Travel Medicine and Infectious Disease最新文献

{"title":"What's the worst that could happen? The risk of illness, injury, and death related to international travel-the Australian experience","authors":"Siobhan C. Carroll ,&nbsp;Maria Eugenia Castellanos ,&nbsp;Andreas Neumayr ,&nbsp;Lars Henning","doi":"10.1016/j.tmaid.2025.102933","DOIUrl":"10.1016/j.tmaid.2025.102933","url":null,"abstract":"<div><h3>Introduction</h3><div>Medical advisors to travellers whose journeys begin and end in Australia will benefit from a review of the associated risks, to guide pre- and post-travel advice and care.</div></div><div><h3>Methods</h3><div>A literature search was conducted for original research on medical events in Australian residents related to international travel. Important findings were summarised, incidence and risk factor data extracted, and grouped thematically for narrative review.</div></div><div><h3>Results</h3><div>31 studies published between 1995 and 2024 were identified. Reports of medical events during travel ranged between 28 % and 82 % of travellers, most commonly respiratory and gastrointestinal in nature (34 %–63 % of cases combined). Trauma accounted for 25 %–49 %. 23 studies (74 %) provided data only on events identified or treated after the traveller had returned. Respiratory, gastrointestinal and febrile illnesses were the most frequent reasons for these presentations. Respiratory infection was more common in older returned travellers. Younger adult travellers, more commonly experienced gastrointestinal infection and traumatic injury, including animal bites. Travellers Visiting Friends and Relatives (VFR) were at a higher risk of introducing notifiable diseases to Australia, and contracting tropical diseases.</div></div><div><h3>Conclusions</h3><div>Many travellers seek care after returning from international travel, with the majority due to diseases which commonly occur in Australia. Tropical diseases, however, which can be life-threatening, and require high levels of care, must be excluded. The changing demographic of the migrant population presents a public health risk when VFR travellers are exposed to diseases with limited presence in Australia. Travel advice should include a discussion about possible rabies exposure.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102933"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and outcomes of dengue and scrub typhus in hospitalized adults in the Maldives","authors":"Rajib Kumar Dey ,&nbsp;Fernando Mosler ,&nbsp;Rifau Adam ,&nbsp;Isha Ali ,&nbsp;Aishath Sausan ,&nbsp;Zaidhoon Jaleel ,&nbsp;Rashda Mahir ,&nbsp;Izza Abdul Habeeb ,&nbsp;Aishath Maeesha ,&nbsp;Nihla Ali Rasheed ,&nbsp;Aminath Aroosha ,&nbsp;Wasin Matsee ,&nbsp;Hisham Ahmed Imad","doi":"10.1016/j.tmaid.2025.102914","DOIUrl":"10.1016/j.tmaid.2025.102914","url":null,"abstract":"<div><h3>Background</h3><div>Dengue and scrub typhus are common causes of acute undifferentiated febrile illness in the Maldives.</div></div><div><h3>Methods</h3><div>This retrospective study compared the clinical characteristics of 184 hospitalized adults diagnosed with dengue (n = 94) or scrub typhus (n = 90) at a national referral hospital in the Maldives. Clinical data were collected from 2013 to 2021 for scrub typhus and from 2018 to 2021 for dengue, identified using ICD-10 codes from both physical and electronic records. National dengue and scrub typhus data from 2015 to 2024 were obtained from the Health Protection Agency of the Maldives.</div></div><div><h3>Results</h3><div>Scrub typhus patients were generally older, with a median age of 42.5 years compared to 27 years in dengue, were more often locals, and tended to present later in the course of illness, on day 10 compared to day 4. Furthermore, scrub typhus patients experienced more complications, 23.9 % compared to 3.2 % in dengue, which resulted in longer hospital stays. An eschar was observed in 63.1 % of scrub typhus cases, serving as a useful diagnostic clue. In contrast, dengue patients more often presented with chills, myalgia, arthralgia, bleeding, and thrombocytopenia. There were no fatalities in this cohort.</div></div><div><h3>Conclusions</h3><div>In acute undifferentiated febrile illness in the Maldives, certain clinical indicators, including eschar for scrub typhus and bleeding with severe thrombocytopenia can aid in bedside diagnosis. Identifying these features can help clinicians in resource-limited settings provide timely and appropriate care.