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Vázquez Villegas J. [«Visiting friends and relatives». New risk group in the primary care consulta]. Aten Primaria 2018; 50:574-575. [PMID: 29983201 PMCID: PMC6836917 DOI: 10.1016/j.aprim.2018.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 05/22/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- José Vázquez Villegas
- Director UCG de La Mojonera, Distrito Sanitario Poniente de Almería, El Ejido, Almería, España; Unidad de Medicina Tropical del Hospital y Distrito Poniente de Almería, El Ejido, Almería, España; Grupo de trabajo de Inequidades en Salud-Salud Internacional semFYC.
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Providing Japanese health care information for international visitors: digital animation intervention. BMC Health Serv Res 2018; 18:373. [PMID: 29783982 PMCID: PMC5963085 DOI: 10.1186/s12913-018-3191-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/07/2018] [Indexed: 01/08/2023] Open
Abstract
Background Over 24 million international visitors came to Japan in 2016 and the number is expected to increase. Visitors could be at a risk of illness or injury that may result in hospitalization in Japan. We assessed the effects of a four-minute digital animation titled Mari Info Japan on the level of anxiety experienced by international visitors to Japan. Methods We conducted a non-randomized, controlled study at Narita International Airport outside Tokyo in December 2014. On the first day, we recruited international visitors for the intervention group at predetermined departure gates and, the following day, we sampled visitors for the control group at the same gates. We repeated this procedure twice over 4 days. The intervention group watched the digital animation and the control group read a standard travel guidebook in English. After receiving either intervention, they completed a questionnaire on their level of anxiety. The outcome was assessed using the Mari Meter-X, The State-Trait Anxiety Inventory Form Y (STAI-Y), and a face scale, before and immediately after the intervention. We analyzed data with Wilcoxon rank sum tests. Results We recruited 265 international visitors (134 in the intervention group, 131 in the control group), 241 (91%) of whom completed the questionnaire. Most of them had no previous Japanese health information before arrival in Japan. The level of anxiety about health services in Japan was significantly reduced in the intervention group (Mari Meter-X median: − 5 and 0, p < 0.001 and STAI-Y median: − 3 and 0, p < 0.001). The face scale analysis showed no significant difference. Conclusions Watching a digital animation is more effective in reducing anxiety among international visitors to Japan compared with reading a standard brochure or guidebook. Such effective animations of health information should be more widely distributed to international visitors. Trial registration UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), UMIN000015023, September 3, 2014. Electronic supplementary material The online version of this article (10.1186/s12913-018-3191-x) contains supplementary material, which is available to authorized users.
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Heywood AE, Zwar N. Improving access and provision of pre-travel healthcare for travellers visiting friends and relatives: a review of the evidence. J Travel Med 2018; 25:4934909. [PMID: 29608738 DOI: 10.1093/jtm/tay010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/02/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Travellers visiting friends and relatives (VFR travellers) in their country of origin are at increased risk of a range of preventable infections. Risks are broadly related to circumstances of travel, risk misconceptions and access to health services. Despite nearly two decades of literature highlighting these increased risks little impact has been made on their risk disparity. METHODS This review draws on evidence from travel medicine literature, supplemented by evidence from the broader field of immigrant health, and is structured to include strategies that aim to reduce barriers at the patient, provider and health system level. RESULTS For the travel medicine provider, tailored risk communication that is cognisant of the unique health beliefs and barriers to travel health for VFR travellers is needed, including enhanced communication through the use of interpreters and supplementary written communication. Primary care providers are uniquely placed to identify future travel plans among immigrant patients, however, greater awareness of VFR traveller risks and training in travel medicine are required. Community health promotion interventions that are culturally appropriate, translated into multiple languages and takes into account the cumulative risk of multiple return visits are key to normalizing travel healthcare seeking behaviours and improving awareness of VFR travel risks. Currently, there are few examples of novel strategies to engage migrant communities in travel health with no formal evaluations of their effectiveness. Best practice includes the use of community-consulted approaches in collaboration with government, primary care and travel medicine. CONCLUSIONS Multifactorial barriers related to health beliefs and access to health services require a range of strategies and interventions in both reaching and providing advice to VFR travellers. To improve the evidence base, future research should focus on the evaluation of novel strategies that address these barriers and improve access and provision of pre-travel healthcare to VFR travellers.
