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Santaolaya C, Malhotra J, Fowler JA, Warzywoda S, Debattista J, Mills DJ, Lau C, Furuya-Kanamori L, Durham J, Mullens AB, Istiko SN, Dean JA. Integrating sexual and reproductive health into pre-travel consultations. J Travel Med 2024; 31:taae024. [PMID: 38340322 PMCID: PMC11149722 DOI: 10.1093/jtm/taae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Casual sex during travel is a major preventable factor in the global transmission of sexually transmissible infections (STI). Pre-travel consults present an excellent opportunity for practitioners to educate travellers about sexual and reproductive health (SRH) and safety. This scoping review aims to explore and understand the extent to which SRH is included in pre-travel consultations. METHODS PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, Medline and Web of Science were systematically searched for primary research articles exploring whether health care practitioners (HCP) included SRH in pre-travel consultations. Extracted findings were synthesized and presented in narrative form. RESULTS Findings across 13 articles suggest HCPs infrequently broached SRH in pre-travel consultations with HCP discomfort, and lack of time and resources presented as key barriers. Urban practice settings, HCP experience, training in travel medicine and traveller characteristics such as sexual orientation were positively associated with discussions about SRH. SRH advice reported was general in nature, primarily focusing on safer sex, condoms or unspecified STI advice. Risk assessments based solely on age or stereotypes around sexual preferences led to key aspects of SRH care being missed for some (e.g. SRH was less likely to be discussed with older travellers). CONCLUSIONS HCPs frequently miss opportunities to integrate SRH into pre-travel consultations. Strategies to promote HCP confidence and awareness present a promising means to boost the frequency and quality of SRH advice disseminated. Integrating culturally safe and responsive SRH history-taking and advice into pre-travel consultations may contribute to global reductions in STI transmission and promote traveller SRH well-being.
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Affiliation(s)
- Carlos Santaolaya
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Juhi Malhotra
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Sarah Warzywoda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Joe Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Brisbane, QLD 4053, Australia
| | | | - Colleen Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Luis Furuya-Kanamori
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Jo Durham
- School of Public Health and Social Work, Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Satrio N Istiko
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- UQ Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4066, Australia
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Linares-Rufo M, Bermudez-Marval H, García-Bertolín C, Santos-Galilea J, Balsa-Vázquez J, Pérez-Tanoira R, Santos-Larrégola L, Cuadros-González J, Rojo-Marcos G, Ramos-Rincón JM. Perspectives of primary care physicians in Spain on malaria: a cross-sectional survey and retrospective review of cases. Malar J 2024; 23:7. [PMID: 38178126 PMCID: PMC10768253 DOI: 10.1186/s12936-023-04826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In Spain, the risk of imported malaria has increased in recent years due to the rise in international travel and migration. Little is known about the knowledge, information sources, clinical practice, and specific needs of primary care physicians (PCPs) concerning malaria despite the pivotal role played by these professionals in managing the health of tourists. The objective of this study was to assess the knowledge, attitudes, and practices of PCPs in Spain regarding malaria. METHODS This research analyses data from (1) a cross-sectional nationwide survey assessing the knowledge and attitudes of PCPs regarding malaria, and (2) a retrospective review of 373 malaria cases appearing in primary care medical records (PCMRs) in the Madrid area over the past 15 years to determine how cases were documented, managed, or characterized in the primary care setting. RESULTS The survey findings reveal a modest level of self-perceived familiarity with malaria (221/360, 57.6%), even though 32.8% of the practitioners reported having delivered care for confirmed or suspected cases of the disease, these practitioners had greater knowledge of malaria (80.4%) compared to physicians who reported not having delivered care for malaria (19.6%, p < 0.001). Ten percent of the survey participants did not know the name of the mosquito that transmits malaria, and only 40.7% would promptly request malaria testing for a traveller with symptoms after a trip to an endemic area. Responses provided by younger PCPs varied to a greater extent than those of their more experienced colleagues regarding prevention practices and patient management. A review of PCMRs showed that only 65% of all patients were recorded as such. Among those registered, only 40.3% had a documented malaria episode, and of those, only 16.6% received proper follow-up. Only 23.7% of the patients with a PCMR had a record that specifically indicated travel to an endemic country or travel classified as visiting friends and relatives (VFR). CONCLUSIONS The findings of this study underscore the critical role of PCPs in the field of travel medicine, particularly given the increase in imported malaria cases. These results highlight the need for targeted training in travel medicine and the need to ensure optimal patient education in care settings.
