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Yamakawa M, Tanaka Y, Tokinobu A, Tsuda T. Concerns about vaccines and vaccination behavior among Japanese budget travelers to India. J Infect Chemother 2024:S1341-321X(24)00189-2. [PMID: 39004400 DOI: 10.1016/j.jiac.2024.07.011] [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: 03/03/2024] [Revised: 05/27/2024] [Accepted: 07/11/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Low vaccination coverage among travelers poses a critical challenge to global health security. Indeed, public concerns regarding vaccines can lead to vaccine reluctance and refusal, but evidence about the impacts of concerns regarding vaccines on the uptake of travel vaccinations remains sparse. We examined the associations between concerns about vaccines and vaccination behavior among travelers. METHODS Japanese travelers aged 18 years or older, who stayed at a guesthouse in New Delhi, India, were targeted (n = 153). We conducted cross-sectional surveys from August 23 to September 2, 2019, and from February 19 to March 5, 2020. We examined the associations of three concerns regarding vaccines (5-point scale)-serious side effects from vaccines, vaccine safety, and vaccine effectiveness-with the uptake of travel vaccinations. RESULTS In total, 60 participants (39.2 %) had been vaccinated for this or a past trip. After adjusting for all potential confounding variables, concerns about serious side effects from vaccines and vaccine safety were negatively associated with the uptake of travel vaccinations. The ORs (95 % CIs) for 1-point increases in concerns about serious side effects from vaccines and vaccine safety were 0.72 (0.52, 0.99) and 0.71 (0.52, 0.96), respectively. Sensitivity analyses did not change the results substantially. CONCLUSIONS Concerns about vaccine safety issues were negatively associated with the uptake of travel vaccinations among the participants, with no corresponding association observed for vaccine effectiveness. Addressing concerns about vaccine safety issues, rather than vaccine effectiveness may contribute to an increased uptake of travel vaccinations.
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Affiliation(s)
- Michiyo Yamakawa
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Yuko Tanaka
- Graduate School of Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, 466-8555, Japan.
| | - Akiko Tokinobu
- Center for Diversity and Inclusion, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, 3-1-1 Tsushima-naka, Kita-ku, Okayama, 700-8530, Japan.
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Pennino F, Fiorilla C, Sorrentino M, Armonia U, Parisi A, Mirizzi PD, Di Lillo M, De Silva O, Montuori P, Triassi M, Nardone A. Investigating Awareness Regarding Travel-Related Infectious Disease Prevention in a Metropolitan Area. Trop Med Infect Dis 2023; 8:476. [PMID: 37888604 PMCID: PMC10611143 DOI: 10.3390/tropicalmed8100476] [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: 09/26/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
The rise in international travel has led to an increase in travel-related infectious diseases. It is predicted that by 2030, the number of international travelers will reach 1.8 billion, with over 250 million people affected globally. This issue also has an economic impact, as the eradication of travel-related infectious diseases leads to a loss of USD 12 billion in tourism. To understand the association between demographic variables and knowledge, attitude, and behaviors related to travel-related infectious diseases, a cross-sectional survey-based study was conducted among 1191 individuals in the metropolitan city of Naples, Italy. Multiple linear regression was performed over three models. The results revealed that knowledge about travel-related infectious diseases was positively associated with age, female gender, non-smoking habits, being single, and higher education attainment. The attitude towards travel-related infectious diseases was positively associated with being female, non-smoking habits, being single, higher education attainment, and a higher level of knowledge. A statistically significant association was observed between behaviors and non-smoking habits and between higher levels of knowledge and attitudes. To address this issue, public health programs could be implemented to improve behaviors in the general population. Overall, this study provides valuable information about the determinants of knowledge, attitude, and behaviors related to travel-related infectious diseases in the general population.
