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Lovey T, Hasler R, Gautret P, Schlagenhauf P. Travel-related respiratory symptoms and infections in travellers (2000-22): a systematic review and meta-analysis. J Travel Med 2023; 30:taad081. [PMID: 37310895 PMCID: PMC10481419 DOI: 10.1093/jtm/taad081] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Respiratory tract infections (RTIs) are common in travellers due to the year-round or seasonal presence of respiratory pathogen and exposure to crowded environments during the itinerary. No study has systematically examined the burden of RTI infections among travellers. The aim of this systematic review and meta-analysis is to evaluate the prevalence of RTIs and symptoms suggestive of RTIs among travellers according to risk groups and/or geographic region, and to describe the spectrum of RTIs. METHODS The systematic review and meta-analysis was registered in PROSPERO (CRD42022311261). We searched Medline, Embase, Scopus, Cochrane Central, Web of Science, Science Direct and preprint servers MedRxiv, BioRxiv, SSRN and IEEE Xplore on 1 February 2022. Studies reporting RTIs or symptoms suggestive of RTIs in international travellers after 1 January 2000 were eligible. Data appraisal and extraction were performed by two authors, and proportional meta-analyses were used to obtain estimates of the prevalence of respiratory symptoms and RTIs in travellers and predefined risk groups. FINDINGS A total of 429 articles on travellers' illness were included. Included studies reported 86 841 symptoms suggestive of RTIs and 807 632 confirmed RTIs. Seventy-eight percent of reported respiratory symptoms and 60% of RTIs with available location data were acquired at mass gatherings events. Cough was the most common symptom suggestive of respiratory infections, and the upper respiratory tract was the most common site for RTIs in travellers. The prevalence of RTIs and respiratory symptoms suggestive of RTIs were 10% [8%; 14%] and 37% [27%; 48%], respectively, among travellers. Reporting of RTIs in travellers denoted by publication output was found to correlate with global waves of new respiratory infections. INTERPRETATION This study demonstrates a high burden of RTIs among travellers and indicates that travellers' RTIs reflect respiratory infection outbreaks. These findings have important implications for understanding and managing RTIs among travellers.
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Affiliation(s)
- Thibault Lovey
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich Switzerland
| | - Robin Hasler
- HFR Fribourg – Cantonal Hospital, 1708 Fribourg, Switzerland
| | | | - Patricia Schlagenhauf
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich Switzerland
- Department of Global and Public Health, MilMedBiol Competence Centre, Epidemiology Biostatistics and Prevention Institute, WHO Collaborating Centre for Travellers’ Health, Hirschengraben 84, 8001 Zürich, Switzerland
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Pineda-Reyes R, Lahham R, Quinones S, Glenn SJ, Morales ML, Mozo K, Cabada MM. Incidence of acute mountain sickness and healthcare related behaviors among travelers to Cusco, Peru. Travel Med Infect Dis 2020; 37:101859. [PMID: 32860960 PMCID: PMC7449976 DOI: 10.1016/j.tmaid.2020.101859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 10/26/2022]
Affiliation(s)
- Roberto Pineda-Reyes
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center - Cusco, Jr. Jose Carlos Mariategui J-6, Wanchaq, 08002, Cusco, Peru; Sede Cusco - Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102, Lima, Peru.
| | - Rana Lahham
- School of Medicine, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA.
| | - Sophia Quinones
- School of Medicine, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA.
| | - Spencer J Glenn
- School of Medicine, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA.
| | - Maria Luisa Morales
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center - Cusco, Jr. Jose Carlos Mariategui J-6, Wanchaq, 08002, Cusco, Peru; Sede Cusco - Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102, Lima, Peru.
| | - Karen Mozo
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center - Cusco, Jr. Jose Carlos Mariategui J-6, Wanchaq, 08002, Cusco, Peru; Sede Cusco - Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102, Lima, Peru.
| | - Miguel M Cabada
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center - Cusco, Jr. Jose Carlos Mariategui J-6, Wanchaq, 08002, Cusco, Peru; Sede Cusco - Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porres, 15102, Lima, Peru; Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, 301 University Blvd., Route 0435, Galveston, TX, 77555, USA.
