Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges

Investigating Awareness Regarding Travel-Related Infectious Disease Prevention in a Metropolitan Area

The rise in international travel has led to an increase in travel-related infectious diseases. It is predicted that by 2030, the number of international travelers will reach 1.8 billion, with over 250 million people affected globally. This issue also has an economic impact, as the eradication of travel-related infectious diseases leads to a loss of USD 12 billion in tourism. To understand the association between demographic variables and knowledge, attitude, and behaviors related to travel-related infectious diseases, a cross-sectional survey-based study was conducted among 1191 individuals in the metropolitan city of Naples, Italy. Multiple linear regression was performed over three models. The results revealed that knowledge about travel-related infectious diseases was positively associated with age, female gender, non-smoking habits, being single, and higher education attainment. The attitude towards travel-related infectious diseases was positively associated with being female, non-smoking habits, being single, higher education attainment, and a higher level of knowledge. A statistically significant association was observed between behaviors and non-smoking habits and between higher levels of knowledge and attitudes. To address this issue, public health programs could be implemented to improve behaviors in the general population. Overall, this study provides valuable information about the determinants of knowledge, attitude, and behaviors related to travel-related infectious diseases in the general population.

[Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students]

PURPOSE

This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students.

METHODS

A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ²-test, Fisher's exact test, t-test, Wilcoxon signed-rank test, and Mann-Whitney U test.

RESULTS

The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning.

CONCLUSION

The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students' clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

Provision of Travel Health Advice Through Local Tourist Handlers: Perspectives of Safari Tour Operators in Uganda

BACKGROUND

The public health burden of travel related diseases (TRDs) remains significant despite the fact that most can be avoided, particularly with the assistance of local tourist handlers such as Safari Tour Operators' (STOs). The STO's are the immediate close contact with tourist groups, and yet their perspectives regarding provision of travel health advice are unknown in Uganda. This study was conducted to determine the level of knowledge, attitude, and practices of STOs regarding TRDs in Uganda.

METHODS

A cross sectional study was carried out among selected STOs in Kampala and Wakiso Districts using self-administered questionnaires.

RESULTS

The overall level of knowledge about travel health information was inadequate. Although 77.5% of the STOs were aware of some TRDs, the availability of travel health information or database in their organisations was not observed. Knowledge of the current TRDs in Uganda among the STOs was very low, with a few individuals mentioning yellow fever (9.7%), malaria (9.2%), cholera (9.2%), and HIV/AIDs (8.9%). Knowledge related to the sources of the travel health information was also low, with STOs (19.1%) and travel health clinics (14.9%) being mentioned as the main sources. The STOs had mostly positive attitude towards provision of travel health advice related to travellers, and all agreed that STOs should play a big role in the provision of travel health advice. First Aid and simple treatment options were mentioned as practices that STOs conducted to keep the travellers safe.

CONCLUSIONS

While the STOs are motivated to do the right thing and provide their clients with sound travel health advice, they have a limited awareness of the actual TRDs in Uganda. The STOs must be educated on pertinent travel health advice, and intra-travel disease and injury management. The responsible government and non-governmental entities in Uganda need to develop educational materials emphasising the relevance of travel health advice.

Development and validation of a questionnaire to evaluate the knowledge, attitude and practices regarding travel medicine amongst physicians in an apex tertiary hospital in Northern India

OBJECTIVES

Travel medicine focuses primarily on pre-travel preventive care and the conditions and diseases acquired during or after travel. There is a paucity of validated tools to assess the knowledge, attitude and practises of physicians with regard to travel medicine. We attempted to develop a tool to assess existing expertise among Medicine and Infectious Diseases resident doctors with respect to travel medicine.

METHODS

Item level content validity index (I-CVI) and scale level content validity index (S-CVI/Ave) were estimated for each of the items to establish the content validity. Refined measures of inter-rater agreement (Brennan and Prediger Agreement Coefficient and Gwet's Agreement Coefficient) were estimated for the tool.

RESULTS

The final version of the questionnaire had satisfactory content validity (I-CVI > 0∙6 and S-CVI/Ave > 0∙9) and possessed high agreement among the raters (Brennan and Prediger AC > 0∙7, p < 0∙01 and Gwet's AC > 0∙8, p < 0∙01) with regard to necessity, clarity and relevance of the scale.

CONCLUSIONS

This tool covers a wide range of questions and is scientifically validated. The final version of the tool can be used largely for the assessment of knowledge, attitude and practices among medical practitioners. This is instrumental to build targeted intervention programs to enhance the knowledge regarding travel medicine among health care providers.

