Journal of travel medicine最新文献

{"title":"Early transmission risks of Ebola disease outbreak caused by Bundibugyo virus in the Democratic Republic of the Congo.","authors":"Zihao Guo, Yongdi Yu, Zhaojun Ding, Lirong Cao, Sheikh Taslim Ali, Zhuang Cui, Kai Wang, Marc K C Chong, Daihai He, Shi Zhao, Abdulrazaq G Habib, Yuantao Hao","doi":"10.1093/jtm/taag085","DOIUrl":"https://doi.org/10.1093/jtm/taag085","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of travelers to high altitude with self-reported sulfonamide allergy: experience from a travel clinic in Thailand.","authors":"Sakarn Charoensakulchai, Tammatat Veeramanomai, Patcharapol Wittayatechakul, Suda Punrin, Watcharapong Piyaphanee","doi":"10.1093/jtm/taag084","DOIUrl":"https://doi.org/10.1093/jtm/taag084","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningitis Burden and Vaccine Impact in the WHO Western Pacific Region, 1990-2023.","authors":"Seungjae Byun, Yeongtaek Hwang, Yejun Son, Taelim Choi, Hyeon Jin Kim, Lee Smith, Ho Geol Woo, Christa J Nehs, Dong Keon Yon, Jiseung Kang","doi":"10.1093/jtm/taag083","DOIUrl":"https://doi.org/10.1093/jtm/taag083","url":null,"abstract":"<p><strong>Background: </strong>Meningitis remained a major cause of death and disability worldwide, but evidence on long-term trends, pathogen distribution, and the impacts of the vaccine program across the WHO Western Pacific Region (WPR) remained limited.</p><p><strong>Methods: </strong>We used the World Health Organization Immunization Data and the Global Burden of Diseases Study (GBD) 2023 for the period 1990-2023. We assessed the incidence and mortality of meningitis across 32 WPR countries. Incidence and mortality were analyzed by age, sex, and 17 pathogens, with age-standardized rates calculated using the GBD global standard population. To evaluate the impact of the vaccine program, we applied negative binomial generalized linear models with a log link function and population offset to annual pathogen-specific death counts, characterizing vaccine exposure by program introduction and annual coverage.</p><p><strong>Results: </strong>From 1990 to 2023, incident cases of meningitis in the WPR declined from 638.02 thousand (95% uncertainty interval [UI], 497.54-789.94) to 162.67 thousand (136.19-192.51), and deaths declined from 78.16 thousand (55.76-103.50) to 15.17 thousand (11.45-21.03), although marked between-country disparities persisted. Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae accounted for the greatest number of meningitis-related deaths, although their burden declined over time. Haemophilus influenzae type b (Hib3) introduction was associated with a 31.85% reduction in Haemophilus influenzae meningitis deaths across the WPR (95% CI, -39.40% to -23.35%), and pneumococcal conjugate (PCV3) introduction with an 11.53% reduction in Streptococcus pneumoniae meningitis deaths (95% CI, -21.20% to -0.68%). Under a counterfactual scenario of 95% vaccine coverage, Haemophilus influenzae meningitis deaths were projected to further decline by 14.82% (95% CI, 7.33%-21.41%), and Streptococcus pneumoniae meningitis deaths by 12.27% (2.43%-20.92%).</p><p><strong>Conclusions: </strong>The burden of meningitis in the WPR declined substantially from 1990 to 2023, but persistent cross-country inequalities and shifts in age-specific and pathogen-specific patterns remained. Hib3 and PCV3 vaccine introductions were associated with meaningful reductions in vaccine-targeted meningitis mortality, though the effect varied across countries.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Complementary Digital Health Technologies Across the Travel Medicine Continuum: A Narrative Review.","authors":"Perry J J van Genderen, Eric N M van Sprang","doi":"10.1093/jtm/taag082","DOIUrl":"https://doi.org/10.1093/jtm/taag082","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) and complementary digital health technologies are increasingly being applied to improve prevention, diagnosis and surveillance in travel medicine. This narrative review evaluates current applications of these technologies across the pre-travel, peri-travel and post-travel phases of the travel continuum.</p><p><strong>Methods: </strong>A narrative literature review was conducted using a clinically oriented three-phase framework encompassing pre-travel preparation, peri-travel monitoring and post-travel diagnosis and surveillance. Machine learning, clinical decision-support systems, large language models, wearable technologies, telemedicine, outbreak surveillance, precision diagnostics and interoperable digital health infrastructure were reviewed.