Evidence map›Paper›PMID 41566745›Full record

ArticleEpidemiology and infection2026

Risk factors associated with acquiring gastrointestinal infections in UK international travellers: a case-control study.

Nicola K Love, Yanshi Yanshi, Parisha Katwa, Iman Mohamed, Dipti Patel, Hilary Kirkbride, Sooria Balasegaram

Abstract read
In one paragraph

Article in Epidemiology and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicola K Lovehttps://ror.org/00vbvha87UK Health Security Agency North East (UKHSA), UK.ORCID https://orcid.org/0000-0003-3750-7158
Yanshi Yanshihttps://ror.org/00vbvha87UK Health Security Agency North East (UKHSA), UK.ORCID https://orcid.org/0009-0006-1328-5094
Parisha Katwahttps://ror.org/00vbvha87UK Health Security Agency North East (UKHSA), UK.
Iman Mohamedhttps://ror.org/00vbvha87UK Health Security Agency North East (UKHSA), UK.
Dipti Patelhttps://ror.org/02jx3x895National Travel Health Network and Centre (NaTHNaC), UK.
Hilary Kirkbridehttps://ror.org/00vbvha87UK Health Security Agency North East (UKHSA), UK.
Sooria Balasegaramhttps://ror.org/00vbvha87UK Health Security Agency North East (UKHSA), UK.

Funding

National Institute for Health Research Health Protection Research Unit
6 · The paper itself

Abstract

International travel is thought to be a major risk factor for developing gastrointestinal illness in England. Transmission is thought to be more likely in countries which have lower food hygiene standards, poorer sanitation, and lack of access to clean water. However, many studies are conducted within travel clinic settings which may bias findings. Here, we present a case-control study undertaken in returning English travellers in the community conducted with cases of gastrointestinal illness notified to UKHSA.All Cryptosporidiosis, Giardiasis, non-typhoidal Salmonellosis, and Shigellosis cases notified to the UK Health Security Agency (UKHSA) between 01 July 2023 and 15 October 2023 were asked to complete an anonymous electronic questionnaire if travelling during their incubation period. Asymptomatic travellers were recruited as controls via a market research panel and asked to complete the same questionnaire. A destination water, hygiene, and sanitation score were derived from the WHO 'Attributable fraction of diarrhoea to inadequate WASH' dataset. Demographics, travel details, and exposures while travelling were compared by Pearson's chi-squared test, and pathogen and destination specific multivariable analyses were performed using a forward stepwise approach.A total of 653 cases and 483 controls were included. The odds of being a case were significantly higher when travelling to countries outside of the EU (OR:4.6, 95%CI:3.5-6.0; p = <0.001) and to countries with high-risk WASH score (OR 6.6, 95%CI:4.9-9.1; p = <0.001), particularly Egypt, Mexico, Tunisia, and Turkey. For those travelling to a low-risk destination, eating undercooked meat or fish and swallowing water from environmental water sources were significantly associated with higher odds of illness by multivariable analysis (p < 0.05). At high-risk destinations, eating foods consumed on excursions, swallowing water from environmental sources, and eating foods from hotel buffets were significantly associated with higher odds of being a case.Travel to popular tourist destinations is a potentially under-recognized risk factor for acquiring gastrointestinal infections. Exposures at low-risk destinations were broadly similar to risk factors in the UK. Exposures in high-risk destinations highlighted potential risks associated with catered hotels and tourist excursions which should be explored further.

Indexed as

Gastrointestinal DiseasesTravelAdolescentAdultAgedCase-Control StudiesChild, PreschoolFemaleHumansMaleMiddle AgedRisk FactorsSurveys and QuestionnairesUnited KingdomYoung Adultbacillarycase–control studies risk factorscryptosporidiosisdysenterygiardiasisSalmonella infectionstravel

Identifiers

PMID41566745
PMCPMC13100926

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.