1081 (74.6%) non-bloody diarrhoea. A definitive microbiological diagnosis made 310 (20.8%) which 137 (9.4%) had parasite 111 (7.7%) bacterial identified. Factors associated parasitological included history travel South Asia (aOR = 2.55; 95%CI 1.75–3.70, p < 0.0001) absence 0.22; 0.066–0.53, 0.005). bacteriological male gender 1.69; 1.10–2.62, 0.05), an age 37 years 2.04; 1.25–3.43, 0.01), white cells stool microscopy 3.52; 2.09–5.86, C-reactive protein level >5iu/dL 4.68; 2.91–7.72, 0.0001). The majority (1235/1450, 82.6%) full symptomatic resolution by first follow up visit; factors lack female 1.45 1.06–1.99, dysenteric 2.14 (95%CI 1.38–3.25, 0.0005) elevated peripheral leukocyte count 1.58 1.02–2.40, 0.05). Conclusions In travellers, able identify multiple that correlated syndromes. predict these will be valuable development diagnostic therapeutic pathways infections.