title: Post-travel screening of asymptomatic long-term travelers to the tropics for intestinal parasites using molecular diagnostics.
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.
authors.affiliation: Department of Infectious and Tropical Diseases, Leiden University Medical Center, Leiden, The Netherlands; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands; Student Health Department, Wageningen University, Wageningen, The Netherlands.
authors.forename: Darius
authors.initials: D
authors.lastname: Soonawala
authors.forename: Lisette
authors.initials: L
authors.lastname: van Lieshout
authors.forename: Marion A M
authors.initials: MA
authors.lastname: den Boer
authors.forename: Eric C J
authors.initials: EC
authors.lastname: Claas
authors.forename: Jaco J
authors.initials: JJ
authors.lastname: Verweij
authors.forename: André
authors.initials: A
authors.lastname: Godkewitsch
authors.forename: Marchel
authors.initials: M
authors.lastname: Ratering
authors.forename: Leo G
authors.initials: LG
authors.lastname: Visser
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000818:Animals; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003458:Cryptosporidium / Q000302:isolation & purification; D004748:Entamoeba histolytica / Q000302:isolation & purification; D005243:Feces / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D016829:Giardia lamblia / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis*; D008297:Male; D009426:Netherlands; D057089:Pathology, Molecular / Q000379:methods*; D060888:Real-Time Polymerase Chain Reaction; D012547:Schistosoma / Q000235:genetics / Q000302:isolation & purification; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D014195:Travel; D055815:Young Adult