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Vlot JA, Blanter AI, Jonker EFF, Korse NS, Hack E, Visser LG, Soonawala D. Travel preparation and health risks in Dutch and Belgian medical students during an elective in low- or middle-income countries: A prospective self-reporting cohort study. Travel Med Infect Dis 2020; 37:101779. [PMID: 32590061 DOI: 10.1016/j.tmaid.2020.101779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/21/2020] [Accepted: 05/31/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Medical schools offer students the opportunity to perform international electives. This study aimed to assess health risks among medical students, to tailor institutional guidelines. METHODS Multicenter study at Dutch and Belgian universities, among medical students who visited low- or middle-income countries. Students completed four questionnaires: once before the elective and two weeks, three- and six months after return. RESULTS Data was complete for 479 students (follow-up rate 84%). Most traveled to Surinam (29%) and South-Africa (14%). Half of the students encountered difficulties in adapting to local culture. Almost 40% visited malaria endemic countries. Nearly all (87%) used chemoprophylaxis as prescribed. Definite needle-stick or splash injuries were reported by 7%. All were dealt with adequately in accordance with national guidelines. However, less than half of 24 possible incidents were handled adequately. Two-and-a-half percent had unprotected sex with a new partner. The incidence of travelers' diarrhea (TD) was 46%. In those with TD, the incidence of post-travel new-onset abdominal complaints was 3%. Three percent were involved in a minor traffic accident, 18% were injured during leisure activities, 5% were threatened or experienced physical violence. Only half of the students visiting a highly endemic country were screened for tuberculosis post-travel. For schistosomiasis this was 6%. CONCLUSIONS Students abroad are exposed to medical and non-medical challenges, which should be addressed during pre-travel counseling. Contact details of a professional back home should be provided, so students can confer in case of problems while abroad. Lastly, we recommend a centrally organized post-travel health check.
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Affiliation(s)
- Jessica A Vlot
- Department of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, the Netherlands.
| | - Anastassia I Blanter
- Department of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Emile F F Jonker
- Department of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Nina S Korse
- Department of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Evelien Hack
- Medical School Internationalization Network Netherlands & Flanders, Leiden, the Netherlands
| | - Leonardus G Visser
- Department of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Darius Soonawala
- Department of Nephrology, Leiden University Medical Center (LUMC), Leiden, the Netherlands; Department of Internal Medicine, Haga Teaching Hospital, The Hague, the Netherlands
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Ashkenazi S, Schwartz E. Traveler's diarrhea in children: New insights and existing gaps. Travel Med Infect Dis 2019; 34:101503. [PMID: 31654742 DOI: 10.1016/j.tmaid.2019.101503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/15/2019] [Accepted: 10/21/2019] [Indexed: 01/17/2023]
Abstract
The number of children accompanying their parents in international travel is increasing steadily, and with the rising global migration, children more frequently accompany their parents or caregivers for visiting friends or relatives (VFR). As compared to travel for tourism, VFR children are at higher risk of acquiring local diseases, as they more often stay in rural areas in resource-poor locations, have longer periods of visit, are less likely to attend pre-travel consultations, and less frequently adhere to recommended precautions. Travelers's diarrhea (TD) is the most common travel-associated illnesses in children. This review updates the existing knowledge on TD in children, regarding its distinctive epidemiology, risk factors, preventive measures, clinical manifestations, complications, causative microorganisms and management. Despite the limited focused research on pediatric TD, which challenges the formulation of children-oriented evidence-based guidelines, practical recommendations are suggested.