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Affiliation(s)
- Francesca Pennino
- Department of Public Health, “Federico II” University, Via Sergio Pansini No. 5, 80131 Naples, Italy
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García-Marín NM, Marrero GA, Guerra-Neira A, Rivera-Deán A. Profiles of travelers to intermediate-high health risk areas following the reopening of borders in the COVID-19 crisis: A clustering approach. Travel Med Infect Dis 2023; 54:102607. [PMID: 37353065 PMCID: PMC10284617 DOI: 10.1016/j.tmaid.2023.102607] [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: 03/20/2023] [Revised: 05/15/2023] [Accepted: 06/13/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND The reactivation of international travel in 2021 has created a new scenario in which the profile of the traveler to medium-high health risk areas may well have changed. However, few studies have analyzed this new profile since the reopening of borders in that year. METHODS We designed an ad hoc questionnaire that was administered face-to-face by our medical team during appointments with 330 travelers in the second half of 2021. Information was collected on the following topics: sociodemographic and socioeconomic status; type of travel and previous travel experience; health status and risk perception (of COVID-19 and tropical infectious diseases). Using all features simultaneously, an unsupervised machine learning approach (k-means) is implemented to characterize groups of travelers. Pairwise chi-squared tests were performed to identify key features that showed statistically significant differences between clusters. RESULTS The travelers were clustered into seven groups. We associated the clusters with different intensities of perceived risk of acquiring COVID-19 and tropical infectious diseases on the trip. The perceived risk of both diseases was low in the group "middle or lower middle class young inexperienced male tourist" but high in the group "middle or lower middle-class young with children inexperienced business traveler". CONCLUSIONS Broadening our knowledge of the profiles of travelers to intermediate-high health risk areas would help to tailor the health advice provided by practitioners to their characteristics and type of travel. In a changing health context, the k-means approach supposes a flexible statistical method that calculates travelers' profiles and can be easily adapted to process new information.
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Affiliation(s)
- Nidia M García-Marín
- International Vaccination Center at Santa Cruz de Tenerife, Spanish Ministry of Health, Spain; University of La Laguna, Research Center of Social Inequality and Governance (CEDESOG), Spain
| | - Gustavo A Marrero
- University of La Laguna, Department of Economics, Spain; University of La Laguna, Research Center of Social Inequality and Governance (CEDESOG), Spain; University of La Laguna, IUDR, Spain.
| | - Ana Guerra-Neira
- International Vaccination Center at Santa Cruz de Tenerife, Spanish Ministry of Health, Spain; University of La Laguna, Research Center of Social Inequality and Governance (CEDESOG), Spain
| | - Almudena Rivera-Deán
- International Vaccination Center at Santa Cruz de Tenerife, Spanish Ministry of Health, Spain; University of La Laguna, Research Center of Social Inequality and Governance (CEDESOG), Spain
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4
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Lopes VDS, Souza PCD, Garcia ÉM, Lima JC. Yellow fever vaccine hesitancy and its relationship with contextual, individual, or group influences and vaccine-specific issues: a scoping review. CIENCIA & SAUDE COLETIVA 2023; 28:1717-1727. [PMID: 37255148 DOI: 10.1590/1413-81232023286.13522022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/09/2022] [Indexed: 06/01/2023] Open
Abstract
Vaccine hesitancy is a phenomenon with the potential to reduce vaccination coverage rates, as observed with the yellow fever vaccine (YFV), leading to epidemics and the reintroduction of controlled immunopreventable diseases. This study, together with the scientific literature, aims to map the relationship among the lack of information, vaccine safety and adverse events, and vaccine hesitancy concerning YFV. A scoping review was conducted in the Virtual Health Library (VHL), National Library of Medicine (PubMed), SCOPUS, Embase, and Web of Science databases, using controlled (DeCS/MeSH) and uncontrolled descriptors. In this work, we selected eleven articles, published in English, Spanish, and Portuguese, with no time limits, which met the inclusion criteria. False information, inadequate knowledge about the immunizer, lack of time to take a vaccination, acceptance of the vaccine, vaccine safety, and fear of adverse events were related to vaccine hesitancy. This study reinforces the importance of access to adequate information, provides guidance on YFV safety and adverse events, and can aid in the development of public health strategies to mitigate hesitancy.
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Affiliation(s)
- Vanessa da Silva Lopes
- Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2.367. 78060-900 Cuiabá MT Brasil.
| | - Pablo Cristiano de Souza
- Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2.367. 78060-900 Cuiabá MT Brasil.
| | | | - Jaqueline Costa Lima
- Universidade Federal de Mato Grosso. Av. Fernando Corrêa da Costa 2.367. 78060-900 Cuiabá MT Brasil.
