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Almogbel ES, Almutairi SM, Almuzaini AS, Alduraibi AA, Almutairi A, Almarshad AS, Altwaijri M, Alharbi S. The Knowledge, Attitudes, and Practices of Primary Healthcare Physicians in the Al Qassim Region, Saudi Arabia Regarding Travel Medicine: A Cross-Sectional Study. Cureus 2024; 16:e52772. [PMID: 38389614 PMCID: PMC10882419 DOI: 10.7759/cureus.52772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Background and objective In the age of globalization, diseases associated with travel have emerged as a focal point of public health interest. This has become particularly relevant in Saudi Arabia after the changes in tourism policy in recent years. Primary care physicians are expected to suspect diseases of importance in certain geographic areas. They should dispense pre- and post-travel advice. This study aimed to assess the knowledge, attitudes, and practices of primary care physicians in the Al Qassim region, Saudi Arabia regarding travel medicine. Methods This cross-sectional study was conducted in the Al Qassim region, Saudi Arabia between October and November 2023. We reached out to all primary care physicians in the region regardless of their gender, nationality, and years of experience. The data were collected using a self-administered questionnaire, which was designed based on the available literature and validated by experts. Results A total of 197 physicians participated in the study; 74% were male, 46% were general practitioners, and 48% had 5-10 years of experience. More than half (51%) of the participants reported a weekly patient load of 50-100, while 47% engaged with 5-10 travelers annually; 53% provided travel health advice and a quarter of primary healthcare physicians never attended travel update sessions or conferences. In the last six months, 48% and 43% of the physicians conducted pre- and post-travel consultations respectively. Approximately 49.2% demonstrated a fair knowledge of the topic. Factors associated with fair knowledge included non-Saudi nationality, age below 30 years, minimal traveler exposure, and infrequent conference attendance (p<0.05). A positive attitude was linked to being under 30 years old, having <5 years of experience, seeing <5 travelers yearly, and possessing a fair knowledge of the topic (p<0.05). Conclusions Overall, about half of the physicians in the Al Qassim region engage with travelers and demonstrate good attitudes and practices toward travel medicine. Opening Saudi borders to tourism necessitates the inclusion of travel medicine in continuing medical education programs to prepare primary care physicians to care for travelers more efficiently.
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Affiliation(s)
- Ebtehal S Almogbel
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraydah, SAU
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Sørensen HT. Patients with Chronic Diseases Who Travel: Need for Global Access to Timely Health Care Data. Clin Epidemiol 2022; 14:513-519. [PMID: 35505690 PMCID: PMC9057227 DOI: 10.2147/clep.s360699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus N, DK-8200, Denmark
- Clinical Excellence Research Center, Stanford University, Palo Alto, CA, USA
- Correspondence: Henrik Toft Sørensen, Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, Aarhus N, DK-8200, Denmark, Email
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Tardivo S, Zenere A, Moretti F, Marchiori F, Berti D, Migliorini M, Tomasi A, Ferrari S, Tognon F, Napoletano G, Rossanese A. The Traveller's Risk Perception (TRiP) questionnaire: pre-travel assessment and post-travel changes. Int Health 2020; 12:116-124. [PMID: 31294781 PMCID: PMC7057134 DOI: 10.1093/inthealth/ihz033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/18/2019] [Accepted: 06/14/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Travellers' risk perception is a key component of travel risk assessment because it influences the adequate implementation of safety precautions. The aims of this study are to validate a tool to analyse travellers' risk perception to identify which factors can influence it and how it changes upon return. METHODS The Traveller's Risk Perception (TRiP) questionnaire was developed and administered to outpatients before and after travel in three travel clinics. A principal component analysis (PCA) was performed to validate the questionnaire and multivariate regression analysis was used to evaluate the effect of travellers' characteristics on the risk scores. RESULTS A total of 1020 travellers completed the questionnaire. PCA identified two latent factors: 'generic-disseminated risks' and 'specific-circumstantial risks'. Cronbach's α was acceptable (0.76 and 0.70, respectively). The 'generic-disseminated risks' dimension scored higher than the 'specific-circumstantial risks' (p<0.001). The items with the highest scores were insect bites, gastrointestinal disorders and malaria. The mean scores were significantly lower after the travel for all items but one. CONCLUSIONS The TRiP questionnaire is a valid and reliable tool for rating travellers' perceptions. Staff in travel clinics should be trained to systematically assess travellers' risk perception in order to tailor the consultation according to specific information needs.