Using social media listening and data mining to understand travellers' perspectives on travel disease risks and vaccine-related attitudes and behaviours

BACKGROUND

Travellers can access online information to research and plan their expeditions/excursions, and seek travel-related health information. We explored German travellers' attitude and behaviour toward vaccination, and their travel-related health information seeking activities.

METHODS

We used two approaches: web 'scraping' of comments on German travel-related sites and an online survey. 'Scraping' of travel-related sites was undertaken using keywords/synonyms to identify vaccine- and disease-related posts. The raw unstructured text extracted from online comments was converted to a structured dataset using Natural Language Processing Techniques. Traveller personas were defined using K-means based on the online survey results, with cluster (i.e. persona) descriptions made from the most discriminant features in a distinguished set of observations. The web-scraped profiles were mapped to the personas identified. Travel and vaccine-related behaviours were described for each persona.

RESULTS

We identified ~2.6 million comments; ~880 k were unique and mentioned ~280 k unique trips by ~65 k unique profiles. Most comments were on destinations in Europe (37%), Africa (21%), Southeast Asia (12%) and the Middle East (11%). Eight personas were identified: 'middle-class family woman', 'young woman travelling with partner', 'female globe-trotter', 'upper-class active man', 'single male traveller', 'retired traveller', 'young backpacker', and 'visiting friends and relatives'. Purpose of travel was leisure in 82-94% of profiles, except the 'visiting friends and relatives' persona. Malaria and rabies were the most commented diseases with 12.7 k and 6.6 k comments, respectively. The 'middle-class family woman' and the 'upper-class active man' personas were the most active in online conversations regarding endemic disease and vaccine-related topics, representing 40% and 19% of comments, respectively. Vaccination rates were 54%-71% across the traveller personas in the online survey. Reasons for vaccination reluctance included perception of low risk to disease exposure (21%), price (14%), fear of side effects (12%) and number of vaccines (11%).

CONCLUSIONS

The information collated on German traveller personas and behaviours toward vaccinations should help guide counselling by healthcare professionals.

Residents' Support for Tourism Amidst the COVID-19 Era: An Application of Social Amplification of Risk Framework and Knowledge, Attitudes, and Practices Theory

Given that the concept of risk perception stems primarily from consumer behaviour, tourism research has tended to address the issue from tourists' perspective, resulting in a lack of consideration of destination residents' risk perception and its impact on their attitudes and subsequent behaviour. Based on the social amplification of risk framework (SARF) and the knowledge, attitudes, and practices (KAP) theory, this study constructed a theoretical model to deepen the understanding of destination residents' support for tourism. Results indicate that residents' social media use, knowledge of COVID-19 and attitudes to tourism and tourists are all positively related to their support for tourism. Furthermore, residents' risk perception is negatively associated with their attitudes to tourism, attitudes to tourists and support for tourism. However, the relationship between residents' social media use and risk perception was not confirmed. Theoretical and managerial implications were discussed.

Sidek Ahmad Z, Zarkasi K, Ramli N, Che Jamaludin F. Pretravelling health-seeking behavior, knowledge of vaccines, and attitudes toward travel health among malaysian travelers

Background:

Travelers are at higher risk of developing health-related problems, especially travel-related diseases, and this remains a major public health burden.

Aims:

To assess pretravel health behavior-seeking factors, knowledge of vaccine, and travel health attitudes. A cross-sectional design among Malaysian travelers.

Methods:

An online survey was conducted from December 2017 till March 2018 among 226 participants. Demographic data, pretraveling health behaviors, knowledge of vaccine-preventable diseases, and travel health were asked. Independent t-test and ANOVA were performed using SPSS version 20.

Results:

Among travelers, 51.3% and 63.7% used health-related information on their destination before departure and collected information on possible travel hazards at their destination. Participant age (P = 0.02), monthly income (P = 0.01), predeparture health information (P = 0.03), information on possible hazards (P = 0.04), and travel health advice from medical professionals (P = 0.03) have been reported as a major predictor of knowledge of vaccine-preventable disease. Travelers’ gender (P = 0.01), household income (P = 0.01), and travel health advice from professionals (P = 0.002) were significantly associated with travel health attitude.

Conclusions:

Sociodemographic and pretravel health-seeking behavior influence knowledge of vaccine-preventable disease and attitudes towards travel health which requires a public health need for community outreach programs targeting this group.