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Le Goff M, Kendjo E, Thellier M, Piarroux R, Boelle PY, Jauréguiberry S. Impact of Chemoprophylaxis on Plasmodium vivax and Plasmodium ovale Infection Among Civilian Travelers: A Nested Case-Control Study With a Counterfactual Approach on 862 Patients. Clin Infect Dis 2023; 76:e884-e893. [PMID: 35962785 DOI: 10.1093/cid/ciac641] [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: 04/18/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The impact of chemoprophylaxis targeting Plasmodium falciparum on Plasmodium vivax and Plasmodium ovale, which may remain quiescent as hypnozoites in the liver, is debated. METHODS We conducted a nested case-control analysis of the outcomes of P. vivax and P. ovale infections in imported malaria cases in France among civilian travelers from 1 January 2006, to 31 December 2017. Using adjusted logistic regression, we assessed the effect of chemoprophylaxis on the incubation period, time from symptoms to diagnosis, management, blood results, symptoms, and hospitalization duration. We analyzed the effect of blood-stage drugs (doxycycline, mefloquine, chloroquine, chloroquine-proguanil) or atovaquone-proguanil on the incubation period. We used a counterfactual approach to ascertain the causal effect of chemoprophylaxis on postinfection characteristics. RESULTS Among 247 P. vivax- and 615 P. ovale-infected travelers, 30% and 47%, respectively, used chemoprophylaxis, and 7 (3%) and 8 (1%) were severe cases. Chemoprophylaxis users had a greater risk of presenting symptoms >2 months after returning for both species (P. vivax odds ratio [OR], 2.91 [95% confidence interval {CI}, 1.22-6.95], P = .02; P. ovale OR, 2.28 [95% CI, 1.47-3.53], P < .001). Using drugs only acting on the blood stage was associated with delayed symptom onset after 60 days, while using atovaquone-proguanil was not. CONCLUSIONS Civilian travelers infected with P. vivax or P. ovale reporting chemoprophylaxis use, especially of blood-stage agents, had a greater risk of delayed onset of illness. The impact of chemoprophylaxis on the outcomes of infection with relapse-causing species calls for new chemoprophylaxis acting against erythrocytic and liver stages.
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Affiliation(s)
- Maëlle Le Goff
- Université de Bretagne Occidentale, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire La Cavale Blanche, Brest, France.,Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France
| | - Eric Kendjo
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France.,Centre National de Référence du Paludisme, Paris, France
| | - Marc Thellier
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France.,Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, Service de parasitologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Renaud Piarroux
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France.,Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, Service de parasitologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Pierre-Yves Boelle
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France
| | - Stéphane Jauréguiberry
- Centre National de Référence du Paludisme, Paris, France.,Université de Paris Saclay, Service des maladies infectieuses et tropicales, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin Bicêtre, France.,Société Française de Médecine des Voyages, Paris, France.,Université de Paris Saclay, Centre de Recherche en Epidémiologie et Santé des Populations, Inserm, Villejuif, France
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6
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Lin CY, Chang K, Chang CJ. Questionnaire-Based Analysis of Adverse Events and Compliance with Malaria Chemoprophylaxis in Taiwan. J Pers Med 2023; 13:jpm13020179. [PMID: 36836413 PMCID: PMC9967687 DOI: 10.3390/jpm13020179] [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: 11/28/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
Malaria was eradicated in Taiwan in 1952; however, imported malaria cases are reported every year. The subtropical climate in Taiwan permits mosquito propagation and possible outbreaks of mosquito-borne diseases. The aim of this study was to investigate travelers' compliance and side effects of malaria prophylaxis to prevent a malaria outbreak in Taiwan. In this prospective study, we enrolled travelers who visited our travel clinic before going to malarious areas. A total of 161 questionnaires were collected and analyzed. Associations between the occurrence of side effects and compliance with antimalarial drugs were analyzed. Adjusted odds ratios were calculated after adjusting for potential risk factors in multiple logistic regression analysis. Of the 161 enrolled travelers, 58 (36.0%) reported side effects. Insomnia, somnolence, irritability, nausea, and anorexia were associated with poor compliance. Mefloquine was not associated with more neuropsychological side effects than doxycycline. Multiple logistic regression analysis showed that chemoprophylaxis compliance was affected by a younger age, visiting friends and relatives, visiting the travel clinic more than 1 week before the trip, and preferring to use the same antimalarial regimen on the next trip. Our findings could provide information to travelers besides labeled side effects to improve compliance with malaria prophylaxis and consequently help to prevent malaria outbreaks in Taiwan.