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3
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Bauer I. Travel medicine, coca and cocaine: demystifying and rehabilitating Erythroxylum - a comprehensive review. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:20. [PMID: 31798934 PMCID: PMC6880514 DOI: 10.1186/s40794-019-0095-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/02/2019] [Indexed: 11/24/2022]
Abstract
Few travel health measures are as controversial as the use of coca leaves at high altitude; yet, there appears widespread ignorance among health professionals and the general public about coca, its origins as well as its interesting and often flamboyant history. Equally, the cultural and traditional significance to Andean people is not recognised. The coca leaves contain many alkaloids, one of which, cocaine, has gained notoriety as a narcotic, leading to the mistaken idea that coca equals cocaine. This article contrasts coca with cocaine in an attempt to explain the differences but also the reasons for this widespread misconception. By its very nature, there may never be scientific ‘proof’ that coca leaves do or do not work for travellers at altitude, but at least a solid knowledge of coca, and how it differs from cocaine, provides a platform for informed opinions and appropriate critical views on the current confusing and contradictory legal situation.
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Affiliation(s)
- Irmgard Bauer
- College of Healthcare Sciences, James Cook University, Townsville, QLD 4811 Australia
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4
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Gallego V, Berberian G, Siu H, Verbanaz S, Rodríguez-Morales AJ, Gautret P, Schlagenhauf P, Lloveras S. The 2019 Pan American games: Communicable disease risks and travel medicine advice for visitors to Peru - Recommendations from the Latin American Society for Travel Medicine (SLAMVI). Travel Med Infect Dis 2019; 30:19-24. [PMID: 31238107 DOI: 10.1016/j.tmaid.2019.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/29/2022]
Abstract
The next Pan American Games will be held in Peru in the period July-August 2019. Around 6680 participants from 41 countries are expected to take part in the event. There will be a total of 62 sport disciplines. This event poses specific challenges, given its size and the diversity of attendees. Such gatherings also have potential for the transmission of imported or endemic communicable diseases, including measles in view of the global outbreak situation, but also tropical endemic diseases. In anticipation of increased travel, a panel of experts from the Latin American Society for Travel Medicine (SLAMVI) developed the current recommendations taking into consideration the epidemiology and risks of the main communicable diseases at potential destinations in Peru, recommended immunizations and other preventives measures. These recommendations can be used as a basis for advice for travelers and travel medicine practitioners. Mosquito-borne infections also pose a challenge. Although Lima is malaria free, travelers visiting Peruvian high-risk areas for malaria should be assessed regarding the need for chemoprophylaxis. Advice on the correct timing and use of repellents and other personal protection measures is key to preventing vector-borne infections. Other important recommendations for travelers should focus on preventing water- and food-borne diseases including travelers' diarrhea. This paper addresses pre-travel, preventive strategies to reduce the risk of acquiring communicable diseases during the Pan American Games and also reviews the spectrum of endemic infections in Lima and Peru to facilitate the recognition and management of infectious diseases in travelers returning to their countries of origin.