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102914"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application value of droplet digital PCR detection of Em-cfDNA in the diagnosis of hepatic alveolar echinococcosis","authors":"Yuan Jiang ,&nbsp;Lingqiang Zhang ,&nbsp;Yaogang Zhang ,&nbsp;Jing Hou ,&nbsp;Zhixin Wang ,&nbsp;Tao Zhang ,&nbsp;Zihan Yang ,&nbsp;Tingting Jia ,&nbsp;Zhiqin Li ,&nbsp;Li Sun ,&nbsp;Yuhu Hou ,&nbsp;Haining Fan ,&nbsp;Yanyan Ma","doi":"10.1016/j.tmaid.2025.102912","DOIUrl":"10.1016/j.tmaid.2025.102912","url":null,"abstract":"<div><h3>Background</h3><div>Alveolar echinococcosis (AE), a parasitic disease caused by the <em>Echinococcus multilocularis</em> (<em>E. multilocularis</em>), primarily affects the liver and has the potential to spread to other organs, which can be quite invasive. This disease has been receiving increasing attention on a global scale. The objective of this study is to evaluate the clinical value of droplet digital polymerase chain reaction (ddPCR) technology in the diagnosis of hepatic alveolar echinococcosis (HAE) through the detection of plasma and to explore the relationship between ddPCR quantitative results and lesion size and staging.</div></div><div><h3>Methods</h3><div>Researchers collected blood samples from 57 confirmed HAE patients and 34 control samples from individuals without AE. Subsequently, ddPCR was utilized to detect <em>E. multilocularis</em> circulating free DNA (Em-cfDNA) in the plasma. Furthermore, next-generation sequencing (NGS) and antibody tests were utilized as comparative methods.</div></div><div><h3>Results</h3><div>The sensitivity of ddPCR was found to be 91.22 %, with a 100 % specificity, thereby demonstrating superiority over conventional serum antibody tests, which exhibited a sensitivity of 89.50 % and a specificity of 85.3 %. ddPCR demonstrated a comparable performance to NGS testing, which also demonstrated a sensitivity of 89.50 % and a 100 % specificity.</div></div><div><h3>Conclusions</h3><div>ddPCR is characterized by its ease of operation and cost-effectiveness. It also holds significant value for screening in resource-limited areas, thereby helping to improve early diagnosis rates for HAE and enhance patient prognosis. Subsequent research endeavors will concentrate on the refinement of this technology and the validation of its applications in the domains of diagnosis, monitoring, and follow-up.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102912"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of dihydroartemisinin-piperaquine for treating Plasmodium falciparum malaria from sub-Saharan Africa: a retrospective study","authors":"Federica Ciminelli ,&nbsp;Dora Buonfrate ,&nbsp;Cristina Mazzi ,&nbsp;Andreas Neumayr ,&nbsp;Daniel Camprubí-Ferrer ,&nbsp;Federico Gobbi","doi":"10.1016/j.tmaid.2025.102923","DOIUrl":"10.1016/j.tmaid.2025.102923","url":null,"abstract":"<div><h3>Background</h3><div>Artemisinin-based combination therapies (ACTs) are the recommended first-line treatment for uncomplicated malaria. However, growing reports of artemisinin resistance, particularly in Southeast Asia, raise concerns about the efficacy of ACTs. This study aimed to assess potential changes over time in the effectiveness of a three-day regimen of dihydroartemisinin-piperaquine (DHA-PPQ) for treating imported uncomplicated <em>Plasmodium falciparum</em> malaria.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted. We reviewed the records of patients treated for uncomplicated <em>P. falciparum</em> malaria in a single centre in Italy (2013–2024). The inclusion criteria were treatment with DHA-PPQ and available data on parasitaemia at baseline and on day three. The primary objective was to determine the rate of parasitaemia clearance on day three.</div></div><div><h3>Results</h3><div>All 90 patients but one were infected in sub-Saharan Africa. We excluded the patient infected in Yemen to obtain a more homogenous cohort. Baseline median parasitaemia was 0.136 % (IQR 0.029–0.750). On day 3, only 6 patients (6.7 %) still had circulating parasites, though in absence of early treatment failure. Follow-up data (available for 63 patients) excluded also late parasitological failures. No significant trend in day-3 positivity was observed across the three study periods (2013–2015, 2016–2019, 2020–2023; <em>p</em> = 0.339).</div></div><div><h3>Conclusions</h3><div>This study revealed no significant reduction in the effectiveness of DHA-PPQ over time for the treatment of uncomplicated <em>P. falciparum</em> malaria imported from Africa. While ACT failure remains rare in sub-Saharan Africa, continued surveillance is essential, especially to monitor resistance trends and inform treatment protocols.