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Affiliation(s)
- Anita E Heywood
- School of Public Health and Community Medicine, UNSW Sydney, Australia
| | - Nicholas Zwar
- School of Public Health and Community Medicine, UNSW Sydney, Australia.,School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Australia
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Kimura M, Koga M, Hasegawa C, Mutoh Y, Kato Y, Maruyama H. Imported malaria in pregnant women experienced in Japan. J Infect Chemother 2017; 23:545-549. [PMID: 28583709 DOI: 10.1016/j.jiac.2017.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/25/2017] [Accepted: 05/10/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION With ever-growing global exchanges, the number of travelers, including pregnant women, to the tropics is increasing, which poses a risk of contracting malaria. Although there are several reports on imported malaria in pregnancy from Western countries, those focusing on cases experienced in Japan are very limited. METHODS We searched for cases of malaria in pregnancy in the treatment records submitted to the Research Group on Chemotherapy of Tropical Diseases, Japan, during the period 1993-2016. Literature searches were also conducted using an American and a Japanese search system. RESULTS Ten cases of malaria in pregnant women were identified, including four cases with Plasmodium falciparum. Of eight evaluable cases, only one practiced malaria chemoprophylaxis. Among the nine evaluable cases, eight resulted in uneventful delivery and one P. falciparum case developed severe hepatic disturbance, disseminated intravascular coagulation, and intrauterine fetal death. After the initial attack, none of the Plasmodium vivax/Plasmodium ovale cases practiced chloroquine prophylaxis until delivery. One P. ovale case received a lower dose regimen of chloroquine as acute-stage therapy. CONCLUSION This study demonstrated additional cases of imported malaria in pregnant women to the literature and highlighted various epidemiological, demographic, and clinical characteristics. Some of the clinical issues raised need to be investigated. Due to the paucity of the cases worldwide, sharing information among various countries is indispensable, and international guidelines which are now increasingly recommending the use of artemisinins in pregnant women should be referred.
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Affiliation(s)
- Mikio Kimura
- Department of Internal Medicine, Shin-Yamanote Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
| | - Michiko Koga
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Chihiro Hasegawa
- Department of Infectious Diseases, Nagoya City East Medical Center, Nagoya, Japan
| | - Yoshikazu Mutoh
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuyuki Kato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Pre-travel malaria chemoprophylaxis counselling in a public travel medicine clinic in São Paulo, Brazil. Malar J 2017; 16:64. [PMID: 28173862 PMCID: PMC5297158 DOI: 10.1186/s12936-017-1713-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/26/2017] [Indexed: 01/04/2023] Open
Abstract
Background Malaria is one of the most prevalent parasitic diseases in the world and represents a threat to travellers visiting endemic areas. Chemoprophylaxis is the prevention measure used in travel medicine, avoiding clinical manifestations and protecting against the development of severe disease and death. Methods Retrospective and descriptive analysis of malaria prevention data in travellers was recorded from a travel medicine clinic in São Paulo, Brazil, between January 2006 and December 2010. All the medical records of travellers, who had travelled to areas with risk of disease transmission, including Brazil, were analysed. Demographic characteristics of travellers, travel details and recommendations for preventing malaria were also seen. Results During the study period, 2836 pre-travel consultations were carried out on 2744 individuals (92 were consulted twice). The most common reasons for travelling were tourism and work. The most common destinations were Africa (24.5%), Europe (21.2%), Asia (16.6%) and locations within Brazil (14.9%). In general prophylaxis against malaria was recommended in 10.3% of all the consultations. African destinations vs Asian, Brazilian and other destinations and length of stay ≤30 days were independently associated with the higher odds of chemoprophylaxis recommendation after the logistic regression. Conclusion The prophylaxis against malaria was recommended in 10.3% of the consultations. The authors believe that a coherent measure of malaria prevention in Brazil and for international travellers would be to recommend for all parts of the North Brazil, avoidance of mosquito bites and immediate consultation of a physician in case of fever during or after the journey is recommended.