If I told you that there is no need for yellow fever vaccine booster would you still come to the travel clinic?: a cross-sectional study

Background

Yellow Fever (YF) immunization required a single dose vaccine with boosters every 10 years. After International Health Regulation (IHR) amendment annex 7 (July 2016), it was accepted that a single dose confers lifelong immunity. Since pre-travel advice is as important as vaccination when traveling, it is essential to clarify why travelers come to a travel health consultation, with the possibility of IHR amendment having a negative impact on travelers’ health. This study aims to describe travelers’ reasons to come to a pre-travel consultation in Lisbon and if they would return if they wouldn’t need the YF vaccine booster.

Methods

An observational cross-sectional study was conducted during 5 months in the waiting room of Instituto de Higiene e Medicina Tropical travel clinic in Lisbon, Portugal. Travelers were asked about sociodemographic characteristics, destination country, travel duration and reasons to travel in an anonymous self-administered questionnaire.

Results

A total of 1043 travelers agreed to participate in the study. Although 61.0% (627/1028) did not come to the clinic to get the YF vaccine, from those who did, 36.7% (133/362) would not come and 12.9% (47/362) didn’t knew if they would come if the vaccine would not be necessary.

Conclusion

The IHR amendment may have a negative impact on travel clinic attendance and on travelers´ health.

Assessment of knowledge, attitudes, and practices regarding travel health among (King Abdulaziz) international airport travelers in Jeddah, Kingdom of Saudi Arabia 2019

Background:

Travelers to different countries have endemic/pandemic diseases can increase the risk of exposure to various infectious agents and can facilitate their spread across borders.

Objectives:

To determine the levels of travel health knowledge, attitudes and practices among travelers at international airports of KSA.

Methods:

An observational cross-sectional study was conducted starting from 30 September, 2019 at the departure halls of King Abdulaziz International airport (KAIA). Representative sample adult travelers who were waiting to board were recruited.

Results and Discussion:

Good level of knowledge regarding travel health was observed among 28.2%. The majority of the participants (84.7%) got information about their destination prior to the trip. The main reported source of information was family/friends (53.8%). Negative health seeking behavior was observed among 70.8% of the participants. Purpose of the trip and duration of destination were significantly associated with health seeking behavior. Knowledge, attitude towards health information seeking behavior and practice-related to travel health among international travelers at King Abdulaziz International airport are insufficient.

A Normative Behavior of Pre-Travel Health Consultation and the Associated Factors among Travelers

Introduction: Travelers may transmit diseases due to their behavior of travel, consequently travelers should consider preventive measurement through pre-travel health consultation seeking behavior. Pre-travel health consultation is a particular preparation ideally conducted by international travelers to obtain risk assessment and management to prevent the transmission of diseases. This study investigates the relationship of socio-demographic characteristics and itinerary on pre-travel health consultation behavior among international travelers in Badung, Bali.Methods: A descriptive-correlative design using a cross-sectional approach employed 125 participants determined by a purposive sampling technique performed in the ten tourist destinations of Badung Regency. Data collection was conducted on February 15th until March 5th, 2020. Data demography, travel plan, and anonymous questionnaires regarding pre-travel health consultation behavior are used in this research. The Gamma coefficient correlation and Kruskal-Wallis statistic tests were performed in the study for bivariate analysis.Results: The results showed that age (p<0.0001; r=-0.650) and past-travel history to Bali (p=0.004; r=-0.475) were significantly correlated with pre-travel health consultation behavior among international travelers in Badung, Bali. Meanwhile sex, nationality, last education, travel duration, and types of the destination visited were not significantly associated with pre-travel health consultation behavior among international travelers in Badung, Bali (p>0.05).Conclusion: The age and past-travel history to Bali seem to be predictors for travelers to uptake pre-travel health consultation, thus nurses should be able to promote the implementation of pre-travel health consultation by utilizing the media promotion appropriately adjusted to the age of travelers and travel experience.

The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study

Background

Pretravel health advice can play a crucial role in improving both travelers’ awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non–mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims’ health behaviors.

Objective

The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims’ awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses.

Methods

A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015.

Results

A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses.

Conclusions

Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.

Knowledge, attitude and compliance towards travel vaccines among Nigerian travellers at an international airport

BACKGROUND

The risk of contracting a travel-related disease does not only depend on the destination of travel and length of the trip, but also on the traveller's own health status. Travel vaccines avert the increase of communicable disease. Awareness of traveller's behaviours and their attitudes concerning infectious diseases can inform policy aimed at protecting the individual travellers, their contacts and the communities into which they travel.

AIM

This study on travel vaccine was aimed to determine the level of knowledge, attitude and compliance to travel vaccines.