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102923"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imported dengue fever in South Korea, 2020–2024: Epidemiological trends and serotype distribution from national laboratory surveillance","authors":"Ye-Ji Lee ,&nbsp;Seung-Rye Cho ,&nbsp;Won Kyong Kim ,&nbsp;Myung Guk Han ,&nbsp;Seon-Young Lee ,&nbsp;So-dam Lee ,&nbsp;Jonghee Kim ,&nbsp;Heui Man Kim","doi":"10.1016/j.tmaid.2025.102939","DOIUrl":"10.1016/j.tmaid.2025.102939","url":null,"abstract":"<div><h3>Background</h3><div>South Korea remains at risk for dengue virus (DENV) importation, primarily due to the widespread presence of <em>Aedes albopictus</em> and increasing international travel. This study investigated diagnostic trends, serotype distribution, and geographic origins of imported dengue cases in South Korea from 2020 to 2024.</div></div><div><h3>Methods</h3><div>Laboratory-confirmed dengue cases reported from January 2020 to December 2024 were retrospectively analyzed using data from public institutions and selected private laboratories. Diagnostic confirmation utilized IgM ELISA and RT-PCR. Serotyping of DENV-1–4 was performed in public institutions. Travel history information aided the analysis of temporal and geographic trends. Fisher's exact test was used for statistical evaluation.</div></div><div><h3>Results</h3><div>A total of 551 dengue cases were confirmed, with only one nosocomial infection and no local vector-borne transmission. Public laboratories identified most cases (89.1 %). RT-PCR confirmed 279 (50.6 %) and IgM ELISA 270 (49.0 %) cases. Serotype analysis of 221 cases detected all four DENV serotypes, with DENV-1 and DENV-2 predominant. Most exposures occurred in Vietnam, Indonesia, the Philippines, and Thailand, highlighting key importation sources.</div></div><div><h3>Conclusions</h3><div>Nationwide public laboratory surveillance is vital for timely detection and characterization of imported dengue. These findings underscore the influence of international travel and the need for sustained vector monitoring, vaccine preparedness where appropriate, and traveler-targeted prevention in non-endemic regions<strong>.</strong></div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102939"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of contact tracing interventions for international arrivals by air, sea, or land","authors":"Rosalie Allison ,&nbsp;Anjali Pai ,&nbsp;Bharat Sibal ,&nbsp;Robert Sookoo ,&nbsp;Sarah R. Anderson","doi":"10.1016/j.tmaid.2025.102924","DOIUrl":"10.1016/j.tmaid.2025.102924","url":null,"abstract":"<div><h3>Introduction</h3><div>As part of the public health response, one role of health protection specialists is to identify contacts of people who have travelled whilst infectious, and provide advice or other public health actions.</div><div>This paper aims to review the latest evidence for contact tracing of specific infectious diseases on incoming international travel by air, sea, or land. Twenty key gastrointestinal, respiratory, rash, and high consequence infectious diseases were included in this systematic review.</div></div><div><h3>Methods</h3><div>Electronic databases were systematically searched for studies published between 2008 and 2023, that focused on people arriving from international destinations with an infectious disease, and their contacts. Results were exported to Endnote; duplicates removed; eligible studies identified and critically appraised by two independent reviewers; and data extracted. Due to heterogeneity across studies, results were presented narratively.</div></div><div><h3>Results</h3><div>There was some evidence for contact tracing to reduce community transmission for international arrivals by aircrafts, but less rigorous evidence for those arriving by sea-vessels, and even less for ground crossings.</div></div><div><h3>Conclusions</h3><div>Informed by this systematic review, public health agencies should consider developing or reviewing their national disease-specific guidance, ensuring guidance for all key modes of international transport is included. Higher quality studies are required to inform the effectiveness of contact tracing for preventing further transmission related to international travel. Strategic efforts should continue to concentrate on improving the relationship between public health organisations and transport providers to facilitate timely public health actions.