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Affiliation(s)
- Ching-Yun Lin
- Department of Family Medicine, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung 812, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chai-Jan Chang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence:
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Harish V, Buajitti E, Burrows H, Posen J, Bogoch II, Corbeil A, Gubbay JB, Rosella LC, Morris SK. Geographic clustering of travel-acquired infections in Ontario, Canada, 2008-2020. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001608. [PMID: 36963058 PMCID: PMC10022755 DOI: 10.1371/journal.pgph.0001608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/20/2023] [Indexed: 03/19/2023]
Abstract
As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario's laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric fever in Ontario, Canada between 2008-2020 to identify high-resolution geographical clusters for potential targeted pre-travel prevention. Smoothed standardized incidence ratios (SIRs) and 95% posterior credible intervals (CIs) were estimated using a spatial Bayesian hierarchical model. High- and low-incidence areas were described using data from the 2016 Census based on the home forward sortation area of patients testing positive. A second model was used to estimate the association between drivetime to the nearest travel clinic and incidence of TAI within high-incidence areas. There were 6,114 microbiologically confirmed TAIs across Ontario over the study period. There was spatial clustering of TAIs (Moran's I = 0.59, p<0.0001). Compared to low-incidence areas, high-incidence areas had higher proportions of immigrants (p<0.0001), were lower income (p = 0.0027), had higher levels of university education (p<0.0001), and less knowledge of English/French languages (p<0.0001). In the high-incidence Greater Toronto Area (GTA), each minute increase in drive time to the closest travel clinic was associated with a 3% reduction in TAI incidence (95% CI 1-6%). While urban neighbourhoods in the GTA had the highest burden of TAIs, geographic proximity to a travel clinic in the GTA was not associated with an area-level incidence reduction in TAI. This suggests other barriers to seeking and adhering to pre-travel advice.
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Affiliation(s)
- Vinyas Harish
- MD/PhD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Emmalin Buajitti
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Holly Burrows
- Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Joshua Posen
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada
| | - Isaac I. Bogoch
- Division of Infectious Diseases, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Jonathan B. Gubbay
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Laura C. Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Shaun K. Morris
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
- * E-mail:
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Golets A, Farias J, Pilati R, Costa H. COVID-19 pandemic and tourism: The impact of health risk perception and intolerance of uncertainty on travel intentions. CURRENT PSYCHOLOGY 2023; 42:2500-2513. [PMID: 34539156 PMCID: PMC8436199 DOI: 10.1007/s12144-021-02282-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 10/26/2022]
Abstract
Understanding tourist behavior during and after major tourism crises is essential to help destinations recover. The COVID-19 pandemic - a period of uncertainty and risk - makes it relevant to assess factors that influence travel intentions. There has been little research on tourist behavior during health crises and, in particular, on perceived health risk and uncertainty effects on travel intentions. This study was carried out at the beginning of the pandemic in Brazil and aims to investigate the role of health risk perception and intolerance of uncertainty on travel intentions for 2020 and 2021. We applied an online survey to 1150 Brazilian participants from April to May 2020. Our findings indicate that perceived COVID-19 severity, perceived probability of infection, and expected duration of the pandemic are significant predictors of travel intentions for both years. This paper contributes to a deeper understanding of crisis-resistant tourists' characteristics and provides insights for destinations' recovery.
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Affiliation(s)
- Anastasiya Golets
- grid.7632.00000 0001 2238 5157Centre of Sustainable Development, University of Brasilia, Brasilia, Brazil
| | - Jéssica Farias
- grid.7632.00000 0001 2238 5157Institute of Psychology, University of Brasilia, Brasilia, Brazil
| | - Ronaldo Pilati
- grid.7632.00000 0001 2238 5157Institute of Psychology, University of Brasilia, Brasilia, Brazil
| | - Helena Costa
- grid.7632.00000 0001 2238 5157Faculty of Business Administration, Accounting, Economics and Public Policy Management, University of Brasilia, Brasilia, Brazil
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Failoc-Rojas VE, Becerra-Silva F, Chero-Salvador J, Iglesias-Osores S, Valladares-Garrido MJ, Zeña-Ñañez S. Knowledge, attitudes, and practices about malaria in travelers to risk areas in Peru. Travel Med Infect Dis 2022; 52:102522. [PMID: 36513317 DOI: 10.1016/j.tmaid.2022.102522] [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: 08/09/2022] [Revised: 11/07/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Travelers from international airports who travel to endemic countries know the knowledge, attitudes, and practices (KAP) about malaria; however, it is still unknown to interprovincial travelers who go to the endemic regions of Peru. The objective is to determine the level of KAP about malaria among Peruvian travelers to risk areas. METHODS AND PRINCIPAL FINDINGS This are an analytical cross-sectional study of 277 passengers from a bus station in a low-risk area of malaria in Peru, whose destination was an intermediate/high-risk area during February-March 2018. Absolute and relative frequencies of personal variables associated with the trip and KAP were estimated. RESULTS Less than 50% know the main symptoms of malaria and at what time of day there is a greater risk of becoming infected. Five out of ten people knew which practices were preventive against contagion, and four out of ten answered that the treatment can be given in a health establishment, pharmacy, or by some healer. CONCLUSIONS Travelers to malaria endemic areas have a low level of knowledge and practice (39.7%) as well as an inadequate preventive attitude (35.4%) against malaria.
