{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:53:38Z","timestamp":1789239218190,"version":"build-2803163510"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T00:00:00Z","timestamp":1705795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100011015","name":"International Society of Travel Medicine","doi-asserted-by":"publisher","award":["1 U01CK000632-01-00"],"award-info":[{"award-number":["1 U01CK000632-01-00"]}],"id":[{"id":"10.13039\/100011015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian National Health and Medical Research Council","award":["APP11550055"],"award-info":[{"award-number":["APP11550055"]}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prolonged diarrhoea is common amongst returning travellers and is often caused by intestinal protozoa. However, the epidemiology of travel-associated illness caused by protozoal pathogens is not well described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analysed records of returning international travellers with illness caused by Giardia duodenalis, Cryptosporidium spp., Cyclospora cayetanensis or Cystoisospora belli, reported to the GeoSentinel Network during January 2007\u2013December 2019. We excluded records of travellers migrating, with an unascertainable exposure country, or from GeoSentinel sites that were not located in high-income countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 2517 cases, 82.3% giardiasis (n\u2009=\u20092072), 11.4% cryptosporidiosis (n\u2009=\u2009287), 6.0% cyclosporiasis (n\u2009=\u2009150) and 0.3% cystoisosporiasis (n\u2009=\u20098). Overall, most travellers were tourists (64.4%) on long trips (median durations: 18\u201330\u00a0days). Cryptosporidiosis more frequently affected people\u2009&amp;lt;\u200918\u00a0years (13.9%) and cyclosporiasis affected people\u2009\u2265\u200940\u00a0years (59.4%). Giardiasis was most frequently acquired in South Central Asia (45.8%) and sub-Saharan Africa (22.6%), cryptosporidiosis in sub-Saharan Africa (24.7%) and South-Central Asia (19.5%), cyclosporiasis in South East Asia (31.3%) and Central America (27.3%), and cystoisosporiasis in sub-Saharan Africa (62.5%). Cyclosporiasis cases were reported from countries of uncertain endemicity (e.g. Cambodia) or in countries with no previous evidence of this parasite (e.g. French Guiana). The time from symptom onset to presentation at a GeoSentinel site was the longest amongst travellers with giardiasis (median: 30\u00a0days). Over 14% of travellers with cryptosporidiosis were hospitalized.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This analysis provides new insights into the epidemiology and clinical significance of four intestinal protozoa that can cause morbidity in international travellers. These data might help optimize pretravel advice and post-travel management of patients with travel-associated prolonged gastrointestinal illnesses. This analysis reinforces the importance of international travel-related surveillance to identify sentinel cases and areas where protozoal infections might be undetected or underreported.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taae010","type":"journal-article","created":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T22:21:51Z","timestamp":1705875711000},"source":"Crossref","is-referenced-by-count":13,"title":["Intestinal protozoa in returning travellers: a GeoSentinel analysis from 2007 to 2019"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-2123","authenticated-orcid":false,"given":"Thomas","family":"Weitzel","sequence":"first","affiliation":[{"name":"Travel Medicine Program , Cl\u00ednica Alemana, Facultad de Medicina Cl\u00ednica Alemana, , Santiago 7650568 , Chile"},{"name":"Universidad del Desarrollo , Cl\u00ednica Alemana, Facultad de Medicina Cl\u00ednica Alemana, , Santiago 7650568 , Chile"},{"name":"Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM) , Facultad de Medicina Cl\u00ednica Alemana, , Santiago 7590943 , Chile"},{"name":"Universidad del Desarrollo , Facultad de Medicina Cl\u00ednica Alemana, , Santiago 7590943 , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Global Migration and Quarantine, Centers for Disease Control and Prevention , Atlanta, GA 30329 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3416-6482","authenticated-orcid":false,"given":"Michael","family":"Libman","sequence":"additional","affiliation":[{"name":"J.D. 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