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Travelers Diarrhea

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61. Health problems and health care seeking behavior among adult backpackers while traveling in Thailand (PubMed)

reported at least health problem during travel. Most of them (79.1 %) had single episode of illness. Of this, diarrhea was the most common health problem (30.4 %), followed by abdominal pain (14.3 %), skin problems (8.9 %), respiratory problems (8.9 %), accident-associated injury (7.1 %), and febrile illness (7.1 %). One third of backpackers with health problems spontaneously recovered without any treatment, while nearly a quarter treated themselves with standby medication, and one in five had to buy (...) Health problems and health care seeking behavior among adult backpackers while traveling in Thailand Health problems among travelers in developing countries are not uncommon. Little is known about the occurrence of health problems and their impacts among backpackers in Thailand. The objective of this study was to assess the health problems and the health seeking behavior among adult backpackers who visited Thailand.This was a cross-sectional questionnaire-based study. Data were collected from

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2016 Tropical diseases, travel medicine and vaccines

62. Norovirus: new developments and implications for travelers’ diarrhea (PubMed)

Norovirus: new developments and implications for travelers’ diarrhea Noroviruses are the leading cause of acute gastroenteritis in the United States and are responsible for at least 50 % of acute gastroenteritis outbreaks occurring worldwide each year. In addition, noroviruses have caused outbreaks on cruise ships, in nursing homes and hospitals, and in deployed military personnel, but its role in the etiology of travelers' diarrhea is not well defined. The aim of this review is to describe (...) the role of noroviruses in travelers' diarrhea in terms of epidemiology, current diagnostics, treatment and vaccine development efforts. Studies have shown prevalence rates of noroviruses in travelers' diarrhea cases ranging from 10-65 %. It is likely that norovirus prevalence rates are highly underestimated in travelers' diarrhea due to rapid onset, short duration of the illness, limited availability of laboratory facilities, and the fact that most clinical laboratories lack the diagnostic capability

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2016 Tropical diseases, travel medicine and vaccines

63. Business travel-associated illness: a GeoSentinel analysis. (PubMed)

Business travel-associated illness: a GeoSentinel analysis. Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers.GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 (...) through 31 December 2014.Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified

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2018 Journal of Travel Medicine

64. Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America. (PubMed)

and references for each recommendation, which is available in the online version of the article, published in this journal as a supplement. The supplement contains 10 reviews referring to endemic or travel diseases (eg, tuberculosis, Chagas disease [ChD], leishmaniasis, malaria, strongyloidiasis and schistosomiasis, travelers diarrhea, arboviruses, endemic fungal infections, viral hepatitis, and vaccines) and an illustrative section with maps (http://www.pmourao.com/map/). Contributors included experts from (...) Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America. The Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America clinical practice guideline is intended to guide clinicians caring for solid-organ transplant (SOT) donors, candidates and recipients regarding infectious diseases (ID) issues related to this geographical region, mostly

2018 Transplantation

65. Real-time incidence of travel-related symptoms through a smartphone-based app remote monitoring system: a pilot study. (PubMed)

Real-time incidence of travel-related symptoms through a smartphone-based app remote monitoring system: a pilot study. Trip Doctor®, a Smartphone-based app monitoring system, was developed to detect infections among travelers in real-time. For testing, 106 participants were recruited (62.2% male, mean age 36 years (SD = 11)). Majority of trips were for tourism and main destinations were in South East Asia. Mean travel duration was 14 days (SD = 10). Diarrhea was the most frequently reported

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2018 Journal of Travel Medicine

66. Medical Considerations before International Travel. (PubMed)

IM N Engl J Med. 2016 Oct 13;375(15):e32 27732813 N Engl J Med. 2016 Oct 13;375(15):e32 27732814 N Engl J Med. 2016 Oct 13;375(15):e32 27732815 N Engl J Med. 2016 Oct 13;375(15):e32 27732816 Arbovirus Infections prevention & control Diarrhea prevention & control Endemic Diseases prevention & control Humans Internationality Jet Lag Syndrome prevention & control Malaria prevention & control Rabies prevention & control Travel Travel Medicine Tuberculosis, Pulmonary prevention & control Vaccination (...) Medical Considerations before International Travel. 27468061 2016 08 09 2016 10 17 1533-4406 375 3 2016 Jul 21 The New England journal of medicine N. Engl. J. Med. Medical Considerations before International Travel. 247-60 10.1056/NEJMra1508815 Freedman David O DO From the William C. Gorgas Center for Geographic Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham (D.O.F.); the Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA (L.H.C