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Affiliation(s)
- Manuel Linares-Rufo
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
- Foundation iO, Madrid, Spain.
| | - Harold Bermudez-Marval
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Carlos García-Bertolín
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | - Javier Balsa-Vázquez
- Internal Medicine Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Ramón Pérez-Tanoira
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
- Biomedicine and Biotechnology Department, University Alcalá de Henares, Alcalá de Henares, Madrid, Spain
| | | | - Juan Cuadros-González
- Microbiology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
- Biomedicine and Biotechnology Department, University Alcalá de Henares, Alcalá de Henares, Madrid, Spain
| | - Gerardo Rojo-Marcos
- Internal Medicine Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - José-Manuel Ramos-Rincón
- Clinical Medicine Department, Miguel Hernández of Elche University, Elche, Alicante, Spain
- Internal Medicine Department, Dr. Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
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Alhumsi IM. Knowledge, attitude, and practice of primary care physicians for pretravel counseling for type 2 diabetes patients in Jazan Region, Kingdom of Saudi Arabia. J Family Med Prim Care 2023; 12:1268-1275. [PMID: 37649759 PMCID: PMC10465030 DOI: 10.4103/jfmpc.jfmpc_1529_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 09/01/2023] Open
Abstract
Background and Objective Pretravel advice given by the primary healthcare (PHC) physicians is of vital importance to diabetic patients to maintain their glycemic status during their travel as many of them are not aware of the risks of travel on their health status. Our objective was to assess the status of pretravel counseling for type 2 diabetic patients (knowledge, attitude, and practice) in Jazan Region, Kingdom of Saudi Arabia (KSA) among the PHC physicians. Materials and Methods A cross-sectional study was carried out among a sample of PHC physicians working at the PHC centers in Jazan Region, KSA. The data were collected using a validated self-administered questionnaire. Results The study included 250 PHC physicians. The age of 45.2% of them ranged between 30 and 39 years, and males represented 56.2% of them. Overall, the knowledge score ranged between 0 and 10 with a median (interquartile range [IQR]) of 6 (5-7). Physicians aged 40-49 years (P < 0.001), non-Saudis (P = 0.005), and more experienced physicians (>15 years) (P < 0.001) were more knowledgeable than their counterparts. The attitude score ranged between 6 and 30 with a median (IQR) of 25 (22-27). Saudi physicians were more likely than non-Saudis to have more positive attitude toward pretravel counseling for diabetic patients (P = 0.007). The practice score ranged between 1 and 13 with a median (IQR) of 6 (5-8). Conclusion The PHC physicians in Jazan Region, KSA, had a moderate level of knowledge and practice as well as encouraging attitude concerning pretravel counseling for type 2 diabetic patients. However, their knowledge and attitude from one side were not associated with their practice from the other side.