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Affiliation(s)
- S Tardivo
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - A Zenere
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - F Moretti
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - F Marchiori
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - D Berti
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - M Migliorini
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - A Tomasi
- Public Health Department, Lucca, Italy
| | - S Ferrari
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - F Tognon
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | | | - A Rossanese
- IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
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Tan EM, Marcelin JR, Virk A. Pre-travel counseling for immunocompromised travelers: A 12-year single-center retrospective review. Infect Dis Health 2018; 24:13-22. [PMID: 30541695 DOI: 10.1016/j.idh.2018.09.083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/13/2018] [Accepted: 09/17/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Immunocompromised travelers (ICTs) are medically complex and challenging for travel medicine providers. Our study hypothesizes that ICTs have high-risk travel itineraries and do not have adequate immunity against vaccine-preventable infections. METHODS This retrospective review of 321 ICTs from 2004 to 2015 included patients with solid organ transplant (SOT, n = 134), connective tissue disease (CTD, n = 121), inflammatory bowel disease (IBD, n = 46), and human immunodeficiency virus (HIV, n = 20). Variables included immunosuppressive medications, hepatitis A and B vaccination and serology, gamma-globulin use, and antimalarial and antidiarrheal prophylaxis. Chi-square analysis was used for categorical variables and Kruskal-Wallis for continuous variables. RESULTS Malaria-endemic regions accounted for 38.9% (125/321) of travel destinations. High-risk activities were planned by 37.4% (120/321) of travelers. A significant proportion of HIV patients [70.0% (14/20)] visited friends and relatives, whereas other ICTs traveled for tourism. Hepatitis A and B vaccination rates were 77.3% (248/321) and 72.3% (232/321). Post-vaccination hepatitis A and B serologic testing were completed by 66.1% (41/62) and 61.1% (11/18) of travelers, respectively. CONCLUSION ICTs demonstrate differences in travel patterns and risk. Serologic testing was uncommon, and vaccination rates were low. Providers should screen ICTs early for upcoming travel plans and advise vaccine completion prior to departure.
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Affiliation(s)
- Eugene M Tan
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
| | - Jasmine R Marcelin
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Abinash Virk
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
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Learoyd TP. Asian travel: from the rare to the difficult. J Travel Med 2018; 25:S1-S2. [PMID: 29718438 DOI: 10.1093/jtm/tay015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 02/08/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Tristan P Learoyd
- Valneva UK, Centaur House, Ancells Business Park, Ancells Road, Hampshire, Fleet GU51 2UJ, UK
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Farnham A, Ziegler S, Blanke U, Stone E, Hatz C, Puhan MA. Does the DOSPERT scale predict risk-taking behaviour during travel? A study using smartphones. J Travel Med 2018; 25:5069446. [PMID: 30107438 DOI: 10.1093/jtm/tay064] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/08/2018] [Indexed: 11/13/2022]
Abstract
BACKGROUND Despite the continuing growth of international tourism, very little research has been done on the link between individual risk attitudes and health behaviours during travel. Our study uses a validated risk-taking questionnaire Domain-Specific Risk-Taking Scale (DOSPERT) and data from a smartphone application to study the association between pre-travel risk attitudes and the occurrence of behaviours during travel. METHODS A prospective cohort of travellers to Thailand used a smartphone application to answer a daily questionnaire about health behaviours and events. Prior to travel, participants completed the DOSPERT, a validated 30-item scale that assesses risk-taking and perception in five content domains: financial decisions, health/safety, recreational, ethical and social decisions. Multiple linear regression models were used to model the relationship between DOSPERT risk-taking subdomain score and health behaviour. RESULTS Of the 75 travellers that completed the study, 70 (93.3%) completed the DOSPERT pre-travel. Men, backpackers and young travellers reported a higher willingness to take recreational risks than women, luxury travellers and older travellers. Incidence of drug and alcohol risk behaviours during travel, itching from mosquitoes, smoking and failing to use a seatbelt in automobiles while at home were all significantly associated with an individual's score on the health and safety DOSPERT subdomain. CONCLUSIONS In our study, individual scores on risk-taking in the health and safety subdomain of the DOSPERT questionnaire seem to be predictive of health behaviours both during travel and at home. By pairing new methods of data collection with questionnaires such as DOSPERT that identify key traveller characteristics to intervene on, travel medicine doctors will be able to provide more specialised health advice, ensuring that all travellers receive well-rounded advice about the full range of health challenges they will face during travel.