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Affiliation(s)
- Viviana Gallego
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Griselda Berberian
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Hugo Siu
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Lima, Peru
| | - Sergio Verbanaz
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina
| | - Alfonso J Rodríguez-Morales
- Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, Institute for Epidemiology, Biostatistics and Prevention, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Susana Lloveras
- Panel of Sports and Travel, Latin American Society for Travel Medicine (SLAMVI), Buenos Aires, Argentina; Panel of Scientific Publications and Teaching, Latin American Society for Travel Medicine (SLAMVI), Pereira, Colombia
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5
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Abstract
Respiratory tract infections (RTIs) are a common health problem of international travelers. Travelers may be at increased risk of RTIs due to travel itself (mingling and close quarters in airports, airplanes, cruise ships, and hotels), and due to unique exposure at travel destinations. The clinical spectrum of RTIs in travelers is broad and includes upper RTIs, pharyngitis, otitis, laryngitis, bronchitis, and pneumonia. Most travelers who acquire an RTI only develop mild disease, and only a minority seek medical attention. All travelers should be up to date on any indicated vaccines based on age and medical condition that prevent RTIs, including influenza, measles, pneumococcal diseases, Haemophilus influenzae b, Neisseria meningitidis, diphtheria, and pertussis. Respiratory tract infections (RTIs) are among the most common illnesses reported by travelers. Most RTIs are viral, involve the upper respiratory tract, and do not require specific diagnosis or treatment. Influenza is often considered the most important travel-related infection. Travelers play an integral role in the yearly and global spread of influenza. Lower RTIs, including pneumonia, often require antimicrobial therapy. High-risk groups such as infants, small children, the elderly, and subjects with chronic tracheobronchial or pulmonary disease are at increased risk of developing severe clinical consequences should infection occur. All international travelers should be immunized for seasonal influenza unless otherwise contraindicated, and travelers should be instructed in hand hygiene and sneeze and cough hygiene. All travelers should be up to date on any indicated vaccines that prevent RTIs, including measles, pneumococcal diseases, Haemophilus influenzae b (Hib), meningococcal disease, diphtheria, and pertussis. Travelers may be at increased risk of geographically restricted RTIs, and clinicians should be familiar with the major manifestations of these illnesses.
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Smith SM, Montero L, Paez M, Ortega E, Hall E, Bohnert K, Sanchez X, Puebla E, Endara P, Cevallos W, Trueba G, Levy K. Locals get travellers' diarrhoea too: risk factors for diarrhoeal illness and pathogenic Escherichia coli infection across an urban-rural gradient in Ecuador. Trop Med Int Health 2018; 24:205-219. [PMID: 30444557 DOI: 10.1111/tmi.13183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Diarrhoea is a common and well-studied cause of illness afflicting international travellers. However, traveller's diarrhoea can also result from travel between high and low disease transmission regions within a country, which is the focus of this study. METHODS We recruited participants for a case-control study of diarrhoea at four sites along an urban-rural gradient in Northern Ecuador: Quito, Esmeraldas, Borbón and rural communities outside of Borbón. At each of these sites, approximately 100 subjects with diarrhoea (cases) were recruited from Ministry of Health clinics and were age-matched with subjects visiting the same clinics for other complaints (controls). RESULTS Travellers to urban destinations had higher risk of diarrhoea and diarrhoeagenic Escherichia coli (DEC) infections. Travel to Quito was associated with diarrhoea (aOR = 2.01, 95% CI = 1.10-3.68) and travel to Guayaquil (another urban centre in Ecuador) was associated with Diffuse Adherent E. coli infection (OR = 2.09, 95% CI = 1.01-4.33). Compared to those not travelling, urban origins were also associated with greater risk of diarrhoea in Esmeraldas (aOR = 2.28, 95% CI = 1.20-4.41), and with higher risk of diarrhoeagenic E. coli infections in Quito (aOR = 2.61, 95% CI = 1.16-5.86), with >50% of travel from Quito and Esmeraldas specified to another urban destination. CONCLUSIONS This study suggests that individuals travelling from lower-transmission regions (rural areas) to higher transmission regions (urban centres) within a single country are at a greater risk of acquiring a diarrhoea-related illness. Investments to improve water, sanitation and hygiene conditions in urban areas could have impacts on outlying rural areas within a given country.
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Affiliation(s)
- Shanon M Smith
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lorena Montero
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Maritza Paez
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Estefania Ortega
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Eric Hall
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kate Bohnert
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Xavier Sanchez
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Edison Puebla
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Pablo Endara
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - William Cevallos
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Karen Levy
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Bauer IL. Airport surveys at travel destinations--underutilized opportunities in travel medicine research? J Travel Med 2015; 22:124-9. [PMID: 25393948 DOI: 10.1111/jtm.12175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/08/2014] [Accepted: 09/16/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Research in destination airports, especially in resource-poor areas, allows unique immediate access to travelers at the conclusion of their trip. Response rates are high and the recall gap small. Trip-related health matters can be elicited relatively easily. An insight into travelers' decision-making processes on location would fill large gaps in our knowledge regarding travel health advice provision; yet, this approach is still much underutilized. METHODS Using PubMed, ScienceDirect, Google Scholar, and ProQuest, a review of the literature on airport surveys was conducted to determine where they were used, their response rates and purpose, and location-relevant methodological information. RESULTS The lack of methodological guidelines in the reviewed literature resulted in recommendations for planning and conducting an airport survey at a destination airport. CONCLUSIONS Millions of travelers in airports around the world represent an underutilized sample of potential study participants for topics that cannot be studied adequately in other settings. Benefiting from close cooperation between travel health professionals and airport authorities, researchers can expect not only large-scale convenience samples for surveys, but also opportunities to explore exciting and creative research topics to broaden our understanding of travel medicine and health.
