Post-travel screening of asymptomatic long-term travelers to the tropics for intestinal parasites using molecular diagnostics

Am J Trop Med Hyg. 2014 May;90(5):835-9. doi: 10.4269/ajtmh.13-0594. Epub 2014 Mar 10.

Abstract

The incidence of asymptomatic travel-related parasitic infection is uncertain. Previous studies did not distinguish new incident infections, from past infections. Regardless of symptoms, we performed multiplex real-time polymerase chain reaction on pre- and post-travel stool samples of Dutch long-term travelers to the (sub)tropics. Serological screening for Schistosoma spp. was only performed in travelers to sub-Saharan Africa. In total, 679 travelers were included in the study. The follow-up rate was 82% (556 of 679). Participants' median travel duration was 12 weeks. There was one incident infection with Strongyloides stercoralis; there were none with Entamoeba histolytica, 4 with Cryptosporidium spp. (1%), and 22 with Giardia lamblia (4%). Nine of 146 travelers (6%) seroconverted for Schistosoma spp. Routine screening of stool samples for parasitic infection is not indicated for asymptomatic people, who travel to the (sub)tropics for up to 3 months. Screening for Schistosoma spp. should be offered to travelers with fresh-water contact in endemic regions.

MeSH terms

  • Adult
  • Africa South of the Sahara / epidemiology
  • Animals
  • Cohort Studies
  • Cross-Sectional Studies
  • Cryptosporidium / isolation & purification
  • Entamoeba histolytica / isolation & purification
  • Feces / parasitology
  • Female
  • Follow-Up Studies
  • Giardia lamblia / isolation & purification
  • Humans
  • Incidence
  • Intestinal Diseases, Parasitic / diagnosis*
  • Male
  • Netherlands
  • Pathology, Molecular / methods*
  • Real-Time Polymerase Chain Reaction
  • Schistosoma / genetics
  • Schistosoma / isolation & purification
  • Strongyloides stercoralis / isolation & purification
  • Travel*
  • Young Adult