2016 NEJM

67. Diagnostic Value of Platelet and Leukocyte Counts in the Differential Diagnosis of Fever in the Returning Traveler. (PubMed)

Diagnostic Value of Platelet and Leukocyte Counts in the Differential Diagnosis of Fever in the Returning Traveler. Malaria, arbovirus infection and travelers' diarrhea are among the most common etiologies of fever after a stay in the tropics. Because the initial symptoms of these diseases often overlap, the differential diagnostic remains a challenge. The aim of this study was to establish the effectiveness of platelet and leukocyte counts in the differential diagnosis of fever (...) in the returning traveler. Between 2013 and 2016, patients with a clinical suspicion of malaria, who had thick blood smears performed were retrospectively included. The microbiological etiology of each episode was established based on molecular detection in the case of arbovirus infection, the detection of pathogens in stool samples for diarrhea and other gastrointestinal symptoms and the thick and thin blood smear results for malaria. A total of 1,218 episodes were included. Malaria, arbovirus infection

2018 American Journal of Tropical Medicine & Hygiene

68. Statement on older travellers

in the post-travel setting, and may herald serious and life-threatening illness, the most important of which is malaria. All febrile patients or patients complaining of fever should therefore be asked about recent travel. While fever in the returning traveller may be due to benign self-limited infections, such as common agents of travellersdiarrhea, or typical cosmopolitan causes unrelated to travel, it must be initially construed as a medical emergency , and warrants prompt and thorough evaluation (...) support with guidance in the evaluation and management of fever in the returning traveller beyond the initial phase. Epidemiology of fever in the returning traveller Fever in the returning traveller may be due to tropical infections or illnesses that have more of a cosmopolitan distribution globally . Numerous large series of illness after international travel have repeatedly identified malaria (20- 30%) 1 , acute travellersdiarrhea (10-20%), and respiratory tract infections (10-15%) as the top

2011 CPG Infobase

69. Fever in the returning international traveller: Initial assessment guidelines

and life-threatening illness, the most important of which is malaria. All febrile patients or patients complaining of fever should therefore be asked about recent travel. While fever in the returning traveller may be due to benign self-limited infections, such as common agents of travellersdiarrhea, or typical cosmopolitan causes unrelated to travel, it must be initially construed as a medical emergency, and warrants prompt and thorough evaluation. Accurate diagnosis and appropriate management (...) traveller may be due to tropical infections or illnesses that have more of a cosmopolitan distribution globally. Numerous large series of illness after international travel have repeatedly identified malaria (20-30%) , acute travellersdiarrhea (10-20%), and respiratory tract infections (10-15%) as the top causes of fever in travellers – (Table 1). Other common causes of fever in the returning traveller include dengue (5%), enteric fever due to Salmonella enterica serovar Typhi or Paratyphi (2-7

2011 CPG Infobase

70. Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016 (PubMed)

(ETEC) is a leading cause of both acute infant diarrhea and traveler's diarrhea in Nepal. The MDR prevalence and associated resistance mechanisms of ETEC isolates responsible for enteric infections in Nepal are largely unknown.A total of 265 ETEC isolates were obtained from acute diarrheal samples (263/265) or patient control samples (2/265) at traveler's clinics or regional hospitals in Nepal from 2001 to 2016. Isolates were screened for antibiotic resistance, to include extended spectrum beta (...) Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016 Multidrug-resistant (MDR) Gram-negative bacterial species are an increasingly dangerous public health threat, and are now endemic in many areas of South Asia. However, there are a lack of comprehensive data from many countries in this region determining historic and current MDR prevalence. Enterotoxigenic Escherichia coli

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2018 Antimicrobial resistance and infection control

71. MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea

MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea Giardiasis should be considered in patients with chronic diarrhea MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea | | October 27, 2018 4 Shares Test your medicine knowledge with the , in partnership with the . A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia (...) that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in the stool. She works in a day care center and has not traveled recently or had exposure to antibiotics. She is otherwise healthy and takes no medications. On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 112/74 mm Hg, and pulse rate is 70/min. The abdomen is soft with normal bowel sounds and mild distention but no tenderness. Which of the following is the most appropriate management

2018 KevinMD blog

72. Critical Role of Zinc in a New Murine Model of Enterotoxigenic Escherichia coli Diarrhea (PubMed)

Critical Role of Zinc in a New Murine Model of Enterotoxigenic Escherichia coli Diarrhea Enterotoxigenic Escherichia coli (ETEC) is a major cause of traveler's diarrhea as well as of endemic diarrhea and stunting in children in developing areas. However, a small-mammal model has been badly needed to better understand and assess mechanisms, vaccines, and interventions. We report a murine model of ETEC diarrhea, weight loss, and enteropathy and investigate the role of zinc in the outcomes. ETEC (...) strains producing heat-labile toxins (LT) and heat-stable toxins (ST) that were given to weaned C57BL/6 mice after antibiotic disruption of normal microbiota caused growth impairment, watery diarrhea, heavy stool shedding, and mild to moderate intestinal inflammation, the latter being worse with zinc deficiency. Zinc treatment promoted growth in zinc-deficient infected mice, and subinhibitory levels of zinc reduced expression of ETEC virulence genes cfa1, cexE, sta2, and degP but not of eltA in vitro

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2018 Infection and immunity

73. Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea (PubMed)

of antibiotic resistance was observed and 58% of the EAEC strains were multidrug resistant. Multidrug resistance was most pronounced in cases of travelers' diarrhea, and it was seen that antibiotic treatment did not reduce the duration of diarrhea. (...) Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea Enteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been discussed. Since the level of antibiotic resistance

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2018 Frontiers in cellular and infection microbiology

74. Visualization-assisted binning of metagenome assemblies reveals potential new pathogenic profiles in idiopathic travelers’ diarrhea (PubMed)

Visualization-assisted binning of metagenome assemblies reveals potential new pathogenic profiles in idiopathic travelers’ diarrhea Travelers' diarrhea (TD) is often caused by enterotoxigenic Escherichia coli, enteroaggregative E. coli, other bacterial pathogens, Norovirus, and occasionally parasites. Nevertheless, standard diagnostic methods fail to identify pathogens in more than 40% of TD patients. It is predicted that new pathogens may be causative agents of the disease.We performed (...) a comprehensive amplicon and whole genome shotgun (WGS) metagenomic study of the fecal microbiomes from 23 TD patients and seven healthy travelers, all of which were negative for the known etiologic agents of TD based on standard microbiological and immunological assays. Abnormal and diverse taxonomic profiles in TD samples were revealed. WGS reads were assembled and the resulting contigs were visualized using multiple query types. A semi-manual workflow was applied to isolate independent genomes from

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2018 Microbiome

75. Prophylactic efficacy of probiotics on travelers’ diarrhea: an adaptive meta-analysis of randomized controlled trials (PubMed)

Prophylactic efficacy of probiotics on travelers’ diarrhea: an adaptive meta-analysis of randomized controlled trials The 2017 guideline for the prevention of travelers' diarrhea (TD) by the International Society of Travel Medicine suggested that 'there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.' However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary

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2018 Epidemiology and health

76. Enterotoxigenic Escherichia coli Adhesin-Toxoid Multiepitope Fusion Antigen CFA/I/II/IV-3xSTaN12S-mnLTG192G/L211A-Derived Antibodies Inhibit Adherence of Seven Adhesins, Neutralize Enterotoxicity of LT and STa Toxins, and Protect Piglets against Diarrhea (PubMed)