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Affiliation(s)
- Andrea Farnham
- Department of Public Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Travel Clinic, University of Zurich, 8001 Zurich, Switzerland
| | - Sarah Ziegler
- Department of Public Health, 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
- Department of Public Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Christoph Hatz
- Department of Public Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.,Travel Clinic, University of Zurich, 8001 Zurich, Switzerland.,Medical Services and Diagnostic Department, University of Basel, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Infectious Diseases, Cantonal Hospital, 9007 St. Gallen, Switzerland
| | - Milo A Puhan
- Department of Public Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Farnham A, Furrer R, Blanke U, Stone E, Hatz C, Puhan MA. The quantified self during travel: mapping health in a prospective cohort of travellers. J Travel Med 2017; 24:4085918. [PMID: 28931147 DOI: 10.1093/jtm/tax050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 11/12/2022]
Abstract
BACKGROUND Travel medicine research has remained relatively unchanged in the face of rapid expansion of international travel and is unlikely to meet health challenges beyond infectious diseases. Our aim was to identify the range of health outcomes during travel using real-time monitoring and daily reporting of health behaviours and outcomes and identify traveller subgroups who may benefit from more targeted advice before and during travel. METHODS We recruited a prospective cohort of travellers ≥ 18 years and planning travel to Thailand for <5 weeks from the travel clinics in Zurich and Basel (Switzerland). Participants answered demographic, clinical and risk behaviour questionnaires pre-travel and a daily health questionnaire each day during travel using a smartphone application. Environmental and location data were collected passively by GPS. Classification trees were used to identify predictors of health behaviour and outcomes during travel. RESULTS Non-infectious disease events were relatively common, with 22.7% (17 out of 75 travellers) experiencing an accident, 40.0% ( n = 30) a wound or cut and 14.7% ( n = 11) a bite or lick from an animal. Mental health associated events were widely reported, with 80.0% ( n = 60) reporting lethargy, 34.7% ( n = 26) anxiety and 34.7% ( n = 26) feeling tense or irritable. Classification trees identified age, trip length, previous travel experience and having experienced a sports injury in the past year as the most important discriminatory variables for health threats. CONCLUSIONS Our study offers a revolutionary look at an almost real-time timeline of health events and behaviours during travel using mHealth technology. Non-infectious disease related health issues were common in this cohort, despite being largely unaddressed in traditional travel medicine research and suggest a substantial potential for improving evidence-based travel medicine advice.
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Affiliation(s)
- Andrea Farnham
- Epidemiology, Biostatistics and Prevention Institute.,Travel Clinic, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Reinhard Furrer
- Department of Mathematics.,Department of Computational Science, University of Zurich, 8057 Zurich, Switzerland
| | - Ulf Blanke
- Wearable Computing Laboratory, ETH Zurich, Swiss Federal Institute of Technology, 8092 Zurich, Switzerland
| | - Emily Stone
- Epidemiology, Biostatistics and Prevention Institute
| | - Christoph Hatz
- Epidemiology, Biostatistics and Prevention Institute.,Travel Clinic, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.,Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland.,University of Basel, 4003 Basel, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute
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