</p><p><strong>Results: </strong>Machine learning improved individualized risk prediction before travel and supported diagnostic decision-making after travel, while clinical decision-support systems enabled more personalized preventive and therapeutic recommendations. During travel, AI-assisted border screening detected SARS-CoV-2 outbreaks up to nine days earlier than conventional surveillance, and wearable Internet of Things (IoT) technologies enabled continuous physiological monitoring in travelers and mass gatherings. The MALrisk model predicted imported malaria with an area under the receiver operating characteristic curve of 0.98, achieving 100% sensitivity and 72% specificity. In hospitalized returned travelers, ChatGPT-4o identified the correct diagnosis in 68% of patients and included the correct diagnosis among its three leading differential diagnoses in 78%, while metagenomic next-generation sequencing increased the diagnostic yield by 24.2% beyond routine investigations.</p><p><strong>Conclusions: </strong>AI and complementary digital health technologies have the potential to improve travel healthcare throughout the travel continuum. The principal challenge is no longer the development of individual AI applications, but determining how complementary technologies can be effectively integrated into routine travel medicine. Current evidence remains largely retrospective, highlighting the need for prospective multicenter implementation studies evaluating clinically meaningful outcomes.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Typhoid Fever in Africa: Trends, Demographic Determinants, and Relevance to Travel Medicine.","authors":"Kui Wang, Shanshan Zhang","doi":"10.1093/jtm/taag073","DOIUrl":"https://doi.org/10.1093/jtm/taag073","url":null,"abstract":"<p><strong>Background: </strong>Although global typhoid fever burden has declined, African destination-level risk remains incompletely characterised for travel medicine. We assessed trends, demographic drivers and traveller-relevant typhoid risk across African destinations.</p><p><strong>Methods: </strong>We analysed GBD 2023 modelled estimates for typhoid fever in 54 African Union destinations, 2010-2023. Outcomes were incidence, prevalence, deaths and DALYs. We estimated age-standardised rates, all-age numbers and trends, developed a burden-trend typology, attributed DALY-count changes to population growth, age-structure change and age-specific DALY-rate change, and estimated destination-specific expected cases per 100 000 travellers. This model-derived metric was used for relative destination ranking, not as an observed individual-level traveller risk estimate. We also performed exploratory interrupted time-series, ecological deaths-to-incidence ratio and 2030 scenario extrapolation analyses.</p><p><strong>Results: </strong>From 2010 to 2023, estimated incident cases declined from approximately 1.36 million to 902 000, and age-standardised incidence from 103.8 to 52.3 per 100 000. Age-standardised prevalence, death and DALY rates declined from 6.6 to 3.3, 1.3 to 0.7, and 96.9 to 53.9 per 100 000, respectively. The highest 2023 incidence rates occurred in the Central African Republic, the Republic of the Congo, the Democratic Republic of the Congo, Gabon and Angola; the Democratic Republic of the Congo had the largest absolute burden. Malawi was the only high-burden, non-declining destination across incidence, deaths and DALYs. DALY counts decreased by approximately 403 000, mainly due to lower age-specific DALY rates. Traveller risk ranged from 0.03 to 9.0 expected cases per 100 000 travellers, with the five highest-risk destinations in Central Sub-Saharan Africa. Scenario extrapolation suggested incidence may decline to 36.1 per 100 000 by 2030.</p><p><strong>Conclusions: </strong>Typhoid fever incidence is declining overall, but substantial heterogeneity persists across African destinations. These findings support destination-specific risk assessment, typhoid vaccination where appropriate, food and water precautions, and clinical vigilance for febrile returning travellers from higher-risk destinations.