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Affiliation(s)
- Ibrahim M. Alhumsi
- Family Medicine Specialist, Primary Health Care - Jazan Region, Kingdom of Saudi Arabia
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Nishikawa M, Yamanaka M, Shibanuma A, Kiriya J, Jimba M. Japanese health and safety information for overseas visitors: a randomized controlled trial. BMC Public Health 2023; 23:1194. [PMID: 37340334 DOI: 10.1186/s12889-023-16117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/13/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION International travel to Japan increased steadily until the coronavirus disease 2019 (COVID-19) outbreak. Although international travel was curtailed worldwide due to the pandemic, the number of overseas visitors to Japan should increase again after the restrictions are lifted. We assessed the effect of a five-minute digital game on the knowledge of health information and the level of satisfaction with educational health resources of overseas visitors to Japan. METHODS We conducted a randomized controlled trial among 1062 previous and potential visitors to Japan utilizing an internet portal. We recruited previous and potential visitors to Japan from the internet portal sites of the UK, the US and Australia. We randomly allocated participants to two groups: an intervention group that played an animated game and a control group that viewed an online animation. All participants answered a self-administered questionnaire online from March 16 to 19, 2021. We assessed visitors' levels of health knowledge and satisfaction using the CSQ-8. We analyzed the data with a t test and the difference in differences test. Our RCT followed the SPIRIT guidelines. RESULTS Of the 1062 previous and potential visitors recruited via the three countries' internet portals (354 from each country), some had visited Japan previously (174 in the intervention group, 220 in the control group), while some were potential visitors to Japan (357 in the intervention group, 311 in the control group). Some had gathered health and safety information about Japan prior to this study (180 in the intervention group, 211 in the control group). Both groups improved their health information levels after the intervention. The level of satisfaction with health information in Japan was significantly increased in the intervention group (average difference of 4.5 points) compared to that in the control group (average difference of 3.9 points) (p < 0.05). Both groups' mean CSQ-8 scores increased significantly after the intervention (p < 0.001): from 23 to 28 in the intervention group and from 23 to 24 in the control group. CONCLUSIONS Our study introduced unique educational strategies using an online game to provide health and safety information to previous and potential visitors to Japan. The online game was a more effective way to increase satisfaction than the online animation about health information. This study was registered in the UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry) as Version 1, and the trial registration data are available as UMIN000042483, 17/11/2020. TRIAL REGISTRATION Trials UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), UMIN000042483 (Japanese health and safety information for overseas visitors: A randomized controlled trial), 17/11/2020.
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Affiliation(s)
- Mariko Nishikawa
- Department of Global Health and Nursing, Graduate School of Nursing, The University of Human Environments, Nagoya, Japan.
- , 3-220, Ebata Cho, Obu City, 474-0035, Aichi, Japan.
| | - Masaaki Yamanaka
- Department of Maritime Science and Technology, Japan Coast Guard Academy, Kure, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Al-Dahshan A, Selim N, Al-Kubaisi N, Mahfoud Z, Kehyayan V. Primary care physicians’ knowledge of travel vaccine and malaria chemoprophylaxis and associated predictors in Qatar. PLoS One 2022; 17:e0265953. [PMID: 35358236 PMCID: PMC8970385 DOI: 10.1371/journal.pone.0265953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background In an era of globalization, travel-related illnesses have become a focus of public health concern, especially in the Arab region where travel health services are insufficient and not well-established. This study was conducted to assess travel vaccine and malaria chemoprophylaxis knowledge and associated predictors among primary care physicians (PCPs) in Qatar. Methods This was a cross-sectional study. A structured questionnaire was used to collect data from all physicians working at all 27 primary healthcare centers from March 1st to May 31st 2020. Knowledge scores were computed and a multivariable linear regression model was built to identify predictors of higher knowledge. Results A total of 364 PCPs participated (response rate of 89.2%). Participants’ mean age was 44.5 (±7.8) with 59.1% being males. Their overall mean knowledge score was 9.54/16 (±3.24). Significant predictors of higher knowledge included: aged 40–49 years (1.072; 95% CI: 0.230, 1.915), had medical degree from non-Arab countries (0.748; 95% CI: 0.065, 1.432), had training in TM (1.405; 95% CI: 0.407, 2.403), and provided ≥10 consultations/ month (2.585; 95% CI:1.294, 3.876). Online information was the main reported resource of travel medicine consultation. Conclusions The overall PCPs’ mean percentage knowledge score of travel medicine was 59.6% (±20.3). A high volume of pretravel consultation, prior training, middle age group, and medical degree from non-Arab countries were significant predictors of higher knowledge. Continuing education and training provided by recognised international institutions for all PCPs is highly recommended to narrow the gap in travel medicine knowledge.
