immunocompromised traveller imuungecompromiteerde reiziger diabetic travelel reiziger met diabetes mellitus MTX biological
Conditions
Interventions
No intervention (Observational cohort study).
Sponsors
None listed
Eligibility
Inclusion criteria
Inclusion criteria: Inclusion immunocompromised traveller: 1. The subject is treated OR have been treated for at least 3 months with one or more of the following medication: methotrexaat (Emthexate®, Ledertrexate®), Imuran® / Puri-Nethol®, leflunomide (Arava®) infliximab (Remicade®), etanercept (Enbrel®), adalimumab (Humira®), Abatacept (Orencia®), rituximab (Mabthera®), anakinra (Kineret®), tocilizumab (RoActemra®), Simponi® or Cimzia®; 2. Travelling to a (sub)tropical destination during therapy, OR returning from a (sub)tropical destination within a 3 months period after ending therapy; 3. A subject may be included without travel companion; 4. Is autochthon or non-western immigrant. The group diabetic traveller: 1. Independent of type of diabetes mellitus (I or II); 2. Diabetic medication: Insulin and/or oral; 3. Independent of complications due to diabetes mellitus; 4. A diabetic subject may be included without travel companion; 5. Autochthon or non-western immigrant.
Exclusion criteria
Exclusion criteria: The following persons cannot take part in this study: 1. Individuals less than 18 years; 2. Persons speaking another language than Dutch, Moroccan, Turkish or English; 3. Mentally incapacitated persons; 4. Western immigrant.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence, morbidity, mortality and association between variables will be calculated. These endpoints will be compared in several subpopulations. In the immunocompromised patients, we will assess the association between subject-related variables (personal characteristics, including immigrant status, disease activity, cumulative use of immunosuppression, ...) on the one hand and travel-related disease variables (febrile illness, febrile respiratory illness, diarrhoea) on the other hand, after correcting for the independent travel-related variables (destination, duration, accommodation, purpose). Subjects reporting a travel-related disease will be compared to those reporting no travel-related disease. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Serum antibody levels at several time points before and after active immunisation against DTP, hepatitis A, hepatitis B, meningococci (A/C/Y/W-135) and Vi polysaccharide in relation to age, gender, medical condition, and type of immunosuppression; 2. Conversion rate in quantiferon testing and Interferon Gamma Release Assay (IGRA); 3. Distribution of regulatory T-cell subset markers in (high and low) responders to vaccinations; 4. Incidence of faecal carriage of potentially pathogenic micro-organisms after travel in the subgroup rheumatic travellers and travel companion (basic sample); 5. Incidence of carriage of MRSA, antibiotic-resistant Gram-negatives, and Clostridium in those hospitalized abroad; 6. Incidence of household transmission of the following indicator micro-organisms: methicillin-resistant Staphylococcus aureus (MRSA), Salmonella, extended spectrum betalactamase-producing or gentamycine-resistant Gram-negatives. Clostridium species in faeces, or penicillin-resistant pneumococci in throat. | — |
Contacts
Public ContactH.J. Brockhoff
Leids Universitair Medisch Centrum Divisie 4 Infectieziekten Postbus 9600
Outcome results
None listed