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Exposure Prophylaxis for Travellers: A New Opportunity for HIV Prevention in Travel Medicine.","authors":"Thibaut Vanbaelen, Ula Maniewski-Kelner, Matilde Hens","doi":"10.1093/jtm/taag060","DOIUrl":"https://doi.org/10.1093/jtm/taag060","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic Injuries among International Travellers in Nepal.","authors":"Abhishek Shrestha, Ishwor Ghimire Padhya, Jasmine Shrestha, Pratigya Aryal, Prativa Pandey","doi":"10.1093/jtm/taag081","DOIUrl":"https://doi.org/10.1093/jtm/taag081","url":null,"abstract":"","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SEVMALrisk: An Externally Validated Clinical Risk Score for Early Risk Stratification of Severe Imported Malaria.","authors":"Perry J J van Genderen, Michele Fumarola, Robert-Jan Hassing, Foekje Stelma, Jaap J van Hellemond","doi":"10.1093/jtm/taag080","DOIUrl":"https://doi.org/10.1093/jtm/taag080","url":null,"abstract":"<p><strong>Background: </strong>Early recognition of severe imported malaria is essential because treatment decisions frequently need to be made before reliable parasite density measurements become available. Objective tools to support early risk stratification during this interval are lacking. This study developed and externally validated SEVMALrisk, an explainable clinical risk score derived from a machine-learning prediction model using routinely available admission laboratory parameters.</p><p><strong>Methods: </strong>Adult patients with confirmed malaria from the Rotterdam Malaria Cohort (n = 832) were used for prediction model development. Eight supervised machine-learning algorithms were compared. The best-performing model was optimized, interpreted using SHapley Additive exPlanations (SHAP) and translated into the SEVMALrisk clinical risk score. Independent external validation was performed in a multicenter cohort (n = 124).</p><p><strong>Results: </strong>Random Forest showed the highest discriminative performance and was selected for model development. The optimized prediction model achieved an area under the receiver operating characteristic curve (AUROC) of 0.962 with good calibration (Brier score 0.048). SHAP analysis identified eight routinely available laboratory parameters (total bilirubin, ASAT, leukocytes, thrombocytes, erythrocytes, creatinine, CRP and urea) for inclusion in the clinical risk score. The predefined decision threshold (26 points) remained unchanged during external validation. Internal validation yielded likelihood ratios of 9.39 (LR+) and 0.19 (LR-), corresponding to post-test probabilities of 51.9% and 2.1%, respectively. External validation demonstrated comparable performance (LR+ 8.02; LR- 0.18), with post-test probabilities of 59.2% and 3.2%.</p><p><strong>Conclusion: </strong>SEVMALrisk is an explainable and externally validated clinical risk score for early risk stratification of severe imported malaria. Rather than replacing parasite density assessment or WHO severity criteria, it supports evidence-based treatment decisions before reliable parasite quantification becomes available.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autochthonous chikungunya virus outbreak in Verona province, Italy, 2025.","authors":"Concetta Castilletti, Leonardo Ancillotti, Antonio Mori, Silvia Accordini, Michela Deiana, Samuele Cheri, Natasha Gianesini, Lorena Maria Chesini, Simone Malagò, Andrea Matucci, Federico Cubi, Chiara Zanchi, Paolo Cattaneo, Ralph Huits, Luisa Barzon, Monia Pacenti, Davide Gentili, Michele Tonon, Chiara Postiglione, Francesco Marchiori, Salvatore Falcone, Tamara Zerman, Federica Gobbo, Christina Merakou, Martina Del Manso, Fabrizio Montarsi, Giulietta Venturi, Patrizio Pezzotti, Dora Buonfrate, Giovanna Varischi, Anna Teresa Palamara, Francesca Russo, Federico Giovanni Gobbi","doi":"10.1093/jtm/taag079","DOIUrl":"https://doi.org/10.1093/jtm/taag079","url":null,"abstract":"<p><strong>Background: </strong>Chikungunya virus (CHIKV), primarily transmitted by Aedes mosquitoes, has increasingly caused autochthonous outbreaks in temperate regions, including Italy. In 2025, a local CHIKV outbreak occurred in Verona province, Veneto Region. We report the findings of integrated epidemiological, virological, and entomological investigations.</p><p><strong>Methods: </strong>In 2025, a dedicated surveillance protocol was implemented to assess local transmission of arboviral infections in Verona province, enabling early detection of a local CHIKV circulation. Following notification of the index case, investigations were conducted in accordance with the national and regional arbovirus surveillance plans, including comprehensive epidemiological, virological, and entomological analyses.