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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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Kc B, Khan TM, Xuan WY, Alrasheedy AA, Mohamed Ibrahim MI, Leggat PA. Travel health-related activities and services provided by community pharmacies in Selangor, Malaysia: A cross-sectional analysis. Travel Med Infect Dis 2019; 33:101463. [PMID: 31376464 DOI: 10.1016/j.tmaid.2019.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Millions of tourists visit Malaysia annually while a large number of Malaysians travel overseas. Taking care of travellers' healthcare needs is important aspect of the healthcare system. Community pharmacies are ideally positioned to provide travel health-related services. However, studies are lacking in this area. Therefore, this study aims to explore the nature and type of travel health-related services provided by Malaysian community pharmacies. METHODS A survey was carried out at 135 community pharmacies in nine districts of Selangor, Malaysia, from November 2017 to February 2018, using a self-administered standardized questionnaire. RESULTS The majority (n = 95, 85%) of community pharmacies reported to have provided services to both international travellers and outbound Malaysian travellers. The common healthcare services provided to international travellers were monitoring of chronic diseases including hypertension and diabetes, and advice on minor ailments, supplements and medical devices. The key health services provided to outbound Malaysian travellers were advice on vaccination requirements, better management of chronic diseases and necessary medications to manage illness during travel. Most of the respondents supported the provision of travel health-related services through the community pharmacies. CONCLUSION The study findings showed that Malaysian community pharmacies provided several travel health-related services to both international and Malaysian outbound travellers. Pharmacists in Malaysia are ideally positioned to have an increased role in travel medicine. They have the training to advise on complex medication issues especially with regard to interactions and polypharmacy. However, further training and courses should be provided that are tailored specifically for the needs of this professional group.
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Affiliation(s)
- Bhuvan Kc
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia.
| | - Tahir Mehmood Khan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia; Institute of Pharmaceutical Science, UVAS Lahore, Pakistan.
| | - Wong Yin Xuan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia.
| | | | | | - Peter A Leggat
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia; Faculty of Science, University of Nottingham Malaysia Campus, Jalan Broga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia.
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Pediatric travelers presenting to an Australian emergency department (2014-2015): A retrospective, cross-sectional analysis. Travel Med Infect Dis 2018; 31:101345. [PMID: 30395939 DOI: 10.1016/j.tmaid.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Epidemiological data on pediatric travelers are lacking, especially from Oceania. We aimed to evaluate travelers presenting to a pediatric emergency department in Sydney during a time of heightened travel surveillance. METHOD Cases between December 2014 and February 2015 were ascertained by screening medical records for key terms and visa status, as well as laboratory data for malaria testing. Cases were restricted to communicable diseases and evidence of travel within 21 days. RESULTS 104 children were identified. 82 children were Australian-resident travelers returning from abroad, 11 were visitors to Australia, 8 were recent migrants/refugees and 3 were medical transfers. Travel and behavioral patterns were characterized by exposures to low-income countries in the Asia-Pacific, visiting families and relatives, prolonged exposure periods and limited uptake of prophylaxis. Intrinsic vulnerabilities included extremes of age (median: 3.3 years) and pre-existing co-morbidities (6.7%). Common syndromes were respiratory (38.5%), systemic febrile illness (19.2%), acute diarrhea (17.3%) and dermatological conditions (9.6%). A minority were diagnosed with tropical infections: four typhoid or paratyphoid fever, two dengue and one tropical ulcer. CONCLUSIONS Young travelers are a heterogeneous group who present with a broad spectrum of diseases, from the benign to the life-threatening. Our data may be used to inform diagnostic approaches, empiric therapies and contribute towards public health strategies.
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Affiliation(s)
- Luca Cegolon
- IRCCS Burlo Garofolo, Scientific Directorate, Trieste, Italy.,Primary care unit, Local Health Unit N.4, Veneto Region, Italy
| | - W C Heymann
- Florida Department of Health, Sarasota County Health Department, Sarasota, Florida, FL, USA.,Department of Clinical Sciences, Florida State University, College of Medicine, Sarasota, FL, USA
| | - John H Lange
- Envirosafe Training and Consultants, Pittsburgh, PA, USA
| | - Carla Xodo
- FISPPA Department, Padua University, Padua, Italy
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Piyaphanee W, Chanthavanich P. Residency training in travel medicine-a 3-year journey to become a specialist. J Travel Med 2016; 23:taw041. [PMID: 27296585 DOI: 10.1093/jtm/taw041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/12/2016] [Indexed: 11/12/2022]
Affiliation(s)
| | - Pornthep Chanthavanich
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Leder K, Bouchaud O, Chen LH. Training in Travel Medicine and General Practitioners: A Long-Haul Journey! J Travel Med 2015; 22:357-60. [PMID: 26503092 DOI: 10.1111/jtm.12240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Karin Leder
- Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Parkville, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Olivier Bouchaud
- Hôpital Avicenne - Service des Maladies Infectieuses et Tropicales-Université Paris 13-Sorbonne Paris Cité, Bobigny, France
| | - Lin H Chen
- Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, MA, USA.,Harvard Medical School, Boston, MA, USA
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