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Affiliation(s)
- Ayman Al-Dahshan
- Department of Medical Education, Community Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar
- * E-mail:
| | - Nagah Selim
- Department of Public Health and Preventive Medicine, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Noora Al-Kubaisi
- Department of Clinical Affairs, Primary Health Care Corporation, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Global and Public Health, Weill Cornell Medical College, Doha, Qatar
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Yamamoto K, Asai Y, Nakatani I, Hayashi K, Nakagawa H, Shinohara K, Kanai S, Shimatani M, Yamato M, Shimono N, Kitaura T, Komiya N, Nagasaka A, Mikawa T, Manabe A, Matono T, Yamamoto Y, Ogawa T, Kutsuna S, Ohmagari N. Characteristics and potential quality indicators for evaluating pre-travel consultations in Japan hospitals: the Japan Pretravel consultation registry (J-PRECOR). Trop Dis Travel Med Vaccines 2022; 8:6. [PMID: 35101123 PMCID: PMC8805374 DOI: 10.1186/s40794-021-00160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Awareness of pre-travel consultations (PTCs) and prevention methods for overseas travel-related diseases, and the understanding of PTCs among Japanese travelers and medical professionals remains low in Japan. A multicenter registry was established to examine PTCs in Japan. This study assessed the PTC implementation rate and examined the indicators of PTCs that can be used as criteria for evaluating quality. METHODS Clients who presented for their PTCs at 17 facilities and were registered between February 1, 2018, and May 31, 2020, were included. Medical information was extracted retrospectively via a web-based system. Correlations between vaccination risk categories and advice/intervention proportions by the facility were evaluated using Spearman's ordered phase relations (α = 0.05). RESULTS Of the 9700 eligible clients (median age, 32 years; 880 [9.1%] aged < 16 years and 549 [5.7%] aged ≥65 years), the most common travel duration was ≥181 days (35.8%); higher among younger clients. The most common reason for travel was business (40.5%); the US (1118 [11.5%]) and Asia (4008 [41.3%]) were the most common destinations and continents, respectively. The vaccine number (median three per person) increased after the PTCs except for the tetanus toxoid. Only 60.8% of the clients recommended for malaria prophylaxis received anti-malarial agents. The gross national income; the incidence of human rabies, typhoid fever, falciparum malaria; and dengue risk category were associated with the percentage of hepatitis-A vaccines; explaining rabies post-exposure prophylaxis, typhoid-fever vaccinations, malaria-prophylaxis prescriptions; and mosquito repellants, respectively. CONCLUSIONS Although the characteristics of the travelers differed, the quality of the PTCs should be improved to address, for example, the lower rate of acceptance of malaria prophylaxis in Japan.
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Affiliation(s)
- Kei Yamamoto
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Yusuke Asai
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | | | - Kenichi Hayashi
- Department of Infectious Diseases, Kenwakai Otemachi Hospital, Kitakyushu, Japan
| | - Hidenori Nakagawa
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan
| | - Koh Shinohara
- Department of Infectious Diseases, Kyoto City Hospital, Kyoto, Japan
| | - Shinichiro Kanai
- Department of Infection Control, Shinshu University Hospital, Matsumoto, Japan
| | | | - Masaya Yamato
- Department of General Medicine and Infectious Diseases, Travel Clinic, Rinku General Medical Center, Izumisano, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Tsuyoshi Kitaura
- Center for Infectious Disease, Tottori University Hospital, Yonago, Japan
| | - Nobuhiro Komiya
- Department of Infectious Diseases, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
| | - Atsushi Nagasaka
- Department of Infectious Diseases, Sapporo City General Hospital, Sapporo, Japan
| | - Takahiro Mikawa
- Department of General Medicine and Infectious Diseases, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Akihiro Manabe
- Department of Clinical Laboratory Medicine, Fukuyama City Hospital, Fukuyama, Japan
| | - Takashi Matono
- Department of Infectious Diseases, Aso Iizuka Hospital, Iizuka, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Taku Ogawa
- Center for Infectious Diseases, Nara Medical University Hospital, Kashihara, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
