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Angelo KM, Haulman NJ, Terry AC, Leung DT, Chen LH, Barnett ED, Hagmann SHF, Hynes NA, Connor BA, Anderson S, McCarthy A, Shaw M, Van Genderen PJJ, Hamer DH. Illness among US resident student travellers after return to the USA: a GeoSentinel analysis, 2007-17. J Travel Med 2018; 25:5078557. [PMID: 30202952 PMCID: PMC6503850 DOI: 10.1093/jtm/tay074] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/20/2018] [Indexed: 11/12/2022]
Abstract
Background The number of US students studying abroad more than tripled during the past 20 years. As study abroad programmes' destinations diversify, students increasingly travel to resource-limited countries, placing them at risk for infectious diseases. Data describing infections acquired by US students while travelling internationally are limited. We describe illnesses among students who returned from international travel and suggest how to prevent illness among these travellers. Methods GeoSentinel is a global surveillance network of travel and tropical medicine providers that monitors travel-related morbidity. This study included the records of US resident student international travellers, 17-24 years old, who returned to the USA, had a confirmed travel-related illness at one of 15 US GeoSentinel sites during 2007-17 and had a documented exposure region. Records were analysed to describe demographic and travel characteristics and diagnoses. Results The study included 432 students. The median age was 21 years; 69% were female. More than 70% had a pre-travel consultation with a healthcare provider. The most common exposure region was sub-Saharan Africa (112; 26%). Students were most commonly exposed in India (44; 11%), Ecuador (28; 7%), Ghana (25; 6%) and China (24; 6%). The median duration of travel abroad was 40 days (range: 1-469) and presented to a GeoSentinel site a median of 8 days (range: 0-181) after travel; 98% were outpatients. Of 581 confirmed diagnoses, the most common diagnosis category was gastrointestinal (45%). Acute diarrhoea was the most common gastrointestinal diagnosis (113 of 261; 43%). Thirty-one (7%) students had vector-borne diseases [14 (41%) malaria and 11 (32%) dengue]. Three had vaccine-preventable diseases (two typhoid; one hepatitis A); two had acute human immunodeficiency virus infection. Conclusions Students experienced travel-related infections, despite the majority having a pre-travel consultation. US students should receive pre-travel advice, vaccinations and chemoprophylaxis to prevent gastrointestinal, vector-borne, sexually transmitted and vaccine-preventable infections.
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Affiliation(s)
- Kristina M. Angelo
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - N. Jean Haulman
- Hall Health Center, University of Washington, Seattle, WA 98195, USA
| | - Anne C. Terry
- Hall Health Center, University of Washington, Seattle, WA 98195, USA
| | - Daniel T. Leung
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Lin H. Chen
- Division of Infectious Diseases, Mt. Auburn Hospital, Cambridge, MA 02138, USA
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Elizabeth D. Barnett
- Department of Pediatrics, Section of Infectious Diseases, Boston Medical Center, Boston, MA 02138, USA
| | - Stefan H. F. Hagmann
- Division of Pediatric Infectious Disease, Steven and Alexandra Cohen Children’s Medical Center of New York, New Hyde Park, NY 11557, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
| | - Noreen A. Hynes
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Bradley A. Connor
- New York Center for Travel and Tropical Medicine, New York, NY 10022, USA
- Weill Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Susan Anderson
- Department of Medicine/Infectious Diseases, Stanford University, Palo Alto, CA 94305, USA
| | - Anne McCarthy
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Marc Shaw
- James Cook University, Queensland, Australia
- Worldwise Travellers’ Health Centres, Auckland, New Zealand
| | | | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA 02118, USA
- Department of Medicine, Section of Infectious Diseases, Boston Medical Center, Boston, MA 02118, USA
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Farnham A, Blanke U, Stone E, Puhan MA, Hatz C. Travel medicine and mHealth technology: a study using smartphones to collect health data during travel. J Travel Med 2016; 23:taw056. [PMID: 27592821 DOI: 10.1093/jtm/taw056] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/04/2016] [Indexed: 11/13/2022]
Abstract
BACKGROUND mHealth methodology such as smartphone applications offers new opportunities to capture the full range of health risks during travel in real time. Our study aims to widen the scope of travel health research in tropical and subtropical destinations by using a smartphone application to collect detailed information on health behaviours, clinical symptoms, accidents and environmental factors during travel. METHODS We enrolled travel clinic clients in Zurich and Basel ≥18 years of age travelling to Thailand for <5 weeks. Sociodemographic, clinical and risk behaviour information was collected pre-travel. Participants were equipped with a smartphone and an application that (1) actively administers a daily self-report questionnaire on the health risks, behaviours and symptoms the traveller encountered, and (2) passively collects information on the traveller's location and environmental conditions by transformation of raw GPS data. RESULTS A prospective cohort of 101 travellers planning travel to Thailand between January and June 2015 was recruited. Of the 101 enrolled travellers, 75 (74.3%) answered at least one questionnaire during travel, 10 (9.9%) had technical difficulties and 16 (15.8%) dropped out. Those who completed questionnaires were a median of 27.0 years old (range 18-57). Travellers filled out a median of 12.0 questionnaires during their trip (range 1-30), corresponding to a median completion rate of 85.0% days of travel. The typical example of a healthy female traveller shows that many and diverse health issues arise during a trip that clusters on certain days. The rich data on behaviour and local environment may be used to explain the occurrence and clustering of health issues. CONCLUSIONS Use of a smartphone app to collect health information is technically feasible and acceptable amongst a traveller population, minimizes recall bias and greatly increases the quality and quantity of data collected during travel. mHealth technology shows great potential for innovation in travel medicine.
