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Table 2 Studies identifying the syndromic diagnosis of chronic diarrhea with ranking relative to all assessed syndromic diagnosesa

From: Review: chronic and persistent diarrhea with a focus in the returning traveler

Author

Publication Year

Surveillance Years

Origin of Travelers

%Male

Age

Median (IQR/Range)

Mean (std)

Destinationc

Number of Travelers

PMd Chronic Diarrhea (CD)

Rank Among Syndromic Diagnoses

Leading Syndromic Dignoses [Rank & PM]b

Freedman

2006

1996–2004

Global

52

33 (26–45) IQR

Global

17353

113

4

#1: AFI 226

#2: AD 222

#3: D 170

46

37 (27–50) IQR

Carribean

1115

132

4

#1: D: 261

#2: AD 196

#3: AFI 166

55

30 (23–42) IQR

South America

1675

130

4

#1: D 264

#2: AD 219

#3: AFI 143

48

32 (24–45) IQR

Central Am/Mexico

1326

173

3

#1: AD 234

#2: D: 225

56

34 (27–45) IQR

SSA

4524

57

7

#1: AFI 371

#2: AD 167

#3: D 127

50

32 (25–45) IQR

SC Asia

2403

129

4

#1: AD 327

#2: AFI 171

#3: D 130

53

32 (25–42) IQR

SE Asis

2793

97

4

#1: AD 248

#2: D 212

#3: AD 210

Leder

2006

1996–2004

Global

49

36.4 (1–85)

SSA

2062

40

4

#1: AFI 180

#2: AD 130

#3: D 130

48

34.8 (1–91)

Asia

4615

60

5

#1: AD 210

#2: D 140

#3: AFI 120

#4: R 60

47

35 (1–83)

Latin America

2581

80

4

#1: D 230

#2: AD 150

#3: AFI 100

Greenwood

2008

2000–2005

Global

--

--

Global

22569

57

--

--

Davis

2008

1998–2007

Global

--

--

SE Asia

6913

66

6

#1: D 209

#2: AFI 205

#3: AD 168

#4: ND GI 76

#5: R 73

--

--

SC Asia

3543

116

3

#1: AD 294

#2: AFI 168

Chene

2009

1996–2008

Global-Short Terme

50

38 (NA)

Global

24807

45

4

#1 AD 123

#2: D 60

#3: GI Parasites 55

Global-Long Terme

57

33 (NA)

Global

4039

50

1

#1: CD 50

#2: G 36

#3: IBS 36

---

---

South America

----

58

3

#1: CL: 72

#2: IBS: 66

---

---

Central Am/Mexico

----

108

1

#1: CD 108

#2: IBS 97

#3: AD 37

---

---

North Africa

----

--

--

#1: G 44

#2: AD 44

#3: IBS 37

---

---

Middle East

----

31

2

#1: G 109

#2: CD 31

---

---

SC Asia

----

87

1

#1: CD 87

#2: G 86

---

---

SE Asia

----

54

2

#1: D 63

Mendelson

2010

1997–2009

Global

52

 

SSA

13460

56

6

#1: AFI 314

#2: AD 166

#3: D 118

#4: ND GI 91

#5: R 64

50

--

South Africa

823

66

5

#1: AFI 390

#2: D 156

#3: AD 130

#4: R 68

Field

2010

2008

European

51.1

36 (0–89)

Global

6957

70

5

#1: AFI 200

#2: AD 170

#3: D 120

#4: R: 80

---

---

Carribean

116

80

4

#1: D: 300

#2: AD 240

#3: AFI 200

---

---

South Am

477

90

4

#1: D: 180

#2: AD: 150

#3: AFI 150

---

---

Central Am/Mexico

133

110

5

#1: AD 320

#2: D: 260

#3: AFI 160

---

---

North Africa

366

160

2

#1: AD 360

---

---

SSA

1832

50

6

#1: AFI 330

#2: AD 180

#3: D 120

---

---

Middle East

109

90

5

#1: AD 310

#2: AFI 150

#3: D 130

---

---

SC Asia

683

110

3

#1: AD 390

#2: AFI 170

---

---

SE Asia

637

90

5

#1: AFI 250

#2: D 220

#3: AD 210

#4: R 100

Schlagenhauf

2010

1997–2007

Global (Males)

100%

35.9 (NA)

Global

29265

53

4

#1 AD 216

#2 AFI 174

#3 R 107

Global (Females)

100%

34.4 (NA)

Global

29643

65

4

#1 AD 246

#2 R 116

#3 AFI 113

Flores-Figueroa

2011

1996–2010

NA Europe

46

35.9 +/− 14.7

Central America

4779

114

4

#1:AD 235

#2: D 201

#3: AFI 128

Gautret

2012

1997–2009

Global

Elderly >60

49

65 (60–98)

Global

7034

59

7

#1: AD 167

#2: R 146

#3: D 145

#4: AFI 126

#5: ND GI 76

#6: MSK 65

  

Latin America

1161

102

5

#1: D 188

#2: AD 152

#3: AFI 121

  

Africa

1543

70

5

#1: AFI 225

#2: AD 150

#3: D 148

#4: R 79

  

Middle East

179

78

6

#1: D 179

#2: AD 168

#3: R 156

#4: AFI 106

  

Asia

3311

37

9

#1: AD 197

#2: R 185

#3: D 127

Gautret

2012

1997–2009

Global

18–45

55

30 (18–45)