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Affiliation(s)
| | - Frank Becerra-Silva
- Facultad Medicina Humana, Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
| | - Juan Chero-Salvador
- Facultad Medicina Humana, Universidad Nacional Pedro Ruiz Gallo, Lambayeque, Peru
| | | | - Mario J Valladares-Garrido
- Universidad Continental, Lima, Peru; Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
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Sente C, Onyuth H, Matovu G, Namara BG, Mugoya GJ. Provision of Travel Health Advice Through Local Tourist Handlers: Perspectives of Safari Tour Operators in Uganda. Travel Med Infect Dis 2022; 49:102407. [PMID: 35961490 DOI: 10.1016/j.tmaid.2022.102407] [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: 07/20/2021] [Revised: 05/10/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The public health burden of travel related diseases (TRDs) remains significant despite the fact that most can be avoided, particularly with the assistance of local tourist handlers such as Safari Tour Operators' (STOs). The STO's are the immediate close contact with tourist groups, and yet their perspectives regarding provision of travel health advice are unknown in Uganda. This study was conducted to determine the level of knowledge, attitude, and practices of STOs regarding TRDs in Uganda. METHODS A cross sectional study was carried out among selected STOs in Kampala and Wakiso Districts using self-administered questionnaires. RESULTS The overall level of knowledge about travel health information was inadequate. Although 77.5% of the STOs were aware of some TRDs, the availability of travel health information or database in their organisations was not observed. Knowledge of the current TRDs in Uganda among the STOs was very low, with a few individuals mentioning yellow fever (9.7%), malaria (9.2%), cholera (9.2%), and HIV/AIDs (8.9%). Knowledge related to the sources of the travel health information was also low, with STOs (19.1%) and travel health clinics (14.9%) being mentioned as the main sources. The STOs had mostly positive attitude towards provision of travel health advice related to travellers, and all agreed that STOs should play a big role in the provision of travel health advice. First Aid and simple treatment options were mentioned as practices that STOs conducted to keep the travellers safe. CONCLUSIONS While the STOs are motivated to do the right thing and provide their clients with sound travel health advice, they have a limited awareness of the actual TRDs in Uganda. The STOs must be educated on pertinent travel health advice, and intra-travel disease and injury management. The responsible government and non-governmental entities in Uganda need to develop educational materials emphasising the relevance of travel health advice.
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Affiliation(s)
- Celsus Sente
- Department of Wildlife and Aquatic Animal Resources (WAAR), School of Veterinary Medicine and Animal Resources (SVAR), College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda.
| | - Howard Onyuth
- Department of Wildlife and Aquatic Animal Resources (WAAR), School of Veterinary Medicine and Animal Resources (SVAR), College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda
| | | | - Benigna Gabriela Namara
- Department of Microbiology, School of Biomedical Sciences (SBS), College of Health Sciences (CHS), Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Gizamba Jacob Mugoya
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town Observatory, 7925, South Africa
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11
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Pretravel preparation and factors associated with willingness to seek pretravel consultation among Taiwanese travelers. Travel Med Infect Dis 2022; 49:102397. [PMID: 35792255 DOI: 10.1016/j.tmaid.2022.102397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/22/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although globalization promotes economic development, cross-border infectious disease transmission is still a serious threat to health. Taiwan is geographically close to Southeast and South Asia, but the needs and expectations of Taiwanese travelers with regard to travel medicine are still largely unknown. This study aimed to clarify the pretravel preparations, needs, willingness to seek pretravel consultation, and factors associated with willingness, in order to provide valuable information for improvement of healthcare service. METHODS Data were collected with anonymous structured questionnaires distributed to 477 visitors who tried to get travel health information from New Southbound Health Center between June and November 2019. A multivariate stepwise logistic regression analysis was applied to identify factors associated with the visitors' willingness to seek pretravel consultation. RESULTS A total of 304 questionnaires (64%) were collected. Eighty-three percent of the respondents were willing to seek pretravel consultation. A higher level of education (odds ratio 3.6 [95% CI 1.58-8.22]), having a plan to obtain travel medical insurance (2.5 [1.18-5.28]), concern with gastrointestinal diseases (2.0 [1.04-3.94]), concern with mosquito-borne diseases (2.0 [2.07-3.95]), and concern with noncommunicable diseases (2.2 [1.02-4.96]) were independent factors associated with willingness to seek pretravel consultation.: CONCLUSIONS: We found that most of the travelers were willing to seek pretravel consultation. Our study highlighted the need to enhance awareness about travel-related illness among these travelers. Strategies should be tailored according to these findings to help prevent epidemics and improve healthcare service in the future.