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102924"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel Healthy, a mobile app for participatory surveillance among U.S. international travelers","authors":"Andrés Colubri ,&nbsp;Nicole Willing ,&nbsp;Andonaq Grozdani ,&nbsp;Yinan Dong ,&nbsp;Hung Hong ,&nbsp;Mansi Khandpekar ,&nbsp;Elizabeth Oliver ,&nbsp;Julie Thwing ,&nbsp;Edward T. Ryan ,&nbsp;Regina C. LaRocque","doi":"10.1016/j.tmaid.2025.102922","DOIUrl":"10.1016/j.tmaid.2025.102922","url":null,"abstract":"<div><h3>Background</h3><div>Global travel plays a role in the spread of infectious diseases. Existing travel surveillance programs collect data before and after trips, resulting in data incompleteness and recall bias. We developed the Travel Healthy mobile app to address these gaps, by enabling U.S. travelers to report daily symptom surveys including GPS location. The app offers traveler tools, including outbreak notices, a travel wallet, and a malaria medication reminder.</div></div><div><h3>Methods</h3><div>We developed Travel Healthy following a user-centric approach. We recruited study participants through an online platform and at the Travelers’ Advice and Immunization Center at Massachusetts General Hospital, between July 2023 and August 2024. We analyzed demographic, GPS, and self-reported symptom data from the first 50 participants. Data were collected starting one day before the trip and ending three days after. A post-travel feedback survey was performed.</div></div><div><h3>Results</h3><div>Participants visited 204 locations in Asia, Africa, the Americas, and Europe. Mean age was 33 years and 66 % were female. The most common purposes of travel were leisure and/or business, with 46 (92 %) of participants listing these as traveling reasons. A total of 755 daily symptom surveys were entered, with 105 reporting symptoms, corresponding to 29 of the 50 (58 %) participants. Among all symptoms with GPS data, 58 % were upper respiratory symptoms, 25 % were gastrointestinal (clustered in South Asia), and 17 % were other. Post-travel questionnaires showed that participants found the application easy to use.</div></div><div><h3>Conclusion</h3><div>This pilot study underscores the potential of participatory surveillance tools to complement traditional public health surveillance methods for travel-related illness.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102922"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful resolution of dengue-associated retinopathy following intravitreal Anti-VEGF therapy","authors":"Yu-Chieh Chang ,&nbsp;Yu-Ting Hsiao ,&nbsp;Hsi-Kung Kuo ,&nbsp;Hsiu-Mei Huang ,&nbsp;Jong-Jer Lee","doi":"10.1016/j.tmaid.2025.102929","DOIUrl":"10.1016/j.tmaid.2025.102929","url":null,"abstract":"<div><div>Dengue fever (DF) is primarily recognized for its systemic manifestations; however, ocular involvement remains uncommon and is often overlooked. Dengue-associated retinopathy, a rare manifestation with poorly understood pathophysiological mechanisms, presents both diagnostic and therapeutic challenges. Although most patients recover spontaneously, some experience persistent visual impairment. We report a case of dengue-associated retinopathy with ischemic macular edema that progressed over 2 months following a diagnosis of DF. Owing to its ischemic nature and the patient's relative contraindications to intravitreal and systemic corticosteroids, intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy was administered, leading to the resolution of macular edema and improvement in visual function. To our knowledge, this is the first reported case demonstrating successful resolution of dengue-associated retinopathy with intravitreal anti-VEGF therapy. These findings suggest that anti-VEGF therapy may serve as an alternative treatment option for dengue-related ocular complications.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102929"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into barriers and adherence to pre-travel advice among West African travelers in Spain: A prospective mixed-methods evaluation","authors":"Nerea Castillo-Fernández ,&nbsp;Manuel Jesús Soriano-Pérez ,&nbsp;Ana B. Lozano-Serrano ,&nbsp;José Vázquez-Villegas ,&nbsp;Begoña del Moral-Hernández ,&nbsp;María del Mar Lozano-Martínez ,&nbsp;Silvia Milán-Gutiérrez ,&nbsp;María Isabel Gálvez-Cano ,&nbsp;Martina Lucía Fernández-López ,&nbsp;Jaime Zevallos-Delgado ,&nbsp;María Pilar Luzón-García ,&nbsp;María Isabel Cabeza-Barrera ,&nbsp;Jaime Borrego-Jiménez ,&nbsp;Pablo Pumares-Fernández ,&nbsp;Joaquín Salas-Coronas","doi":"10.1016/j.tmaid.2025.102932","DOIUrl":"10.1016/j.tmaid.2025.102932","url":null,"abstract":"<div><h3>Introduction</h3><div>Understanding barriers to seeking and following pre-travel advice in Visiting Friends and Relatives (VFR) travelers might enhance preventive behaviors before and during travel.