Global

56042

65

5

#1: AD 229

#2: AFI 183

#3: R 103

#4 D 133

Odolini

2012

2008

Europe

51

36 (27–48) IQR

Global

6957

40

4

#1: AD 60

#2: Viral 60

#3: Malaria 50

---

---

North Africa

330

80 (140)

2

#1: AD 160

#2: CD 80

#3: PI-IBS 60

---

---

SC Asia

676

60

4

#1: G 110

#2: AD 110

---

---

SE Asia

631

50

4

#1: Dengue 100

#2: Viral: 100

#3: AD: 90

---

---

South America

351

50

3

#1: AD: 70

#2: Viral 70

Odolini

2012

20092009

Europe

50

35 (27–47) IQR

Global

6392

40

4

#1: AD 60

#2: Malaria 60

#3: Viral 60

---

---

North Africa

248

60 (150)

3

#1: AD 150

#2: CD 60

#3: PI-IBS 70

---

---

SC Asia

550

70

4

#1: G 110

#2: AD 90

#3: Campy 70

---

---

SE Asia

678

40

5

#1: Dengue 100

#2: AD 80

#3: Viral

#4: Hookworm 60

---

---

South America

374

50

4

#1: AD: 80

#2: Malaria 60

#3: Hookworm 50

Harveyf

2013

1997–2011

U.S.

49

34 (med)

Global

13,059

80

5

#1: Acute Diarrhea 220

#2: GI Other 150

#3 AFI 140

#4 D 120

#5: CD 80

Mendelsong

2014

1997–2011

NA Europe

52

35 (0–92)

Africa

16893

50 (70)

4

#1 Malaria 130

#2: Acute diarrhea 80

#3: Viral Syndrome 70

PI-IBS 20

---

37 (0–87)

North Africa

2474

110 (150)

2

#1: AD 230

#2: CD 110

#3: PIIBS 40

---

35–37 (0–92)

Central/West Africa

7446

30

6

#1: Malaria 250

#2: AD 100

#3: Viral 70

#4: G 40

#5: AFI 30

---

34 (0–89)

East Africa

5516

50 (70)

4

#1: AD 120

#2: Viral 80

#3: Malaria 50

#4: CD 50

#5: PI-IBS 20

---

40 (0–89)

South Africa

1457

50

4

#1: R 190

#2: Viral 120

#3: AD 70

Boggild

2014

2009–2011

Canadian

42

38 (0–89)

Global

2010

82 (166)

3

#1: AD 85

#2: PI-IBS 84

Wilson

2014

1997–2013

Global

55

33 (0–78)

Brazil

(South Ameica)

1586

44

4

#1: D 397

#2: AFI 187

#3: AD 92

Monge-Maillo

2014

1989–2010

Spain

44

36 (28–44)

SSA

209

10

--

----

35

Latin America

142

63

--

--

Hagmann

2014

2000–2012

U.S.

48.6

33 (0–94)

Global

9624

105

6

#1: AD--

#2: AFI 182

#3: GI other 178

#4: Dem 166

#5: Respiratory 108

---

---

Caribbean

---

---

---

#1: AD: 156

#2: Dengue 69

#3: Viral 50

#4: R 39

#6: PIIBS 36

---

---

South America

---

34 (121)

5

#1: AD 197

#2: PIIBS 87

---

---

Central Am/Mexico

---

30 (99)

4

#1: AD 275

#2: PIIBS 69

#3: D 46

---

---

North Africa

---

40 (103)

4

#1: AD: 280

#2: Giardia 85

#3: PIIBS: 63

---

---

SSA

---

(28)

7

#1: Malaria 127

#2: AD 145

#3: Giardia 42

PIIBS 28 #7

---

---

Middle East

---

(57)

4

#1: AD: 220

#2: Shistosomiasis 68

#3: G 57

#4: PIIBS 57

---

---

SC Asia

---

28 (83)

3

#1: AD: 250

#2: Giadia 81

#3: PIIBS: 55

#4: R: 36

CD: 28 #8

---

---

SE Asia

---

31 (84)

5

#1: AD 194

#2: PIIBS 53

#3: Dengue 41

#4: R 32

Schlagenhaufh

2015

2008–2012

European

51

35 (27–48)

Global

32136

40

4

#1: Malaria 70

#2: AD 70

#3: Viral 55

PI-IBS 20

  1. aThere were 18 total reviews identified. Two studies reported upon two discrete cohorts, therefore 20 total reviews are reported. Most reviews reported relative ranking of the syndromic diagnoses and these are delineated with leading syndromic diagnoses
  2. bSyndromic Diagnoses: CD: Chronic Diarrhea; AD Acute Diarrhea; G: Giardia; IBS: Irritable bowel disease; D: Dermatologic; CL: cutaneous leishmaniasis; AFI: Acute febrile illness; R: respiratory disease; ND GI: Non diarrheal GI disease: MSK: musculoskeletal
  3. cSSA: Subsaharan Africa; Central Am: Central America; SC Asia: South Central Asia; SE Asia: South East Asia
  4. dPM: proportionate morbidity—the number of cases per 1000 travelers surveyed
  5. eIncluding study by Chen e al which reported upon both Long Term Travelers defined as > 6-months; Short Term Travelers < 1-month
  6. f5% of enrollees were <18 years old
  7. g7% of enrollees were < 19 years old
  8. hApproximate values culled from graphs
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Tropical Diseases, Travel Medicine and Vaccines

ISSN: 2055-0936

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