Gaps in Surveillance: Referral of Acutely Ill Returned Travelers in the Emory Healthcare System for Specialty Care and Entry into an International Surveillance Network Restricted; Files Only
Nguyen, Phuong-Vi (Summer 2024)
Abstract
Background: The monitoring and treatment of travel-related illnesses is a critical aspect of public health, especially in major travel hubs like Atlanta. This thesis explores the epidemiological patterns and healthcare utilization among returning travelers with acute illnesses within the Emory Healthcare Network and the Emory TravelWell Center, part of the GeoSentinel Surveillance Network.
Objective: To analyze the demographic and clinical characteristics of travelers seen at Emory Healthcare and Emory TravelWell Center, determine the overlap in patient populations, and identify significant factors associated with malaria diagnosis.
Methods: A primary data analysis was conducted using datasets from Emory Healthcare and the GeoSentinel Surveillance Network, encompassing 2870 patients seen between March 2, 2009 and December 31, 2022. The study employed a retrospective observational design, aligning patients by visit date, age, and gender. Statistical analyses included the Kruskal-Wallis test for age comparison and chi-square tests for categorical variables such as gender distribution and malaria positivity rates.
Results: There were a total of 1,412 patients seen only at an Emory Healthcare site, 794 patients seen only at the TravelWell Center, and 332 patients seen in both systems. The analysis revealed significant differences in the mean ages of patients across the three groups (Emory, TravelWell, and both), with p-values less than 0.0001. Gender distribution also varied significantly, with a higher proportion of females in the TravelWell group. Malaria positivity rates were markedly different across Emory (7.1%) and TravelWell (1.6%), with the highest prevalence observed in patients seen at both Emory and TravelWell (14.5%). The chi-square test confirmed the statistical significance of these differences (p < 0.0001).
Conclusions: The findings highlight distinct demographic and clinical profiles among returning travelers with acute illnesses, emphasizing the need for integrated surveillance and standardized data collection protocols across healthcare networks. The study underscores the importance of continued collaboration between Emory Healthcare and the GeoSentinel Surveillance Network to enhance the identification and management of travel-related diseases.
Implications: This research contributes to the understanding of travel-related illness patterns and the effectiveness of surveillance systems. Recommendations include the standardization of data collection, improved real-time communication between networks and within the healthcare systems, and the expansion of prospective studies to further explore and mitigate travel-related health risks.
Table of Contents
Chapter 1: Introduction……………………………………………………………………………7
Chapter 2: Review of Literature…………………………………………………………………11
Chapter 3: Methodology…………………………………………………………………………23
Chapter 4: Results………………………………………………….…………………………….31
Chapter 5: Conclusion……………………………………………………………………………44
References…………………………………………………………..……………………………48
Appendix…………………………………………………………………………………………50
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File download under embargo until 16 February 2025 | 2024-08-01 18:38:38 -0400 | File download under embargo until 16 February 2025 |
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