ORCID Profile
0000-0002-5642-5257
Current Organisation
The University of Alabama at Birmingham Department of Medicine
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Publisher: Oxford University Press (OUP)
Date: 07-2008
DOI: 10.1111/J.1708-8305.2008.00203.X
Abstract: Data on relative rates of acquisition of gastrointestinal infections by travelers are incomplete. The objective of this study was to analyze infections associated with oral ingestion of pathogens in international travelers in relation to place of exposure. We performed a multicenter, retrospective observational analysis of 6,086 travelers ill enough with any gastrointestinal infection to seek medical care at a GeoSentinel clinic after completion of travel during 2000 to 2005. We determined regional and country-specific reporting rate ratios (RRRs) in comparison to risk in northern and western Europe. Travel to sub-Saharan Africa (RRR = 282), South America (RRR = 203), and South Asia (RRR = 890) was associated with the greatest rate of gastrointestinal infections. RRRs were moderate (25-142) for travel to Oceania, the Middle East, North Africa, Central America, the Caribbean, and Southeast Asia. RRRs were least (<28) following travel to southern, central, and eastern Europe North America Northeast Asia and Australasia. Income level of the country visited was inversely proportional to the RRR for gastrointestinal infection. For bacterial and parasitic infections examined separately, the regions group in the same way. RRRs could be estimated for 28 in idual countries and together with regional data were used to derive a global RRR map for travel-related gastrointestinal infection. This analysis of morbidity associated with oral ingestion of pathogens abroad determines which parts of the world currently are high-risk destinations.
Publisher: Oxford University Press (OUP)
Date: 07-2008
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 04-2014
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Publisher: American College of Physicians
Date: 19-03-2013
Publisher: Oxford University Press (OUP)
Date: 03-2007
DOI: 10.1086/511690
Publisher: American Society of Tropical Medicine and Hygiene
Date: 06-02-2013
Publisher: Oxford University Press (OUP)
Date: 10-08-2011
DOI: 10.1093/CID/CIR468
Abstract: Mexico and Central America are important travel destinations for North American and European travelers. There is limited information on regional differences in travel related morbidity. We describe the morbidity among 4779 ill travelers returned from Mexico and Central America who were evaluated at GeoSentinel network clinics during December 1996 to February 2010. The most frequent presenting syndromes included acute and chronic diarrhea, dermatologic diseases, febrile systemic illness, and respiratory disease. A higher proportion of ill travelers from the United States had acute diarrhea, compared with their Canadian and European counterparts (odds ratio, 1.9 P < .0001). During the 2009 H1N1 influenza outbreak from March 2009 through February 2010, the proportionate morbidity (PM) associated with respiratory illnesses in ill travelers increased among those returned from Mexico, compared with prior years (196.0 cases per 1000 ill returned travelers vs 53.7 cases per 1000 ill returned travelers P < .0001) the PM remained constant in the rest of Central America (57.3 cases per 1000 ill returned travelers). We identified 50 travelers returned from Mexico and Central America who developed influenza, including infection due to 2009 H1N1 strains and influenza-like illness. The overall risk of malaria was low only 4 cases of malaria were acquired in Mexico (PM, 2.2 cases per 1000 ill returned travelers) in 13 years, compared with 18 from Honduras (PM, 79.6 cases per 1000 ill returned travelers) and 14 from Guatemala (PM, 34.4 cases per 1000 ill returned travelers) during the same period. Plasmodium vivax malaria was the most frequent malaria diagnosis. Travel medicine practitioners advising and treating travelers visiting these regions should dedicate special attention to vaccine-preventable illnesses and should consider the uncommon occurrence of acute hepatitis A, leptospirosis, neurocysticercosis, acute Chagas disease, onchocerciasis, mucocutaneous leishmaniasis, neurocysticercosis, HIV, malaria, and brucellosis.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 07-2013
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 07-2008
Publisher: Elsevier BV