</p><p><strong>Results: </strong>The index case was identified on 6 August 2025, with retrospective detection of the first case with symptom onset on 31 July; the primary case was not identified. As of 15 October, 69 cases were reported (62 confirmed, 7 probable), with a mean age of 55 years; 91.3% had identifiable epidemiological links, mainly clustered in two municipalities of the Verona province. Most cases (76.8%) occurred between mid-August and mid-September. The outbreak lasted approximately fifteen weeks, from the end of July to the mid of October. CHIKV-RNA was detectable in whole blood and, less frequently, urine only within the first five days after symptom onset, with higher viral loads in blood. CHIKV-specific IgM antibodies were detectable from days 4-5 and IgG from days 7-10. A total of 225 Aedes albopictus specimens were collected, all testing negative for CHIKV. Phylogenetic analysis revealed a highly homogeneous, monophyletic cluster within the East-Central-South African (ECSA) genotype, closely related to strains from the 2024-2025 Réunion outbreak.</p><p><strong>Conclusions: </strong>This outbreak underscores the value of dedicated surveillance protocols for early detection of febrile/suspected arboviral cases, while also highlighting key vulnerabilities, namely, an undetected primary case and negative entomological findings, pointing to the need for lower testing thresholds and earlier, risk-based vector sampling.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of chronic arthralgia after chikungunya virus infection: a systematic review and meta-analysis.","authors":"Lucas Bussiki Corrêa da Costa Kotecki, itória Diniz de Medeiros, Mariana Bussiki Corrêa da Costa Kotecki, Bianca Gabriela Tavares Castiglioni, Miguel Chaves Lenzi, sadora Pasqualette Silva, Rafaela Coelho Duarte, João Vitor Kayser de Souza, Cláudia Figueredo Nascimento Salomão Santos, Gabriela Stutz F Moreira, José Aldair Kotecki, Lucas Pompeu Salomão, Tatiana Fortes de Oliveira","doi":"10.1093/jtm/taag078","DOIUrl":"10.1093/jtm/taag078","url":null,"abstract":"<p><strong>Background: </strong>Chikungunya is an expanding global health threat, with chronic arthralgia representing the main long-term driver of disability. Although many studies have assessed post-chikungunya outcomes, evidence remains fragmented and contradictory. We aimed to identify reproducible predictors of chronic arthralgia (≥3 months) after laboratory-confirmed chikungunya and to distinguish stable prognostic signals from context-dependent associations.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, and BVS/LILACS from inception to Feb 6, 2026, without restrictions. Eligible studies compared participants with and without chronic arthralgia at follow-up and reported extractable baseline or acute-phase factors. Two reviewers independently screened records, extracted data, and assessed risk of bias using QUIPS. Random-effects restricted maximum likelihood meta-analyses pooled odds ratios and mean differences, with subgroup analyses by follow-up window. PROSPERO: CRD420251169320.</p><p><strong>Results: </strong>Of 1784 records, 29 studies were included, comprising 4108 participants: 1838 with chronic arthralgia and 2230 without. After harmonization, 22 predictors were meta-analyzed. The most consistent associations were female sex (OR 2.08, 95% CI 1.77-2.46; I2=8.3%), comorbidity presence (1.99, 1.55-2.55; I2=0%), and high blood pressure (1.52, 1.13-2.04; I2=33.4%). In contrast, several acute-phase manifestations and treatment-related markers showed less stable, timing-dependent, or study-sensitive associations. Overall risk of bias was high in most studies and moderate in the remainder.</p><p><strong>Conclusions: </strong>Chronic post-chikungunya arthralgia was most reproducibly associated with readily identifiable baseline host factors, rather than with a uniform acute-severity phenotype. These findings suggest that risk stratification should not rely only on acute symptom burden, and that pre-existing vulnerability may define a clinically important high-risk group. Point-of-care identification of patients with these characteristics could support prioritization of follow-up and resource allocation during outbreaks, inform post-outbreak surveillance and guideline development, and may guide future burden-based vaccination strategies in endemic settings.</p>","PeriodicalId":17407,"journal":{"name":"Journal of travel medicine","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}