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Serre-Delcor N, Treviño B, Monge B, Salvador F, Torrus D, Gutiérrez-Gutiérrez B, López-Vélez R, Soriano-Arandes A, Sulleiro E, Goikoetxea J, Pérez-Molina JA. Eosinophilia prevalence and related factors in travel and immigrants of the network +REDIVI. Enferm Infecc Microbiol Clin 2016; 35:617-623. [PMID: 27032297 DOI: 10.1016/j.eimc.2016.02.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/19/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022]
Abstract
The population movements during the last decades have resulted in a progressively increasing interest in certain infectious diseases. Eosinophilia is a common finding in immigrants and travellers. One of the most common causes of eosinophilia is helminth infection, and some intestinal protozoa. The aim of this paper is to describe the epidemiological characteristics of cases with eosinophilia and its association with the presence of parasites in the REDIVI data network. This is a multicentre prospective observational study that includes patients diagnosed with eosinophilia registered in the cooperative network for the study of infectious diseases in travellers and immigrants (+REDIVI) from January 2009 to December 2012. A total of 5,255 episodes were recorded in the network during the study period, and eosinophilia was observed in 8.1-31.3% of cases (depending on the immigration group). There were 60.2% men, with a median age of 31years. There were 72.4% immigrants, and 81.2% were asymptomatic. The most commonly identified parasites were S.stercoralis (34.4%), Schistosoma sp. (11.0%), and hookworm (8.6%). The relationship between eosinophilia and parasite infection was significant for all helminths (except for cutaneous larva migrans). The symptoms and duration of the journey did not significantly determine the presence of eosinophilia. In the case of eosinophilia in a person who has lived in helminth endemic areas, it is advisable to carry out targeted studies to diagnose the infection, regardless of immigration type, length of stay, or the presence of symptoms.
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Affiliation(s)
- Núria Serre-Delcor
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España.
| | - Begoña Treviño
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Begoña Monge
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Fernando Salvador
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | - Diego Torrus
- Hospital General Universitario de Alicante, Alicante, España
| | | | - Rogelio López-Vélez
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
| | - Antoni Soriano-Arandes
- Unitat de Salut Internacional i Medicina Tropical Vall d'Hebron-Drassanes, PROSICS, Barcelona, España
| | - Elena Sulleiro
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS, Barcelona, España
| | | | - Jose A Pérez-Molina
- Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, España
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Allen KC. Phenomenological analysis of going home in Caribbean-American international travelers. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2015; 1:12. [PMID: 28883943 PMCID: PMC5531102 DOI: 10.1186/s40794-015-0016-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 11/20/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND In travel health risk assessments visiting friends and relatives (VFR) travel status is often used as an indicator for high-risk travel behavior. VFR travelers have been associated with increased risk of travel-associated illnesses due to poor adherence to travel guidelines and lack of pre-travel health consultations. For travelers to dengue endemic regions, guidelines include compliance with mosquito avoidance practices (MAP). The goal of this study is to understand the meaning of travel experiences to the home country for immigrant and first generation American VFR travelers in the United States (US). METHODS A phenomenology study was conducted on VFR travelers to identify social and physical environmental factors associated with travel health behaviors, and determine how 'going home' influences compliance with recommendations for dengue prevention. Purposive sampling identified participants for semi-structured interviews on travel behavior with iterative collection and analysis until data reached saturation. RESULTS Interviews revealed five themes that defined the experience of going home: connectedness; control of the experience; two different experiences at home; seeing what home has to offer; and there is no place like home. Moreover, risk perception of health and disease risks in the travel destination influenced travel behavior and compliance with guidelines. CONCLUSIONS VFR travel status does not fully capture the experience of international travel. Behavior was associated with the emergent concept of Cultural Embeddedness when traveling home and to new destinations. More research on improving terminology for travel health risk assessments is needed to improve prevention strategies in VFR travelers.
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Affiliation(s)
- Koya C Allen
- Department of Biostatistics, Environmental Health & Epidemiology, Kent State University College of Public Health, PO Box 5190, Kent, OH 44242 USA.,Present Address: Counter Bio-threats Cell, Force Health Protection, J42 Medical Readiness Division, US European Command Headquarters, US Department of Defense, Stuttgart, Germany
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Heywood AE, Forssman BL, Seale H, MacIntyre CR, Zwar N. General Practitioners' Perception of Risk for Travelers Visiting Friends and Relatives. J Travel Med 2015; 22:368-74. [PMID: 26173496 DOI: 10.1111/jtm.12229] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/12/2015] [Accepted: 06/08/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND General practitioners (GPs) are an important source of pre-travel health advice for travelers; however, only a few studies have investigated primary healthcare provider-related barriers to the provision of pre-travel health advice, particularly to travelers visiting friends and relatives (VFR). We aimed to investigate Australian GPs' knowledge, attitudes, and practices with regard to VFR travelers. METHODS A postal survey was sent to randomly sampled GPs in Sydney, Australia, in 2012. The questionnaire investigated GPs' perception of risk and barriers to the provision of advice to VFR travelers. RESULTS Of 563 GPs, 431 (76.6%) spoke a language other than English (LOTE) with 361 (64.1%) consulting in a LOTE. Overall, 222 (39.4%) GPs considered VFR travelers to be at higher risk than holiday travelers, with GPs consulting in English only [adjusted odds ratio (aOR) 1.65, 95% confidence interval (CI) 1.11-2.44, p = 0.01] and GPs considering long-term migrants as VFR travelers (aOR 1.86 95% CI 1.07-3.23, p = 0.03) remaining significant on multivariate analysis. CONCLUSIONS Multilingual GPs are a valuable resource to reducing language and cultural barriers to healthcare. Targeted education of this subgroup of GPs may assist in promoting pre-travel health assessments for VFR travelers. Awareness of the need for opportunistic targeting of migrants for pre-travel consultation through routine identification of future travel is needed.