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Affiliation(s)
- Shai Ashkenazi
- Adelson School of Medicine, Ariel University, Ariel, Israel; Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
| | - Eli Schwartz
- Center for Geographic Medicine and Tropical Diseases, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Edouard P, Richardson A, Murray A, Duncan J, Glover D, Kiss M, Depiesse F, Branco P. Ten Tips to Hurdle the Injuries and Illnesses During Major Athletics Championships: Practical Recommendations and Resources. Front Sports Act Living 2019; 1:12. [PMID: 33344936 PMCID: PMC7739783 DOI: 10.3389/fspor.2019.00012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/31/2019] [Indexed: 12/17/2022] Open
Abstract
Participating or winning a medal in major track and field (athletics) competitions is the goal of every athlete. However, health problems can impair sports performance and affect this dream. Therefore, we present ten tips to help hurdle the challenges of illness/injury at major athletics championships: (1) Prepare for travel (medical checking, vaccine, time-zone, jet lag, culture, food habits…), (2) Respect athlete characteristics and discipline specificity (sex, endurance/explosive), (3) Educate athletes and their entourages regarding prevention, (4) Vigilance of painful symptoms and subclinical illness markers, (5) Avoid infection risk (washing hands, safe food and drink, avoid contact with sick people…), (6) Train appropriately and optimally (physical conditioning, technical training, load management, and psychological preparation), (7) Health status (history of previous injuries, well-being in the month before championships), (8) Lifestyle (good sleep, regular hydration and nutrition with safe water/food, regular fruits and vegetables, improve recovery strategies…), (9) Environmental considerations (heat, cold, air cleaning, changes or climatic conditions…), (10) Safety (equipment, rules, own-practice in athletics, and extra-sport activities). These ten tips “PREVATHLES” are based on our field experience in addition to existing epidemiological and experimental literature in athletics and other sports. Although there is currently no scientific evidence for their efficacy, sound judgement, and logical practice provide a strong basis, and given the low risk of using them in the benefit/risk balance, we suggest athletes and those around them follow these ten tips to limit the impact of injury/illness on championship performance.
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Affiliation(s)
- Pascal Edouard
- Inter-University Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint-Étienne, France.,Sports Medicine Unit, Department of Clinical and Exercise Physiology, Faculty of Medicine, University Hospital of Saint-Etienne, Saint-Étienne, France.,Medical Commission, French Athletics Federation (FFA), Paris, France.,Division de Médecine Physique et Réadaptation, Swiss Olympic Medical Centre, Centre de Médecine du Sport, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,European Athletics Medical & Anti-doping Commission, European Athletics Association (EAA), Lausanne, Switzerland
| | - Andy Richardson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew Murray
- Knowledge Translation Team, Sport and Exercise, University of Edinburgh, Edinburgh, United Kingdom.,Human Performance Science Research Group, University of Edinburgh, Edinburgh, United Kingdom
| | - Jennifer Duncan
- Knowledge Translation Team, Sport and Exercise, University of Edinburgh, Edinburgh, United Kingdom
| | - Danny Glover
- Knowledge Translation Team, Sport and Exercise, University of Edinburgh, Edinburgh, United Kingdom.,Health Education Yorkshire and the Humber, Leeds, United Kingdom
| | - Marianna Kiss
- Hungarian Athletics Federation (Magyar Atlétikai Szovetség), Budapest, Hungary.,National Institute for Sport Medicine, Budapest, Hungary
| | - Frédéric Depiesse
- Medical Commission, French Athletics Federation (FFA), Paris, France.,European Athletics Medical & Anti-doping Commission, European Athletics Association (EAA), Lausanne, Switzerland.,Department of Physical Medicine and Rehabilitation, University Hospital of Martinique, Le Lamentin, France.,Health and Science Commission, International Association of Athletics Federations (IAAF), Monaco, Monaco
| | - Pedro Branco
- European Athletics Medical & Anti-doping Commission, European Athletics Association (EAA), Lausanne, Switzerland.,Health and Science Commission, International Association of Athletics Federations (IAAF), Monaco, Monaco
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Edouard P, Richardson A, Navarro L, Gremeaux V, Branco P, Junge A. Relation of Team Size and Success With Injuries and Illnesses During Eight International Outdoor Athletics Championships. Front Sports Act Living 2019; 1:8. [PMID: 33344932 PMCID: PMC7739616 DOI: 10.3389/fspor.2019.00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/15/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: The number of injuries and illnesses during major athletics championships vary according to sex and discipline. They may also differ between countries (national teams) given the differences in training, medical care, nutrition, lifestyle habits, and in travel to the championships. In addition, injuries and illnesses may influence the performance during the championships. Therefore, the aim was to analyse the differences in the injury and illness occurrence during international outdoor athletics championships with regards to the athlete's country, as well as establishing the potential relationships with the success of the country during the respective championships. Method: The national medical teams and the local organizing committee physicians reported all injuries and illnesses daily on a standardized injury and illness report form during 4 World and 4 European outdoor championships from 2007 to 2018. Results were presented as number of registered athletes, injuries, illnesses and medals (absolute and per 1000 registered athletes), and for countries of different team size. Results: During these 8 championships, a total of 219 different countries participated with a total of 13059 registered athletes who incurred 1315 injuries and 550 illnesses. The number of injuries and illnesses per championships varied between countries. Countries with higher numbers of registered athletes had a higher number of injuries and illnesses, as well as a higher number of medals and gold medals. There were significant positive correlations between number of injuries/illnesses and number of registered athletes, medals, gold medals. Injury and illness numbers per 1,000 registered athletes differed between countries and team sizes. Analyzing country participation grouped according to the number of registered athletes, there were significant negative correlations between injury/illness and medals/gold medals per 1,000 registered athletes. Conclusions: Given the correlation between health problems and country size, we suggest that medical services provision and staff should be adapted to the team size. In groups of different country team sizes, lower number of injuries and illnesses per registered athletes were correlated with higher number of medals and gold medals per registered athletes, which can support that injury and illness prevention should be recognized as a win-win performance-prevention strategy.