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Affiliation(s)
- Irmgard L Bauer
- Nursing, Midwifery & Nutrition, College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Australia
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8
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Matteelli A, Saleri N, Ryan ET. Respiratory Infections. TRAVEL MEDICINE 2013. [PMCID: PMC7151982 DOI: 10.1016/b978-1-4557-1076-8.00056-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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9
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Salazar H, Swanson J, Mozo K, White AC, Cabada MM. Acute mountain sickness impact among travelers to Cusco, Peru. J Travel Med 2012; 19:220-5. [PMID: 22776382 DOI: 10.1111/j.1708-8305.2012.00606.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increasing numbers of travelers are visiting high altitude locations in the Andes. The epidemiology of acute mountain sickness (AMS) among tourists to high altitude in South America is not well understood. METHODS A cross-sectional study to evaluate the epidemiology, pre-travel preparation, and impact of AMS among travelers to Cusco, Peru (3,400 m) was performed at Cusco's International Airport during June 2010. Foreign travelers, 18 years or older, staying 15 days or less, departing Cusco were invited to participate. Demographic, itinerary, and behavioral data were collected. The Lake Louise Clinical score (LLCS) was used to assess AMS symptoms. RESULTS In total, 991 travelers participated, median age 32 years (interquartile range 25-49), 55.5% female, 86.7% tourists, mostly from the United States (48.2%) and England (8.1%). Most (76.7%) flew from sea level to Cusco and 30.5% visited high altitude in the previous 2 months. Only 29.1% received AMS advice from a physician, 19% recalled advice on acetazolamide. Coca leaf products (62.8%) were used more often than acetazolamide (16.6%) for prevention. AMS was reported by 48.5% and 17.1% had severe AMS. One in five travelers with AMS altered their travel plans. Travelers older than 60 years, with recent high altitude exposure, who visited lower cities in their itinerary, or used acetazolamide were less likely to have AMS. Using coca leaf products was associated with increased AMS frequency. CONCLUSIONS AMS was common and adversely impacted plans of one in five travelers. Acetazolamide was associated with decreased AMS but was prescribed infrequently. Other preventive measures were not associated with a decrease in AMS in this population. Pre-travel preparation was suboptimal.
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Affiliation(s)
- Hugo Salazar
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
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10
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Bauer I. Australian senior adventure travellers to Peru: Maximising older tourists' travel health experience. Travel Med Infect Dis 2012; 10:59-68. [PMID: 22459635 DOI: 10.1016/j.tmaid.2012.03.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 02/29/2012] [Accepted: 03/05/2012] [Indexed: 11/16/2022]
Abstract
Financially comfortable, with ample spare time and much better health, older people travel more than ever and to more adventurous destinations. Taking Australian senior adventure travellers to Peru as an example, travel health preparations need to take into account the phenomenon 'senior traveller', the destination with its attractions and challenges, and age-related changes and restrictions. The need for routine travel health advice, vaccinations and prophylaxis remains unchanged. However, more emphasis should be placed on locality-specific issues so that age-appropriate advice and preparations maximize the chances for a safe and memorable travel experience.
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Affiliation(s)
- Irmgard Bauer
- School of Nursing, Midwifery and Nutrition, James Cook University, Townsville, QLD 4811, Australia.