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12
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Juneja A. Travel health pharmacy: A new model for sustainability. Can Pharm J (Ott) 2022; 155:143-149. [PMID: 35519080 PMCID: PMC9067071 DOI: 10.1177/17151635221087607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ashwin Juneja
- A. Juneja works as a pharmacy consultant and can be reached at
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Global Travel and Antimicrobial Resistance: a Challenge for Stewardship. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2022. [DOI: 10.1007/s40506-021-00257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Alkadi W, Salih S, Al Darbi M. Assessment of knowledge, attitudes, and practices regarding travel health among (King Abdulaziz) international airport travelers in Jeddah, Kingdom of Saudi Arabia 2019. J Family Med Prim Care 2021; 10:3013-3020. [PMID: 34660440 PMCID: PMC8483095 DOI: 10.4103/jfmpc.jfmpc_148_21] [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: 01/20/2021] [Revised: 02/26/2021] [Accepted: 03/25/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Travelers to different countries have endemic/pandemic diseases can increase the risk of exposure to various infectious agents and can facilitate their spread across borders. Objectives: To determine the levels of travel health knowledge, attitudes and practices among travelers at international airports of KSA. Methods: An observational cross-sectional study was conducted starting from 30 September, 2019 at the departure halls of King Abdulaziz International airport (KAIA). Representative sample adult travelers who were waiting to board were recruited. Results and Discussion: Good level of knowledge regarding travel health was observed among 28.2%. The majority of the participants (84.7%) got information about their destination prior to the trip. The main reported source of information was family/friends (53.8%). Negative health seeking behavior was observed among 70.8% of the participants. Purpose of the trip and duration of destination were significantly associated with health seeking behavior. Knowledge, attitude towards health information seeking behavior and practice-related to travel health among international travelers at King Abdulaziz International airport are insufficient.
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Affiliation(s)
- Wardah Alkadi
- Jazan Health Affairs,Ministry of Health, Jazan, Kingdom of Saudi Arabia
| | - Sarah Salih
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan City, Kingdom of Saudi Arabia
| | - Mohammed Al Darbi
- Family Medicine, Trainer at the Joint Program of Family Medicine, Jazan City, Kingdom of Saudi Arabia
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Expansion and Specification of Knowledge, Skills, Attitudes and Practices Survey Model for Community-Based Tourism Development. SUSTAINABILITY 2021. [DOI: 10.3390/su131910525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This paper investigates the use of the Knowledge Attitude Practices (KAP) survey and suggests its extension to Knowledge Attitude Skills Practices (KSAP). It brings value to tourism theories at the level of the tourist and hosts, and argues that communities must be capacitated with the knowledge, attitudes, skills, and practices that transcend tourism. This is a conceptual paper, compiled using secondary data that already exists in the public domain. The paper suggests carrying out surveys that incorporate KSAP regarding CBT at level 1, tourism at level 2, and livelihoods at level 3, for a holistic understanding of these aspects among community members, tourists, and other stakeholders. The KSAP model posited in this paper is a tool that may be used by considering the prevailing local conditions and contexts, and the appropriate unit of analysis from tourism stakeholders.
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Ferrara P, Masuet-Aumatell C, Ramon-Torrell JM. Acceptance of yellow fever vaccine in the older traveller: a cohort study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021098. [PMID: 34487067 PMCID: PMC8477116 DOI: 10.23750/abm.v92i4.11619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Current demographic changes and improvement of quality of life of elderly population have direct consequences on international travelling. The older traveller demands for specific care and precautions to be observed, as for the yellow fever (YF) vaccination, due to the increased incidence rate of adverse events following immunization (AEFI) in people aged 60 years or over. The aim of our study was to determine the adherence to YF vaccine and travel behaviours in a sample of elderly travellers moving to YF endemic areas. METHODS Participants in this cohort study were offered YF vaccine, and informed about the increased risk of AEFIs and the unavoidable risk of acquiring YF at the destination. The research was planned on survey-based design, using pre- and post-travel questionnaires. RESULTS In 2018, 239 travellers aged 60 years or older attended our travel clinic, of whom 36.8% (n = 88) planned to travel to YF endemic areas and 23.0% (n = 55) for the first time. Of these, 63.6% accepted and 36.4% rejected the vaccination, with 15 travellers moving to endemic areas without immunization, including one patient who presented contraindications to YF vaccine. CONCLUSIONS The presence of more than a third of elderly travellers who travelled without vaccination is a substantial public health problem and, since the number of older travellers continues to increase, it becomes necessary to implement robust actions to improve YF vaccine advocacy and adherence.