Enterotoxigenic Escherichia coli Adhesin-Toxoid Multiepitope Fusion Antigen CFA/I/II/IV-3xSTaN12S-mnLTG192G/L211A-Derived Antibodies Inhibit Adherence of Seven Adhesins, Neutralize Enterotoxicity of LT and STa Toxins, and Protect Piglets against Diarrhea Enterotoxigenic Escherichia coli (ETEC) strains are a leading cause of children's diarrhea and travelers' diarrhea. Vaccines inducing antibodies to broadly inhibit bacterial adherence and to neutralize toxin enterotoxicity are expected (...) to be effective against ETEC-associated diarrhea. 6×His-tagged adhesin-toxoid fusion proteins were shown to induce neutralizing antibodies to several adhesins and LT and STa toxins (X. Ruan, D. A. Sack, W. Zhang, PLoS One 10:e0121623, 2015, https://doi.org/10.1371/journal.pone.0121623). However, antibodies derived from His-tagged CFA/I/II/IV-2xSTaA14Q-dmLT or CFA/I/II/IV-2xSTaN12S-dmLT protein were less effective in neutralizing STa enterotoxicity and were not evaluated in vivo for efficacy against ETEC

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2018 Infection and immunity

77. Persistent Diarrhea: A Clinical Review. (PubMed)

on persistent diarrhea comes from studies of residents in or expatriates of developing countries and travelers to these regions where follow-up studies have been performed. Persistent diarrhea occurs in approximately 3% of individuals traveling to developing countries. Schistosoma mansoni (and rarely Schistosoma haematobium) intestinal infection is also not very common and is found only in endemic areas. The microbiologic causes of protracted diarrhea include detectable parasitic (eg, Giardia (...) Persistent Diarrhea: A Clinical Review. Diarrheal disease is commonly encountered in clinical practice. Persistent diarrhea (≥14 days) can be caused by pathogens that differ from those commonly seen in acute illness; proper etiologic diagnosis is important for appropriate therapeutic management. This review provides an overview of the epidemiology, etiology, diagnosis, and management of persistent diarrhea caused by infectious agents in immunocompetent individuals worldwide.Much of the data

2016 JAMA

78. Anti-diarrhea activity of the aqueous root bark extract of Byrsocarpus coccineus on castor oil-induced diarrhea in Wistar rats (PubMed)

extract of B. coccineus also decreased the distance travelled by activated charcoal in the gastrointestinal tract of treated rats when compared to control rats. Results of castor oil-induced enteropooling revealed slight reduction in the weight of intestinal contents of treated rats compared to control rats. There was significant (p<0.05) decrease in the frequency of defecation as well as in the number of unformed feces produced by castor oil-induced diarrhea at 100 mg/kg dose with 74.96% inhibition (...) Anti-diarrhea activity of the aqueous root bark extract of Byrsocarpus coccineus on castor oil-induced diarrhea in Wistar rats The use of traditional medicine as an alternative source of cure for many ailments has played an important role in health care delivery in both developing and developed countries. Byrsocarpus coccineus Schum and Thonn (Connaraceae) is used in traditional medicine for treatment of various disease conditions, including diarrhea. The anti-diarrhea activity of the root bark

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2017 Veterinary world

79. Development of a travelers' diarrhea vaccine for the military: how much is an ounce of prevention really worth?

Development of a travelers' diarrhea vaccine for the military: how much is an ounce of prevention really worth? Development of a travelers' diarrhea vaccine for the military: how much is an ounce of prevention really worth? Development of a travelers' diarrhea vaccine for the military: how much is an ounce of prevention really worth? Riddle MS, Tribble DR, Cachafiero SP, Putnam SD, Hooper TI Record Status This is a critical abstract of an economic evaluation that meets the criteria (...) : Although the methodology appears to have been appropriate, the results were not clearly reported and are therefore difficult to understand. As a result, it is not possible to ascertain if the authors' conclusions are valid. Funding No internal nor external funding received. Bibliographic details Riddle MS, Tribble DR, Cachafiero SP, Putnam SD, Hooper TI. Development of a travelers' diarrhea vaccine for the military: how much is an ounce of prevention really worth? Vaccine 2008; 26(20): 2490-2502

2008 NHS Economic Evaluation Database.

80. Effect of adjunctive loperamide in combination with antibiotics on treatment outcomes in traveler's diarrhea: a systematic review and meta-analysis

Effect of adjunctive loperamide in combination with antibiotics on treatment outcomes in traveler's diarrhea: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2008 DARE.

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