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Heywood AE, Zhang M, MacIntyre CR, Seale H. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia. BMC Infect Dis 2012; 12:43. [PMID: 22339735 PMCID: PMC3305552 DOI: 10.1186/1471-2334-12-43] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 02/17/2012] [Indexed: 11/24/2022] Open
Abstract
Background Forward planning and preventative measures before travelling can significantly reduce the risk of many vaccine preventable travel-related infectious diseases. Higher education students may be at an increased risk of importing infectious disease as many undertake multiple visits to regions with higher infectious disease endemicity. Little is known about the health behaviours of domestic or international university students, particularly students from low resource countries who travel to high-resource countries for education. This study aimed to assess travel-associated health risks and preventative behaviours in a sample of both domestic and international university students in Australia. Methods In 2010, a 28 item self-administered online survey was distributed to students enrolled at the University of New South Wales, Sydney, Australia. Multiple methods of distributing links to the online survey were utilised. The survey examined the international travel history, travel intentions, infection control behaviours and self-reported vaccination history. Results A total of 1663 respondents completed the online survey, 22.1% were international students and 83.9% were enrolled at an undergraduate level. Half had travelled internationally in the previous 12 months, with 69% of those travelling only once during that time with no difference in travel from Australia between domestic and international students (p = 0.8). Uptake of pre-travel health advice was low overall with 68% of respondents reporting they had not sought any advice from a health professional prior to their last international trip. Domestic students were more likely to report uptake of a range of preventative travel health measures compared to international students, including diarrhoeal medication, insect repellent, food avoidance and condoms (P < 0.0001). Overall, students reported low risk perception of travel threats and a low corresponding concern for these threats. Conclusions Our study highlights the need to educate students about the risk associated with travel and improve preventative health-seeking and uptake of precautionary health measures in this highly mobile young adult population. Although immunisation is not an entry requirement to study at Universities in Australia, large tertiary institutions provide an opportunity to engage with young adults on the importance of travel health and provision of vaccines required for travel, including missed childhood vaccines.
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Affiliation(s)
- Anita E Heywood
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
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12
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Cabada MM, Maldonado F, Mozo K, Dziuba N, Gotuzzo E. Pre-travel preparation for Cusco, Peru: a comparison between European and North American travelers. J Travel Med 2010; 17:382-6. [PMID: 21050317 DOI: 10.1111/j.1708-8305.2010.00461.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Demographics, preferences on health care, and regional differences in pre-travel advice guidelines may influence the preparation of travelers to developing countries. METHODS A secondary data analysis of the database of a travelers' health survey conducted in Cusco in 2002 was performed. Data from those whose place of residence was North America or Western Europe were selected. Illness rates, vaccinations, prophylactic medication use, and general recommendations on disease prevention were compared between the two groups. RESULTS Data from 1,612 North Americans (NAM) and 3,590 Western Europeans (EUR) were analyzed. NAM were older, stayed longer in Cusco, and had less experience traveling to developing countries (p < 0.01). They reported being ill more often than EUR (58% vs 42%, p < 0.01). Diarrhea was more frequent among EUR (55.6% vs 46.7%, p < 0.01), and acute mountain sickness (AMS) was more frequent among NAM (52.8% vs 35.2%, p < 0.01). EUR sought advice from health care professionals (67.1% vs 52.0%, p < 0.01) and travel medicine practitioners (45.8% vs 37%, p < 0.01) more often. NAM used prophylactic medications more often (53% vs 48.6%, p = 0.00) and received a lower mean number of vaccines (1.97 ± 1.68 vs 2.63 ± 1.49; t-test 14.02, p < 0.01). Advice on safe sex and alcohol consumption was low in both groups, especially among NAM. CONCLUSIONS Pre-travel preparation and travel-related illnesses varied between NAM and EUR. Improving consistency of pre-travel preparation based on the best evidence should become a priority among different national bodies providing travel medicine recommendations.
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Affiliation(s)
- Miguel M Cabada
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Diseases and injuries associated with travel among students, employees and teachers of the Central University of Venezuela during the national summer vacations. Travel Med Infect Dis 2010; 8:41-6. [DOI: 10.1016/j.tmaid.2009.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 11/21/2022]
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