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Reasons for seeking care and adherence to pretravel preparation in expatriate or long-term travelers' children in the tropics: A French prospective study. Travel Med Infect Dis 2021; 46:102184. [PMID: 34699957 DOI: 10.1016/j.tmaid.2021.102184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/16/2021] [Accepted: 10/18/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Studies on pediatric travelers' health rarely address expat or long-term travelers' children. METHOD To investigate reasons for seeking care and adherence to pretravel preparation, we prospectively enrolled French children 0-15 years old, either expatriates or staying >6 months in tropical areas, who attended a French health center in Africa, Central America or Southern Pacific regions from October 01, 2011 to October 31, 2012. A standardized questionnaire was completed by a general practitioner at each visit, then anonymized and included in our database. RESULTS 464 questionnaires were collected from 367 children (sex ratio M/F: 1:1). Median age was 6.4 years (IQR: 3.6; 10.3). Reasons for seeking care were mostly infections (n = 378), of which 12 (3.2%) were tropical. There were no deaths, but one child with tuberculosis was repatriated. Coverage was high for routine immunization, but less for travel-related vaccines. Personal antivectorial protection was significantly lower in children aged >5 y or in non-malarial areas. Where indicated, malarial chemoprophylaxis was prescribed to only one third of the children, of whom 60% were poorly compliant. Advice regarding measures against diarrhea and sunburn was followed significantly more for stays >2 yrs. CONCLUSION Mild cosmopolitan illnesses predominated but protection against tropical threats should be optimized before and during the stay.
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Japanese health and safety information for overseas visitors: protocol for a randomized controlled trial. BMC Public Health 2021; 21:558. [PMID: 33743647 PMCID: PMC7981386 DOI: 10.1186/s12889-021-10627-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Before the COVID-19 pandemic occurred in January 2020, the number of overseas visitors to Japan had increased threefold over the last decade. To minimize the risk of health problems, visitors should be able to access information on the health care systems of the places they visit. Most short-term overseas visitors are young adults. Although they are not very likely to get sick from noncommunicable diseases, they are at high risk for injury and often experience stomach ailments, fever, or nausea when travelling. The objective of this study is to evaluate culturally and linguistically appropriate health information on preventive health behaviours and the health care system in Japan. We will examine the level of satisfaction of overseas visitors to Japan with health care-related educational materials using a five-minute digital game named Sa-Chan Japan. METHODS Our study is a randomized controlled trial (RCT). We will assess both satisfaction and motivation before, during, and after the interventions and examine the changes over time. The intervention group will comprise overseas visitors who will view and answer questions in an animation named Sa-Chan Japan. The control group will comprise overseas visitors who will watch an English digital animation named Mari Info Japan. We will recruit 1002 participants through the Macromill Internet portal. We will contact overseas visitors who have either visited or wish to visit Japan from the United Kingdom, United States, and Australia. The participants will fill out a self-administered questionnaire online in the first quarter of 2021. We will determine the participants' levels of satisfaction with the CSQ-8 (8-item Client Satisfaction Questionnaire). We will analyse the median score of the overseas visitors with both the Wilcoxon rank-sum and the Wilcoxon signed-rank tests. Our protocol of randomized controlled trials follows the SPIRIT guidelines. DISCUSSION Our research will utilize unique digital education strategies in a game that promotes health and safety among overseas visitors to Japan. We believe the results of this study will be useful in overcoming the current challenges regarding pretravel health requirements for overseas visitors worldwide. TRIAL REGISTRATION Version 1 of this trial was registered in the UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), and the trial registration data are available on UMIN000042483 , November 17, 2020.