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Affiliation(s)
- Andrea Farnham
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Ulf Blanke
- Wearable Computing Laboratory, ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Emily Stone
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Christoph Hatz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland Swiss Tropical and Public Health Institute, Basel, Switzerland
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Klunge-de Luze C, de Vallière S, Genton B, Senn N. Observational study on the consumption of recreational drugs and alcohol by Swiss travelers. BMC Public Health 2014; 14:1199. [PMID: 25416677 PMCID: PMC4289389 DOI: 10.1186/1471-2458-14-1199] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 11/10/2014] [Indexed: 11/29/2022] Open
Abstract
Background Studies carried out on specific travelers’ groups such as students describe an increase in the consumption of alcohol and drugs during travel and vacation time. The present study investigates the risk behaviors (alcohol and drugs) in a general adult population in Switzerland travelling abroad who visited a travel clinic before departure. Methods This retrospective study was conducted in a travel clinic between January 2006 and December 2008. 14,496 patients came to the clinic for a pre-travel consultation. 3,537 of them answered a questionnaire about their life habits in Switzerland and during their last trip. The only exclusion criterion was an age inferior to 18 years old. The consumption habits of drugs and at-risk alcohol intake (8 standard drinks (SD) per week for women and 15 SD for men) was analyzed according to gender, sex, destination and profession. Predictors of adopting a risky behavior between habits in Switzerland and during their previous trip were also analyzed. Results 7% (229/3477) of participants declared having at-risk alcohol consumption in Switzerland and 14% (473/3275 [95% CI 13–16]) during their trip. 9% (332/3527) of the participants used drugs in Switzerland and 5% (178/3481) during their trip. Risk factors for at-risk alcohol consumption during a trip were: at-risk alcohol consumption in Switzerland (OR 31[95% CI 21–45]), smoking (1.7 [95% CI 1–2]), use of drugs in Switzerland (OR 2.2 [95% CI 2–3]), leisure travel (OR 1.6 [95% CI 1–2]) and managerial professions (OR 1.8 [95% CI 1–3]). Risk factors for the use of drugs during a trip were: alcohol consumption in Switzerland (OR 2.1 [95% CI 1–4]), smoking (OR 1.9 [95% CI 1–3]), and use of drugs in Switzerland (OR 29.7 [95% CI 19–45]). Conclusions At-risk alcohol consumption and, to a lesser extent, use of drugs, affect a large number of travelers which expose them to health problems during a trip. Exploring the alcohol and drugs consumption patterns of people visiting a travel clinic should be part of the pre-travel routine consultation and would allow to identifying people who would benefit most from a specific prevention.
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Affiliation(s)
| | | | | | - Nicolas Senn
- Department of Ambulatory Care and Community Medicine, Travel clinic, University of Lausanne, Bugnon 44, 1011 Lausanne, Switzerland.
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Risquez A, Echezuria L, Rodriguez-Morales AJ. Epidemiological transition in Venezuela: Relationships between infectious diarrheas, ischemic heart diseases and motor vehicles accidents mortalities and the Human Development Index (HDI) in Venezuela, 2005–2007. J Infect Public Health 2010; 3:95-7. [DOI: 10.1016/j.jiph.2010.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 05/25/2010] [Accepted: 05/27/2010] [Indexed: 11/30/2022] Open
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