Introduction

International travelers have grown significantly over last years, as well as imported diseases from tropical areas. Information in pediatric population is scarce. We describe demographic and clinical characteristics of febrile children coming from the tropics.

Methods

Retrospective review of patients under 18 years old, presenting at a tertiary hospital and surrounding primary health care centers between July 2002 and July 2018 with a stay in a tropical region during the previous year. Patients were selected from microbiological charts of thick smears for malaria or dengue serologies.

Results

188 patients were studied: 52.7% were born in Spain with a median age of 3.0 years old (IQR 1.5–8.0). Main regions of stay were Sub-Saharan Africa (54.8%) and Latin America (29.8%), mostly for visiting their friends and relatives (56.3%), followed by recent arrival migrants (32.4%). Only 34% of travelers attended pre-travel consultation. More than 80% of these febrile children attended directly the Emergency Room. The most frequent diagnoses were febrile syndrome without source (56.4%), respiratory condition (15.4%) and acute diarrhea (11.7%). Around a half (52.1%) were managed as outpatients, but 46.2% were hospitalized and 7.4% were admitted to Intensive Care Unit. No specific diagnosis was achieved in 24% of cases. However, 29.7% were diagnosed with malaria.

Conclusion

Children with fever coming from tropical areas were at risk of severe infectious diseases. Malaria was diagnosed in one out of four and 7% required admission in PICU. This information emphasizes the need of reinforcing training about tropical diseases among first line physicians.

中文翻译：

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来自热带地区的发热儿童的病因和结果

 介绍

去年，国际游客以及来自热带地区的输入性疾病显着增长。儿科人群的信息很少。我们描述了来自热带地区的发热儿童的人口统计和临床特征。

 方法

对 2002 年 7 月至 2018 年 7 月期间在三级医院和周边初级卫生保健中心就诊且前一年曾在热带地区住院的 18 岁以下患者进行回顾性分析。患者是从疟疾或登革热血清学厚涂片的微生物图表中选择的。

 结果

研究对象为 188 名患者：52.7% 出生于西班牙，中位年龄为 3.0 岁（IQR 1.5-8.0）。主要停留地区是撒哈拉以南非洲（54.8%）和拉丁美洲（29.8%），主要是为了探亲访友（56.3%），其次是最近抵达的移民（32.4%）。只有34%的旅行者参加了旅行前咨询。超过 80% 的发烧儿童直接前往急诊室。最常见的诊断是无源发热综合征（56.4%）、呼吸道疾病（15.4%）和急性腹泻（11.7%）。大约一半（52.1%）在门诊接受治疗，但 46.2% 住院治疗，7.4% 住进重症监护室。 24%的病例没有得到具体诊断。然而，29.7% 的人被诊断出患有疟疾。

 结论

来自热带地区的发烧儿童面临严重传染病的风险。四分之一的人被诊断出患有疟疾，其中 7% 的人需要住进儿科重症监护病房 (PICU)。这一信息强调需要加强一线医生关于热带病的培训。