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Alduraibi RK, Almigbal TH, Alrasheed AA, Batais MA. Knowledge, attitudes, and practices of primary health care physicians regarding the pre-travel counselling of patients with type 2 diabetes in Riyadh, Saudi Arabia. BMC FAMILY PRACTICE 2020; 21:200. [PMID: 32972370 PMCID: PMC7517797 DOI: 10.1186/s12875-020-01273-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Abstract
Background Travel has become an integral part of Saudi life. People with diabetes face many challenges while travelling that can have detrimental effects on glycaemic control. However, no previous studies have investigated pre-travel counselling in Saudi Arabia. This study aims to assess the knowledge, attitudes and practices of primary health care (PHC) physicians regarding pre-travel counselling for patients with type 2 diabetes. Methods This cross-sectional study was conducted in PHC centres under the Ministry of Health in Riyadh, Saudi Arabia, during the period 2018–2019. A cluster multistage random sampling technique was used to recruit physicians. The data were collected through a self-administered questionnaire. Results Three hundred and eighty-five primary health care physicians were recruited. This study showed that more than half (57.9%) of PHC physicians had poor knowledge scores. Additionally, the following characteristics were significantly associated with poor knowledge: being younger in age, being male, being Saudi, being a general practitioner, and having limited (0–5 years) experience. A total of 183 (47.5%) subjects showed disagreement attitudes towards the importance of pre-travel counselling among patients with diabetes. Furthermore, these disagreement attitudes were significantly associated with being older and having more years of experience. The majority (62.6%) of the physicians had poor practice scores. Poor practices were detected among physicians who were younger, male, and Saudi and who had a general practitioner specialty and degree. Conclusions It could be concluded that a gap was detected in the knowledge and practices of primary health care physicians regarding pre-travel counselling for people with type 2 diabetes. Therefore, it is necessary to create easily accessible travel medicine education programmes for Saudi PHC providers to improve the management of travellers with diabetes.
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Affiliation(s)
- Rabia Khalid Alduraibi
- King Fahad Specialist Hospital, Buraydah, Saudi Arabia. .,Department of Family and Community Medicine, King Khalid University Hospital, Box 2925, Riyadh, PO, 11461, Saudi Arabia.
| | - Turky H Almigbal
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A Alrasheed
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Ali Batais
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
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Alqahtani AS, Alsharif SA, Garnan MA, Tashani M, BinDhim NF, Heywood AE, Booy R, Wiley KE, Rashid H. The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study. JMIR Public Health Surveill 2020; 6:e10959. [PMID: 32673259 PMCID: PMC7388052 DOI: 10.2196/10959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 04/23/2019] [Accepted: 11/08/2019] [Indexed: 11/20/2022] Open
Abstract
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.
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Affiliation(s)
- Amani S Alqahtani
- Saudi Food and Drug Authority, Riyadh, Saudi Arabia.,School of Public Health, The University of Sydney, Sydney, Australia.,National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia
| | | | | | - Mohamed Tashani
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia.,The Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | | | - Anita E Heywood
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia.,The Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia.,WHO Collaborating Centre for Mass Gatherings and High Consequence/High Visibility Events, Flinders University, Adelaide, Australia
| | - Kerrie E Wiley
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead, Sydney, Australia.,The Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia
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Amat C, Bellanger A, Bozon F, Léger R, Gbaguidi-Haore H, Marguet P. Current practice of French health professionals regarding Japanese encephalitis vaccination. Med Mal Infect 2019; 49:602-606. [DOI: 10.1016/j.medmal.2019.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/07/2018] [Accepted: 03/08/2019] [Indexed: 11/16/2022]
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12
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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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Vandererven C, Bellanger AP, Faucher JF, Marguet P. Primary care physician management of tick bites in the Franche-Comté region (Eastern France, 2013). Med Mal Infect 2017; 47:261-265. [PMID: 28457701 DOI: 10.1016/j.medmal.2017.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/11/2016] [Accepted: 03/27/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Tick bites, which may lead to Lyme disease, often prompt patients to consult their primary care physicians (PCPs). The aim of the present study was to assess how and how often PCPs in the Franche-Comté region of France manage tick bites. MATERIAL AND METHODS Standardized questionnaires were sent to a random sample of 400 PCPs in the Franche-Comté region, requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details and practice-related information about tick-bite prophylaxis, Lyme serology, and tick-borne encephalitis vaccination. RESULTS The crude response rate was 54.5% of the PCPs contacted. Tick-bite prophylaxis was prescribed as per current guidelines. However, Lyme serology seemed to be largely overprescribed for tick bites and in case of erythema migrans. A clear lack of knowledge about tick-borne encephalitis vaccination was also observed. DISCUSSION PCPs provide the first line of care for patients presenting with tick bites. This study showed that although PCPs of the Franche-Comté region manage tick bites as per current guidelines, they need further training on Lyme serology limitations and availability of tick-borne encephalitis vaccination.