SETTING

This study was conducted among Nigerian travellers at Murtala Mohammed International Airport, Ikeja, Nigeria.

METHODS

It was a cross-sectional descriptive study using systematic sampling technique, with the aid of interviewer-administered questionnaire to select 198 respondents for the study. The statistical software EPI-Info 7 was used for data analysis.

RESULTS

The mean age of respondents was 35.34 + 9.91 years and majority (58.1%) of the respondents were men. Majority (54.0%) were married and (43.4%) had tertiary education. About 35.9% were travelling to other African countries, 9.6% to Middle Eastern countries, 16.2% to Europe, 13.6% to North America and 7.6% to Australia. Their main purpose of travel was for employment or working (22.2%), business activities (20.7%), touring (16.2%) and visiting families and relatives (15.7%). About a half (41.4%) had good knowledge of travel vaccines, majority (83.8%) had positive attitude and majority (66.2%) had been vaccinated for yellow fever before travel.

CONCLUSION

Significant associations exist between tribe, religion, education and knowledge of travel vaccines.

Malaria prevention in the older traveller: a systematic review

Older travellers are at higher risk of malaria-related morbidity and mortality compared with younger people. Yet, prevention of malaria in this specific group of travellers is a long-standing issue in travel medicine. The aim of this research was to synthetize the existing evidence about this important topic, highlighting older travellers' attitudes and practises toward malaria prevention. Searches were performed on PubMed, Embase, EuropePMC, Web of Science, WHOLIS and LILACS databases for relevant studies reporting malaria prevention measures in older travellers. To measure malaria prevention in the older traveller population, the main information outcomes were obtained from the ABCD framework that included travellers' 'Awareness' towards pre-travel health advice, their utilisation of 'Bite-prevention measures' and adherence to 'Chemoprophylaxis'. Data on 'Diagnosis'-related outcomes were excluded for not being measures of malaria prevention. Three evaluators independently selected studies, extracted data and assessed the quality of the included articles. The research protocol was registered with PROSPERO (protocol number CRD42019124202). Out of the 899 titles and abstracts screened, 13 articles were included in this review synthesis. These studies included a wide range of interventions for malaria prevention: no relevant differences in pre-travel healthcare attendance were found depending on age; older travellers were found to be less likely to comply with bite-prevention measures; three high-quality studies reported that adherence to chemoprophylaxis significantly increased with age, while three studies did not find age-related differences in travellers' adherence. Overall, prevention of malaria in the older traveller has received limited attention from the scientific community. Older travellers seem to be less likely to comply with bite-prevention measures, but there was high heterogeneity across the reports. This population group demands particular attention and tailored health advice before travelling to malaria endemic areas. More research is required on how to improve malaria prevention in the older traveller.

Exploring Australian Hajj Tour Operators' Knowledge and Practices Regarding Pilgrims' Health Risks: A Qualitative Study

Background

Travel agents are known to be one of the main sources of health information for pilgrims, and their advice is associated with positive health behaviors.

Objective

This study aimed to investigate travel agents’ health knowledge, what health advice they provide to the pilgrims, and their sources of health information.

Methods

In-depth interviews were conducted among specialist Hajj travel agents in Sydney, Australia. Thematic analysis was undertaken.

Results

Of the 13 accredited Hajj travel agents, 9 (69%) were interviewed. A high level of awareness regarding gastrointestinal infections, standard hygiene methods, and the risk of injury was noted among the participants and was included in advice provided to pilgrims. However, very limited knowledge and provision of advice about the risk of respiratory infections was identified. Knowledge of the compulsory meningococcal vaccine was high, and all participated travel agents reported influenza vaccine (a recommended vaccine) as a second “compulsory” vaccine for Hajj visas. Conversely, participants reported very limited knowledge about other recommended vaccines for Hajj. The Ministry of Hajj website and personal Hajj experience were the main sources of information.

Conclusions

This study identifies a potential path for novel health promotion strategies to improve health knowledge among Hajj travel agents and subsequently among Hajj pilgrims.