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Affiliation(s)
- Anita E Heywood
- School of Public Health & Community Medicine, UNSW Australia, Sydney, NSW, Australia
| | - Bradley L Forssman
- Public Health Unit, Nepean Blue Mountains Local Health District, Sydney, NSW, Australia
| | - Holly Seale
- School of Public Health & Community Medicine, UNSW Australia, Sydney, NSW, Australia
| | - C Raina MacIntyre
- School of Public Health & Community Medicine, UNSW Australia, Sydney, NSW, Australia
| | - Nicholas Zwar
- School of Public Health & Community Medicine, UNSW Australia, Sydney, NSW, Australia
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Hassan ZI, Afolaranmi TO. The Knowledge and Uptake of Travel Vaccine Among Medical Doctors in a Tertiary Health Institution in Plateau State, North Central Nigeria. Indian J Community Med 2015; 40:177-81. [PMID: 26170542 PMCID: PMC4478659 DOI: 10.4103/0970-0218.158861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 11/04/2014] [Indexed: 11/22/2022] Open
Abstract
Background: Travelers play a significant role in the spread of infectious diseases across international borders, through their travel patterns and behaviors. Travel maybe the only risk factor for infectious diseases that are well controlled in the travelers’ country of residence, particularly vaccine-preventable diseases. The role of vaccination among travelers is an essential component of the control of travel-associated infectious diseases. This study was conducted to assess the knowledge and uptake of travel vaccine among medical doctors in Jos University Teaching Hospital (JUTH). Materials and Methods: This was a descriptive cross-sectional study conducted in 2013 using quantitative method of data collection among 189 medical doctors. Epi Info™ statistical software package version 3.5.4 was used for data analysis and a P ≤ 0.05 was considered statistically significant. Result: The mean age of the respondents was 33.8 ± 4.5 years, majority of the respondents (96.3%) were aware of travel vaccines with 45 (71.4%) of the 63 respondents who had embarked on international travel prior to the study had taken travel vaccine in their last travel. Knowledge of travel vaccination was found to have statistically significant relationship with uptake of travel vaccine (P = 0.013). Conclusion: This study has revealed the need to improve the knowledge and uptake of travel vaccine among medical doctors.
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Brophy J. Summary of the Statement on International Travellers Who Intend to Visit Friends and Relatives. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2015; 41:89-99. [PMID: 29769941 PMCID: PMC5864303 DOI: 10.14745/ccdr.v41i05a01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Travellers intending to visit friends and relatives (VFRs) are a specific group of travellers who have been identified as having an increased risk of travel-related morbidity. OBJECTIVE To provide recommendations for risk reduction in international VFRs. METHODS Recommendations regarding VFRs were developed based on available travel medicine literature and CATMAT expert opinion. Specific travel-related risks, including infectious disease epidemiology and burden in this population, were reviewed and recommendations were provided to attempt to mitigate these risks. Previous CATMAT statements related to VFRs were referred to and reiterated. RECOMMENDATIONS Rates of travel-related illness in VFRs tend to be higher for many conditions. Disease-specific risk factors and recommendations are discussed throughout this Statement. CATMAT recommends that VFRs' vaccinations be up-to-date and they be counselled on the importance of various risk reduction activities such as the use of malaria prophylaxis, safe sex practices and injury prevention. Pre- and/or post-travel tuberculosis testing is indicated in certain situations. CONCLUSION The pre-travel health assessment is an important opportunity to address with VFRs issues regarding health beliefs, health behaviours, current health status and the possibility of pre-existing conditions. Discussions addressing the importance of adherence to health advice and potential challenges to achieving adherence may be necessary.