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Affiliation(s)
- C Vandererven
- Emergency Department, Pontarlier Regional Hospital, 25300 Pontarlier, France
| | - A-P Bellanger
- Department of Parasitology-Mycology, Besançon University Hospital, 25030 Besançon, France; UMR 6249 Chrono-environnement, CNRS-University of Franche-Comté, 25030 Besançon, France.
| | - J-F Faucher
- Infectious Diseases Department, Besançon University Hospital, 25030 Besançon, France
| | - P Marguet
- Emergency Department, Pontarlier Regional Hospital, 25300 Pontarlier, France
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Gagneux-Brunon A, Andrillat C, Fouilloux P, Daoud F, Defontaine C, Charles R, Lucht F, Botelho-Nevers E. Pre-travel advice seeking from GPs by travellers with chronic illness seen at a travel clinic. J Travel Med 2016; 23:taw013. [PMID: 27029909 DOI: 10.1093/jtm/taw013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 01/07/2023]
Abstract
PURPOSE Travellers are ageing and frequently report chronic illness. Pre-travel health advice is crucial, particularly in this subgroup, and general practitioners (GPs) are first in line for treatment adjustment before departure. Our aim is to evaluate pre-travel health advice seeking from GPs by travellers with chronic illness seen at a travel clinic. METHODS A cross-sectional observational survey using a questionnaire was conducted between August 2013 and July 2014 in travellers attending the travel medicine clinic of a tertiary university hospital in France. RESULTS During the study, 2019 travellers were included. Mean age was 39.4 years (±18.8). Three hundred and ninety-one (19.4%) travellers reported a history of a chronic illness. Arterial hypertension and diabetes mellitus were the most frequently reported illnesses, affecting, respectively, 168 (8.3%) travellers and 102 (5.1%). Hajj pilgrims were more likely to report a history of chronic illness than other travellers. Only 810 (40.1%) travellers sought pre-travel advice from their GP. Six hundred and fifty-two (40.1%) healthy travellers and 158 (40.5%) travellers reporting chronic illness sought pre-travel advice from their GP (P = 0.96). CONCLUSION Travellers with a history of chronic illness do not seek pre-travel health advice from their GP more frequently than healthy travellers. Travel health specialists are generally not the best practitioners to manage the care of underlying medical conditions presenting risks during travel. However, GPs offer continuity and disease management expertise to improve the specificity of pre-travel planning. Thus, ongoing collaboration between the traveller, GP and travel health specialist is likely to yield the best outcomes.