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Mace KE, Lucchi NW, Tan KR. Malaria Surveillance - United States, 2017. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2021; 70:1-35. [PMID: 33735166 PMCID: PMC8017932 DOI: 10.15585/mmwr.ss7002a1] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PROBLEM/CONDITION Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, nosocomial exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate rapid transmission control measures if locally acquired cases are identified. PERIOD COVERED This report summarizes confirmed malaria cases in persons with onset of illness in 2017 and trends in previous years. DESCRIPTION OF SYSTEM Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments through electronic laboratory reports or by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all cases from NMSS and NNDSS, CDC reference laboratory reports, and CDC clinical consultations. RESULTS CDC received reports of 2,161 confirmed malaria cases with onset of symptoms in 2017, including two congenital cases, three cryptic cases, and two cases acquired through blood transfusion. The number of malaria cases diagnosed in the United States has been increasing since the mid-1970s; in 2017, the number of cases reported was the highest in 45 years, surpassing the previous peak of 2,078 confirmed cases reported in 2016. Of the cases in 2017, a total of 1,819 (86.1%) were imported cases that originated from Africa; 1,216 (66.9%) of these came from West Africa. The overall proportion of imported cases originating from West Africa was greater in 2017 (57.6%) than in 2016 (51.6%). Among all cases, P. falciparum accounted for the majority of infections (1,523 [70.5%]), followed by P. vivax (216 [10.0%]), P. ovale (119 [5.5%]), and P. malariae (55 [2.6%]). Infections by two or more species accounted for 22 cases (1.0%). The infecting species was not reported or was undetermined in 226 cases (10.5%). CDC provided diagnostic assistance for 9.5% of confirmed cases and tested 8.0% of specimens with P. falciparum infections for antimalarial resistance markers. Most patients (94.8%) had symptom onset <90 days after returning to the United States from a country with malaria transmission. Of the U.S. civilian patients who reported reason for travel, 73.1% were visiting friends and relatives. The proportion of U.S. residents with malaria who reported taking any chemoprophylaxis in 2017 (28.4%) was similar to that in 2016 (26.4%), and adherence was poor among those who took chemoprophylaxis. Among the 996 U.S. residents with malaria for whom information on chemoprophylaxis use and travel region were known, 93.3% did not adhere to or did not take a CDC-recommended chemoprophylaxis regimen. Among 805 women with malaria, 27 reported being pregnant. Of these, 10 pregnant women were U.S. residents, and none reported taking chemoprophylaxis to prevent malaria. A total of 26 (1.2%) malaria cases occurred among U.S. military personnel in 2017, fewer than in 2016 (41 [2.0%]). Among all reported cases in 2017, a total of 312 (14.4%) were classified as severe malaria illnesses, and seven persons died. In 2017, CDC analyzed 117 P. falciparum-positive and six P. falciparum mixed-species samples for antimalarial resistance markers (although certain loci were untestable in some samples); identification of genetic polymorphisms associated with resistance to pyrimethamine were found in 108 (97.3%), to sulfadoxine in 77 (69.4%), to chloroquine in 38 (33.3%), to mefloquine in three (2.7%), and to atovaquone in three (2.7%); no specimens tested contained a marker for artemisinin resistance. The data completeness of key variables (species, country of acquisition, and resident status) was lower in 2017 (74.4%) than in 2016 (79.4%). INTERPRETATION The number of reported malaria cases in 2017 continued a decades-long increasing trend, and for the second year in a row the highest number of cases since 1971 have been reported. Despite progress in malaria control in recent years, the disease remains endemic in many areas globally. The importation of malaria reflects the overall increase in global travel to and from these areas. Fifty-six percent of all cases were among persons who had traveled from West Africa, and among U.S. civilians, visiting friends and relatives was the most common reason for travel (73.1%). Frequent international travel combined with the inadequate use of prevention measures by travelers resulted in the highest number of imported malaria cases detected in the United States in 4 decades. PUBLIC HEALTH ACTIONS The best way to prevent malaria is to take chemoprophylaxis medication during travel to a country where malaria is endemic. Adherence to recommended malaria prevention strategies among U.S. travelers would reduce the numbers of imported cases; reasons for nonadherence include prematurely stopping after leaving the area where malaria was endemic, forgetting to take the medication, and experiencing a side effect. Travelers might not understand the risk that malaria poses to them; thus, health care providers should incorporate risk education to motivate travelers to be adherent to chemoprophylaxis. Malaria infections can be fatal if not diagnosed and treated promptly with antimalarial medications appropriate for the patient's age, medical history, the likely country of malaria acquisition, and previous use of antimalarial chemoprophylaxis. Antimalarial use for chemoprophylaxis and treatment should be informed by the most recent guidelines, which are frequently updated. In 