Travelers' knowledge, attitudes, and behavior related to infectious diseases in Italy

The objectives of this investigation were to examine the travelers’ knowledge, attitudes, and behavior about travel-related diseases and to evaluate the factors that influence their knowledge, attitudes, and behavior. A cross-sectional study was performed between May and September 2018 among a random sample of individuals attending randomly selected travel agencies in the geographical areas of Caserta and Naples, Italy. One fourth of participants (25.6%) had a poor level of knowledge, 50.2% a moderate, and only 24.2% a good level about the most common infectious diseases in the destination country. Those who had received information from physicians about the most common infectious diseases in the destination country and who do not need additional information were significantly more likely to have a good level of knowledge. A large majority (91%) showed no concern about the risk of getting an infectious disease during the travel. Almost half of the respondents had received information concerning the most common infectious diseases in the destination country and the related prevention measures. This information was more likely acquired by those graduated, those who know the foods that can cause the infectious diseases, and those who self-perceived a well health status, and less likely by those who had a poor level of knowledge about the most common infectious diseases in the destination country and who were going to Asia and South America. Education and communication activities regarding all aspects of travel-related diseases are needed to increase the knowledge and the access to preventive measures.

Preparedness against self-infection and importation of Malaria - An airport survey among Saudis traveling to endemic countries

Background:

Infected travelers returning from malaria endemic countries pose the threat of local outbreaks in nonendemic countries. Such outbreaks are becoming potential public health threats with increasing volume of international travels.

Aims:

This study aimed to assess the knowledge, attitude, and practices toward malaria, its prevention and treatment among Saudi air travelers visiting malaria-endemic countries.

Methods:

A cross-sectional survey was conducted among Saudi passengers who were waiting at the departure gates of the King Khalid International Airport, Riyadh to travel to five chosen malaria-endemic countries. Knowledge, attitude, practice, and health-seeking behavior for malaria were assessed using a self-administered questionnaire. Factors associated with favorable responses were identified by statistical tests.

Results:

Among 531 travelers, adequate knowledge, favorable attitude, and healthy practices pertaining to malaria were present in 42.7%, 80.2%, and 55.7%, respectively. Traveling to India, age >=30 years, tourists and traveling businessmen, previous visit to same country or region, seeking malaria-specific advice were significantly associated with adequate knowledge. Only 11.3% had sought pretravel health advice on malaria. Lack of knowledge about the existence and importance of pretravel consultation was the common reason for not seeking advice.

Conclusion:

Knowledge about malaria and practice of preventive measures were suboptimal among Saudi travelers. Public awareness about travel consultation and chemoprophylaxis should be a part of malaria elimination and prevention efforts. Primary care physicians should take into account the level of knowledge among prospective travelers and provide opportunistic travel health services or refer them appropriately.

Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt

OBJECTIVES

to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport.

METHODS

We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire.

RESULTS

Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices.

CONCLUSION

Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services.

Pharmacy travel health services: current perspectives and future prospects

Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers' diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.

Tour leaders with detailed knowledge of travel-related diseases play a key role in disease prevention

In Taiwan, group tours are a popular mode of international travel; hence, group tour leaders must ensure traveler safety and health. This study identified factors influencing tour leaders' willingness to recommend pretravel medical consultation and vaccination.A cross-sectional questionnaire survey was administered to tour leaders from January 2011 to December 2012. Multivariate logistic regression analyses were performed to estimate the odds ratios of having a positive attitude and willingness based on different knowledge scores of the tour leaders after adjustments for age, sex, education level, and seniority.Tour leaders with a more detailed knowledge of both travel-related infectious and noninfectious diseases demonstrated a higher willingness to receive vaccination. They believed that consultation at travel clinics before travel can improve travelers' health (P < .05).This study supports the importance and effectiveness on educating tour leaders' knowledge about travel-related diseases to improve health care for travelers.

Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel

BACKGROUND

Although international travel has become increasingly more common in main land China, few data are available on vaccination knowledge, attitude and practice (KAP) among Chinese travelers.

METHOD

In each of 14 International Travel Healthcare Centers (ITHCs) situated in mainland China 200 volunteers were recruited for a cross-sectional investigation by questionnaire on KAP related to travel vaccinations. For the evaluation the study subjects were grouped by demographic data, past travel experience, travel destination, duration of stay abroad, purpose of travel.

RESULTS

Among the 2,800 Chinese travelers who participated in the study, 67.1% were aware of national and travel vaccination recommendations. The knowledge about vaccine preventable diseases was low. The most common sources (73.4%) of information were requirements by destination countries obtained in connection with the visa application, Chinese companies employing workers/laborers for assignments overseas, and foreign schools. The overall acceptance rate of recommended vaccines was 68.7%, but yellow fever was accepted by 99.8% of the participants when recommended. Among 81.1% respondents who recalled to have received vaccinations in the past, only 25.9% of them brought the old vaccination records with them to their ITHC consultations.

CONCLUSION

The results indicate that increased awareness of the importance of pre-travel vaccination is needed among the travellers in order to improve their KAP.