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Affiliation(s)
- Pascal Edouard
- Inter-University Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France.,Sports Medicine Unit, Department of Clinical and Exercise Physiology, Faculty of Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France.,Medical Commission, French Athletics Federation (FFA), Paris, France.,Division de Médecine Physique et Réadaptation, Swiss Olympic Medical Center, Centre de Médecine du Sport, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,European Athletics Medical & Anti Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland
| | - Andy Richardson
- Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Laurent Navarro
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, Saint-Etienne, France
| | - Vincent Gremeaux
- Division de Médecine Physique et Réadaptation, Swiss Olympic Medical Center, Centre de Médecine du Sport, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Pedro Branco
- European Athletics Medical & Anti Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland.,Health and Science Commission, International Association of Athletics Federations (IAAF), Monaco, Monaco
| | - Astrid Junge
- Medical School Hamburg, Hamburg, Germany.,Swiss Concussion Center, Schulthess Clinic Zurich, Zurich, Switzerland
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Lee YH, Lu CW, Wu PZ, Huang HL, Wu YC, Huang KC. Attitudes and awareness of medical assistance while traveling abroad. Global Health 2018; 14:67. [PMID: 29996856 PMCID: PMC6042459 DOI: 10.1186/s12992-018-0382-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 06/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With globalization, more and more people travel to countries where they are at risk of injuries and travel-related diseases. To protect travelers' health, it is crucial to understand whether travelers accurately perceive medical assistance resources before and during their trips. This study investigated the need, awareness, and previous usage of overseas emergency medical assistance services (EMAS) among people traveling abroad. METHODS Anonymous questionnaires were distributed to patients (n = 500) at a travel clinic in Taipei, Taiwan. RESULTS The results showed that EMAS were important, especially in the following categories: 24-h telephone medical consultation (91.8%), emergent medical repatriation (87.6%), and assistance with arranging hospital admission (87.4%). Patients were less aware of the following services: arrangement of appointments with doctors (70.7%) and monitoring of medical conditions during hospitalization (73.0%). Less than 5% of respondents had a previous experience with EMAS. CONCLUSIONS EMAS are considered important to people who are traveling abroad. However, approximately 20-30% of travelers lack an awareness of EMAS, and the percentage of travelers who have previously received medical assistance through these services is extremely low. The discrepancy between the need and usage of EMAS emphasizes the necessity to adapt EMAS materials in pre-travel consultations to meet the needs of international travelers.
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Affiliation(s)
- Yi-Hsuan Lee
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan.,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan.,Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan
| | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Pei-Zu Wu
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan.,Department of Family Medicine, Taipei City Hospital Heping Fuyou Branch, No.33, Sec. 2, Zhonghua Rd., Wanhua District, Taipei, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Yi-Chun Wu
- Centers for Disease Control, No.6, Linsen S. Rd., Zhongzheng District, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital, No.7, Zhongshan S. Rd., Zhongzheng District, Taipei, Taiwan. .,Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan. .,Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, No.87, Neijiang St., Wanhua District, Taipei, Taiwan.
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