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Affiliation(s)
- J Brophy
- Children’s Hospital of Eastern Ontario, Ottawa, ON
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Shepherd SM, Shoff WH. Vaccination for the expatriate and long-term traveler. Expert Rev Vaccines 2014; 13:775-800. [DOI: 10.1586/14760584.2014.913485] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gurgle HE, Roesel DJ, Erickson TN, Devine EB. Impact of traveling to visit friends and relatives on chronic disease management. J Travel Med 2013; 20:95-100. [PMID: 23464716 DOI: 10.1111/jtm.12010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 11/13/2012] [Accepted: 12/05/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Travelers visiting friends and relatives (VFR) are known to be at high risk of acquiring infectious diseases during travel. However, little is known about the impact of VFR travel on chronic diseases. METHODS This was a nonrandomized, retrospective observational study. Patients were adult VFR travelers who received care from an internal medical clinic serving immigrants and refugees. The primary objective was to determine the impact of VFR travel on markers of chronic disease management including: blood pressure, glycosylated hemoglobin, body mass index, serum creatinine, and anticoagulation. RESULTS Of the 110 VFR travelers in our study, N = 48 traveled to Africa and N = 62 traveled to Asia for a mean duration of 59 (range 21-303) days. Of the 433 counseling points discussed at pre-travel visits, 71% were infectious disease prevention, 16% chronic disease related, and 13% travel safety. A total of 63 patients (57%) reported one or more health problems while traveling. Of these, 35 patients (32%) experienced a problem related to a chronic condition. In comparison, 24 (22%) patients experienced an acute infection. Sixty percent of patients were nonadherent to medications during travel. An average increase in diastolic blood pressure of 3.6 mmHg among patients with hypertension was the only statistically significant change in a chronic disease marker when values before and after travel were compared. Subgroup analysis revealed that travel to Africa and nonadherence to medications were also associated with worsening blood pressure control, and patients traveling to Africa experienced a decrease in body mass index. CONCLUSIONS This study identified a high proportion of problems related to chronic conditions experienced during VFR travel, while pre-travel appointments tended to focus on infectious disease prevention. A greater emphasis on medication adherence and chronic disease management during VFR travel is also needed during pre-travel preparations.
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Affiliation(s)
- Holly E Gurgle
- College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA.
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Visiting Relatives and Friends (VFR), Pregnant, and Other Vulnerable Travelers. Infect Dis Clin North Am 2012; 26:625-35. [DOI: 10.1016/j.idc.2012.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Affiliation(s)
- Suzanne Moore Shepherd
- Department of Emergency Medicine, PENN Travel Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Matteelli A, Stauffer WM, Barnett ED, MacPherson DW, Loutan L, Hatz C, Behrens RH. Is a new definition required for travelers who visit friends and relatives? J Travel Med 2010; 17:430-1; discussion 431. [PMID: 21050328 DOI: 10.1111/j.1708-8305.2010.00468_1.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arguin PM. A definition that includes first and second generation immigrants returning to their countries of origin to visit friends and relatives still makes sense to me. J Travel Med 2010; 17:147-9. [PMID: 20536881 DOI: 10.1111/j.1708-8305.2010.00412.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Barnett ED, MacPherson DW, Stauffer WM, Loutan L, Hatz CF, Matteelli A, Behrens RH. The visiting friends or relatives traveler in the 21st century: time for a new definition. J Travel Med 2010; 17:163-70. [PMID: 20536884 DOI: 10.1111/j.1708-8305.2010.00411.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Travelers visiting friends or relatives (VFR travelers) are a group identified with an increased risk of travel-related illness. Changes in global mobility, travel patterns, and inter-regional travel led to reappraisal of the classic definition of the term VFR. METHODS The peer-reviewed literature was accessed through electronic searchable sites (PubMed/Medline, ProMED, GeoSentinel, TropNetEurop, Eurosurveillance) using standard search strategies for the literature related to visiting friends/relatives, determinants of health, and travel. We reviewed the historic and current use of the definition of VFR traveler in the context of changes in population dynamics and mobility. RESULTS The term "VFR" is used in different ways in the literature making it difficult to assess and compare clinical and research findings. The classic definition of VFR is no longer adequate in light of an increasingly dynamic and mobile world population. CONCLUSIONS We propose broadening the definition of VFR travelers to include those whose primary purpose of travel is to visit friends or relatives and for whom there is a gradient of epidemiologic risk between home and destination, regardless of race, ethnicity, or administrative/legal status (eg, immigrant). The evolution and application of this proposed definition and an approach to risk assessment for VFR travelers are discussed.
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Affiliation(s)
- Elizabeth D Barnett
- Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA 02118, USA.
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