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Affiliation(s)
- Amandine Gagneux-Brunon
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
| | - Carole Andrillat
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
| | - Pascale Fouilloux
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
| | - Fatiha Daoud
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
| | - Christiane Defontaine
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
| | - Rodolphe Charles
- Department of Family Medicine, School of Medicine, University of Saint-Etienne, 55 Avenue Albert Raimond, Saint-Etienne 42055, France
| | - Frédéric Lucht
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
| | - Elisabeth Botelho-Nevers
- Department of Infectious and Tropical Diseases, Travel Clinic, University Hospital of Saint-Etienneand
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Bourgeois B, Marguet P, Gbaguidi-Haore H, Knapp J, Said-Ali Z, Demonmerot F, Bresson-Hadni S, Millon L, Bellanger AP. Alveolar echinococcosis: how knowledgeable are primary care physicians and pharmacists in the Franche-Comté region of France? Acta Parasitol 2015; 60:682-90. [PMID: 26408591 DOI: 10.1515/ap-2015-0097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/25/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alveolar echinococcosis (AE) is a parasitic disease resulting from the intrahepatic growth of Echinococcus multilocularis larva. This zoonotic helminthic disease is rare but, if left untreated or treated too late, can be severe or even fatal. In France, endemic areas containing infected foxes have become larger, spreading towards western regions of the country and leading to an increased risk of environmental contamination. An observational survey was undertaken in 2014 to assess the level of knowledge of AE among primary care physicians (PCPs) and pharmacists in the Franche-Comté region. METHODS Standardized questionnaires were sent to a random sample of 183 PCPs and 236 pharmacists practicing in the Franche-Comté region (eastern France), requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details, self-evaluation and asked multiple choice questions (MCQs) about epidemiology, prevention, diagnosis and management of AE. RESULTS The crude response rate was 37.5% of the PCPs and pharmacists questioned. Responses to MCQs showed that most of the participating PCPs and pharmacists had acceptable basic knowledge of AE, especially concerning epidemiology and prevention of the disease. However, a serious lack of knowledge was observed concerning the management of AE. CONCLUSION PCPs are often the first health professionals to suspect latent AE, which is still a rural disease in France. Both PCPs and pharmacists play an important role in informing and referring patients potentially exposed to AE. This study shows that although AE is rare, PCPs and pharmacists of the Franche-Comté region have a satisfactory level of knowledge of AE.
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Bascom CS, Rosenthal MM, Houle SKD. Are pharmacists ready for a greater role in travel health? An evaluation of the knowledge and confidence in providing travel health advice of pharmacists practicing in a community pharmacy chain in Alberta, Canada. J Travel Med 2015; 22:99-104. [PMID: 25410438 DOI: 10.1111/jtm.12172] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 08/01/2014] [Accepted: 09/01/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients often consult community pharmacists for medication needs related to travel, but little is known of pharmacists' knowledge and readiness to provide this care. The aim of this study was to evaluate pharmacists' knowledge in travel health, and to assess their confidence in providing travel-related advice to patients. METHODS A web-based survey was developed and distributed to 84 pharmacists practicing in a mid-size pharmacy chain in Alberta, Canada. The survey included knowledge and confidence assessment components. To assess knowledge, pharmacists were provided two cases, along with multiple-choice questions examining pre-travel risk assessment, and advice on travel at altitude, vaccines, malaria, travelers' diarrhea, and other potential travel health risks. Confidence was assessed by asking respondents to report their level of confidence in answering each knowledge assessment question and providing travel advice overall, using a 5-point Likert scale. Respondents were also asked to indicate preferred means for receiving additional training in travel health. RESULTS A total of 53 pharmacists responded to the survey, with a response rate of 63%. Most (61%) indicated that they had some level of training in travel health and 69% counseled on travel health more than once a month. Only one respondent correctly answered all six questions in the knowledge assessment section. The mean knowledge score (proportion of correct answers, unaided) for the group was 27%. However, the majority (66%) felt confident that they would know where to seek the information required to answer the questions. Overall confidence in this group of pharmacists was determined to be low, with only 21% of respondents reporting that they felt highly confident in providing travel health advice. CONCLUSIONS Travel health is becoming an increasingly common topic of discussion between patients and pharmacists. This study suggests that pharmacists' baseline knowledge of travel health may be incomplete, affecting their confidence in providing this advice. Undergraduate and continuing education training programs must expand travel health curricula to meet this growing need.
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Wadhwaniya S, Hyder AA. Pre-travel consultation without injury prevention is incomplete. J Travel Med 2013; 20:217-20. [PMID: 23809070 PMCID: PMC4315168 DOI: 10.1111/jtm.12041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 02/12/2013] [Indexed: 11/29/2022]
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