Date: 03-2001
DOI: 10.1016/S0198-8859(00)00259-7
Abstract: Genetic variations in the locus encoding the transporter associated with antigen processing, subunit 1 (TAP1), were systematically studied using s les from Caucasians, Africans, Brazilians, and compared with data from chimpanzees. PCR- lified genomic sequences corresponding to the 11 exons were analyzed by single-strand conformation polymorphism (SSCP) and sequencing. Six nonsynonymous and 2 synonymous single nucleotide polymorphisms (SNPs) were found to be common in one ethnic group or another, and they involved codons 254 (Gly-GGC/Gly-GGT) in exon 3, 333 (Ile-ATC/Val-GTC) in exon 4, 370 (Ala-GCT/Val-GTT) in exon 5, 458 (Val-GTG/Leu-TTG) in exon 6, 518 (Val-GTC/Ile-ATC) in exon 7, 637 (Asp-GAC/Gly-GGC), 648 (Arg-CGA/Gln-CAA) and 661 (Pro-CCG/Pro-CCA) in exon 10. At each SNP site the sequence listed first was predominant in all ethnic groups. Several SNPs segregated on the same chromosome regardless of populations and species. Together, the SNPs produced 5 major human TAP1 alleles, 4 of which matched the officially recognized alleles *0101, *02011, *0301, and *0401 the 5th allele differed from each of those by at least 4 SNPs. Overall, TAP1*0101 was the predominant allele in all ethnic groups, with frequencies ranging from 0.667 in Zambians to 0.808 in US Caucasians. The TAP1*0401 frequency showed the greatest difference between Africans (0.221-0.254) and Caucasians (0.033), with Brazilians (0.058) fitting in the middle. Consistent with earlier work based on Caucasians and gorillas, *0101 appeared to be the newest human TAP1 allele, suggesting a dramatic spread of *0101 into all human populations examined. Characterization of TAP1 polymorphisms allowed the design of a PCR-based genotyping scheme that targeted 7 SNP sites and required 2 separate genotyping techniques.
Publisher: Oxford University Press (OUP)
Date: 15-03-2010
DOI: 10.1086/650575
Abstract: No systematic studies exist on sex and gender differences across a broad range of travel-associated diseases. Travel and tropical medicine GeoSentinel clinics worldwide contributed prospective, standardized data on 58,908 patients with travel-associated illness to a central database from 1 March 1997 through 31 October 2007. We evaluated sex and gender differences in health outcomes and in demographic characteristics. Statistical significance for crude analysis of dichotomous variables was determined using chi2 tests with calculation of odds ratios (ORs) and 95% confidence intervals (CIs). The main outcome measure was proportionate morbidity of specific diagnoses in men and women. The analyses were adjusted for age, travel duration, pretravel encounter, reason for travel, and geographical region visited. We found statistically significant (P < .001) differences in morbidity by sex. Women are proportionately more likely than men to present with acute diarrhea (OR, 1.13 95% CI, 1.09-1.38), chronic diarrhea (OR, 1.28 95% CI, 1.19-1.37), irritable bowel syndrome (OR, 1.39 95% CI, 1.24-1.57), upper respiratory tract infection (OR, 1.23 95% CI, 1.14-1.33) urinary tract infection (OR, 4.01 95% CI, 3.34-4.71), psychological stressors (OR, 1.3 95% CI, 1.14-1.48), oral and dental conditions, or adverse reactions to medication. Women are proportionately less likely to have febrile illnesses (OR, 0.15 95% CI, 0.10-0.21) vector-borne diseases, such as malaria (OR, 0.46 95% CI, 0.41-0.51), leishmaniasis, or rickettsioses (OR, 0.57 95% CI, 0.43-0.74) sexually transmitted infections (OR, 0.68 95% CI 0.58-0.81) viral hepatitis (OR, 0.34 95% CI, 0.21-0.54) or noninfectious problems, including cardiovascular disease, acute mountain sickness, and frostbite. Women are statistically significantly more likely to obtain pretravel advice (OR, 1.28 95% CI, 1.23-1.32), and ill female travelers are less likely than ill male travelers to be hospitalized (OR, 0.45 95% CI, 0.42-0.49). Men and women present with different profiles of travel-related morbidity. Preventive travel medicine and future travel medicine research need to address gender-specific intervention strategies and differential susceptibility to disease.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 04-2015
Publisher: Oxford University Press (OUP)
Date: 05-2009
Publisher: Informa UK Limited
Date: 08-2009
DOI: 10.1586/ERV.09.69
Location: United States of America
Location: United States of America
No related grants have been discovered for David O. Freedman.