Volume 15, Number 11—November 2009
CME ACTIVITY - Research
Multicenter GeoSentinel Analysis of Rickettsial Diseases in International Travelers, 1996–2008
|Variable||Travelers with SFG rickettsiosis, N = 197†||Travelers without SFG rickettsiosis, N = 11,690†||Univariate association
|OR (95% CI)||p value||OR (95% CI)||p value|
|Mean age, y||43.9, n = 196||36.5, n = 11,608||–||<0.0001||1.02 (1.01–1.03)§||<0.0001|
|Male gender, no. (%)||115 (58.4), n = 197||6,105 (52.6), n = 11,599||1.26 (0.95–1.68)||0.11||1.40 (1.02–1.92)||0.035|
|Travel to southern Africa,¶ no. (%)||139 (70.6), n = 197||759 (6.5), n = 11,686||34.5 (25.18–47.28)||<0.0001||23.61 (16.86–33.07)||<0.0001|
|Travel in late summer,# no. (%)||89 (47.1), n = 189||4,220 (40.6), n = 10,402||1.30 (0.98–1.74)||0.07||1.57 (1.15–2.15)||0.005|
|Travel duration >7 d, no. (%)||173 (91.5), n = 189||9,661 (92.9), n = 10,402||0.83 (0.49–1.39)||0.48||0.67 (0.38–1.18)||0.164|
|No pretravel clinic visit, no. (%)||40 (21.7), n = 184||2,823 (26.5), n = 10,665||0.77 (0.54–1.10)||0.15||0.98 (0.66–1.44)||0.903|
|Independent travel,** no. (%)||34 (44.2), n = 77||4,100 (58.6), n = 6,993||0.56 (0.35–0.87)||0.01||0.83 (0.56–1.25)||0.373|
|Tourism as reason for travel, no. (%)||163 (82.7), n = 197||5,027 (43.0), n = 11,686||6.35 (4.38–9.21)||<0.0001||2.96 (1.97–4.45)||<0.0001|
*SFG, spotted fever group; OR, odds ratio; CI, confidence interval.
†n = number of travelers for whom this information was available.
‡This model included all variables considered at univariate level because of their clinical relevance. The Hosmer and Lemeshow goodness-of-fit test for this model is p = 0.575.
§Odds ratio is for 1-y increase in age.
¶United Nations subregion comprising Botswana, Lesotho, Namibia, South Africa, and Swaziland.
**Independent travel was not formally collected by GeoSentinel until after May 2007.
In addition to the authors, the following members of the GeoSentinel Surveillance Network contributed data: Kevin C. Kain, University of Toronto, Toronto, Ontario, Canada; Phyllis E. Kozarsky and Carlos Franco-Paredes, Emory University, Atlanta, Georgia, USA; Louis Loutan and François Chappuis, University of Geneva, Geneva, Switzerland; Joseph Torresi and Graham Brown, Royal Melbourne Hospital, Melbourne, Victoria, Australia; DeVon C. Hale and Stefanie S. Gelman, University of Utah, Salt Lake City, Utah, USA; Alice Pérignon, Hôpital Pitié-Salpêtrière, Paris, France; Gerd-Dieter Burchard, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany; Mary E. Wilson, Harvard University, Cambridge, Massachusetts, USA; Fabrice Simon and Jean Delmont, Hôpital Nord, Marseille, France; William M. Stauffer and Patricia F. Walker, University of Minnesota, Minneapolis, Minnesota, USA; Poh Lian Lim and Annelies Wilder-Smith, Tan Tock Seng Hospital, Singapore; Jose Antonio Perez Molina, Hospital Ramon y Cajal, Madrid, Spain; Bradley A. Connor, Cornell University, Ithaca, New York, USA; Carmelo Licitra and Antonio Crespo, Orlando Regional Health Center, Orlando, Florida, USA; David O. Freedman, University of Alabama at Birmingham, Birmingham, Alabama, USA; Effrossyni Gkrania-Klotsas, Addenbrooke's Hospital, Cambridge, UK; Giampiero Carosi and Francesco Castelli, University of Brescia, Brescia, Italy; Marc Shaw, Worldwise Travelers Health and Vaccination Centre, Auckland, New Zealand; Prativa Pandey, CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal; R. Bradley Sack and Robin McKenzie, Johns Hopkins University, Baltimore, Maryland, USA (Dec 1997–Aug 2007); Elizabeth D. Barnett, Boston University, Boston, Massachusetts, USA; Christina M. Coyle and Murray Wittner, Albert Einstein School of Medicine, Bronx, New York, USA; Stefan Hagmann and Andy Miller, Bronx-Lebanon Hospital Center, Bronx; Michael W. Lynch, Fresno International Travel Medical Center, Fresno, California, USA; Vanessa Field, InterHealth, London, UK; Michael D. Libman and J. Dick Maclean, McGill University, Montreal, Quebec, Canada; Alejandra Gurtman, Mount Sinai Medical Center, New York, New York, USA (Oct 2002–Aug 2005); Shuzo Kanagawa and Yasuyuki Kato, International Medical Center of Japan, Tokyo, Japan; and Patricia Schlagenhauf, Rainer Weber, and Robert Steffen, University of Zürich, Zürich, Switzerland.