</div></div><div><h3>Methods</h3><div>A mixed-method research with an explanatory sequential design among West African VFR travelers was conducted between 2019 and 2022 in an area with a high number of immigrants. Firstly, all travelers were advised to seek pre-travel advice and prospectively followed after the trip. Secondly, focus groups and individual semi-structured interviews were conducted to explain results in more depth. Finally, quantitative and qualitative data were integrated.</div></div><div><h3>Results</h3><div>Eighty-eight travelers, mostly men (92 %), were prospectively followed. Main countries of origin were Mali (29.5 %) and Senegal (29.5 %). Fifty-three percent of travelers did not seek pre-travel advice at the vaccination center. Only 29.5 % took malaria chemoprophylaxis properly. Travelers visiting their home country for the first time, among others, were more likely to attend pre-travel advice (p &lt; 0.005). No differences in risk activities and preventive measures were found between those who sought pre-travel advice and those who did not. Upon returning, 25 travelers (28.7 %) presented with some infectious diseases such as malaria (n = 10; 11.4 %). In the qualitative phase, most VFR travelers did not perceive returning home as a health risk and deemed pre-travel advice unnecessary and culturally inappropriate. Social and family pressure were significant barriers to follow preventive measures, perceiving them as an act of rejection towards their community.</div></div><div><h3>Conclusions</h3><div>Redesigning pre-travel counseling programs from a holistic approach is needed to improve communication and overcome barriers and cultural gaps. Community health workers, facilitated appointments and interventions through primary care may be helpful.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102932"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness in long-term Taiwanese expatriates and domestic residents in the COVID-19 era: A cross-sectional study","authors":"Hung-Yu Chao ,&nbsp;Che-Jui Chang ,&nbsp;Ting-Ju Lai ,&nbsp;Jaw-Shiun Tsai ,&nbsp;Shao-Yi Cheng ,&nbsp;Jen-Kuei Peng","doi":"10.1016/j.tmaid.2025.102928","DOIUrl":"10.1016/j.tmaid.2025.102928","url":null,"abstract":"<div><h3>Background/Aim</h3><div>This study aimed to assess the loneliness in long-term expatriates during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>This retrospective, cross-sectional study distributed an online structured questionnaire through the website and health education events of the New Southbound Health Center, established by Taiwan's CDC. The target population was Taiwanese employees expatriated to Southeast Asian countries and domestic employees, aged 20 years and older. From August 2022 to August 2023, the data of 22 long-term expatriates and 64 domestic employees were included. Outcomes of interest included distress, measured by the Brief Symptom Rating Scale-5 (BSRS-5), and loneliness, measured by the UCLA Three-Item Loneliness Scale (UT-ILS). Other relevant factors examined included demographic data, expatriate status, social factors, psychological factors, and pandemic-related factors. Logistic regression analysis was employed to identify predictors and protectors of loneliness and distress.</div></div><div><h3>Results</h3><div>Loneliness (UT-ILS ≥4) was significantly higher among expatriates (77.3 %) than domestic residents (46.9 %; P = 0.014). Multivariable analysis revealed that higher psychological distress (OR = 1.19, p = 0.001), greater impact of the pandemic (OR = 3.19, p = 0.036), and fewer relatives contacted monthly (OR = 0.82, p = 0.04) predicted loneliness. Additionally, sub-analysis found that higher levels of self-esteem (OR = 5.49, p = 0.003) and less social support (OR = 0.80, p = 0.004) independently predicted psychological distress (BSRS-5 ≥ 6).</div></div><div><h3>Conclusions</h3><div>Psychological distress, greater impact of the pandemic, and fewer relatives contacted monthly are associated with loneliness in expatriates and residents during the COVID-19 pandemic. Social support has a protective effect against psychological distress.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102928"},"PeriodicalIF":4.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}