2018, two formulations of tafenoquine (i.e., Arakoda and Krintafel) were approved by the Food and Drug Administration (FDA) for use in the United States. Arakoda was approved for use by adults for chemoprophylaxis; the regimen requires a predeparture loading dose, taking the medication weekly during travel, and a short course posttravel. The Arakoda chemoprophylaxis regimen is shorter than alternative regimens, which could possibly improve adherence. This medication also might prevent relapses. Krintafel was approved for radical cure of P. vivax infections in those aged >16 years and should be co-administered with chloroquine (https://www.cdc.gov/malaria/new_info/2020/tafenoquine_2020.html). In April 2019, intravenous artesunate became the first-line medication for treatment of severe malaria in the United States. Artesunate was recently FDA approved but is not yet commercially available. The drug can be obtained from CDC under an investigational new drug protocol. Detailed recommendations for preventing malaria are available to the general public at the CDC website (https://www.cdc.gov/malaria/travelers/drugs.html). Health care providers should consult the CDC Guidelines for Treatment of Malaria in the United States and contact the CDC's Malaria Hotline for case management advice when needed. Malaria treatment recommendations are available online (https://www.cdc.gov/malaria/diagnosis_treatment) and from the Malaria Hotline (770-488-7788 or toll-free 855-856-4713). Persons submitting malaria case reports (care providers, laboratories, and state and local public health officials) should provide complete information because incomplete reporting compromises case investigations and efforts to prevent infections and examine trends in malaria cases. Molecular surveillance of antimalarial drug resistance markers (https://www.cdc.gov/malaria/features/ars.html) enables CDC to track, guide treatment, and manage drug resistance in malaria parasites both domestically and internationally. More samples are needed to improve the completeness of antimalarial drug resistance analysis; therefore, CDC requests that blood specimens be submitted for any case of malaria diagnosed in the United States.
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Affiliation(s)
- Kimberly E. Mace
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, CDC
| | - Naomi W. Lucchi
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, CDC
| | - Kathrine R. Tan
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, CDC
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Bechini A, Zanobini P, Zanella B, Ancillotti L, Moscadelli A, Bonanni P, Boccalini S. Travelers' Attitudes, Behaviors, and Practices on the Prevention of Infectious Diseases: A Study for Non-European Destinations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3110. [PMID: 33803553 PMCID: PMC8002973 DOI: 10.3390/ijerph18063110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of this study was to improve our comprehension of the attitudes, behaviors, and practices related to the health risks of travel to non-European destinations. METHODS This cross-sectional study utilized an online questionnaire disseminated through social networks. RESULTS About 79% of the respondents reported that they informed themselves or would inform themselves about travel-related health risks before departure. The most used sources of information were the Internet (52%) and health professionals (42%). Older age groups were positively associated with seeking pretravel health information (OR = 2.44, CI 95%: 1.18-5.01, in the age group 25-34 years and OR = 14.6, CI 95%: 1.77-119.50, in subjects over 65 years). Travelers visiting friends and relatives (VFRs) were less likely to seek health information (OR = 0.49; CI 95%: 0.26-0.95). About 13.9% of participants had doubts about the practice of vaccination. Those who sought information on social media had a higher probability of refusing vaccination (OR = 3.24; CI 95%: 1.02-10.19). CONCLUSIONS The data demonstrate that VFRs and the younger population are less informed about travel risks compared with other travelers. This study also revealed the importance that digital information assumes for travelers. Therefore, decisive efforts should be made to ensure that travelers can find correct and reliable information on the Web, particularly on social media.
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Affiliation(s)
- Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Patrizio Zanobini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Beatrice Zanella
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Leonardo Ancillotti
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Andrea Moscadelli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy;
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (P.Z.); (B.Z.); (L.A.); (P.B.); (S.B.)
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Taibah H, Arlikatti S, Andrew SA, Maghelal P, DelGrosso B. Health information, attitudes and actions at religious venues: Evidence from hajj pilgrims. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2020; 51:101886. [PMID: 32995254 PMCID: PMC7513823 DOI: 10.1016/j.ijdrr.2020.101886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 05/22/2023]
Abstract
Mass gatherings for sporting events, music shows, and religious needs continue to grow in our urban areas, requiring local authorities to develop safety procedures to mitigate the challenges of keeping the attendees safe. These challenges are even more pronounced at pilgrimage venues where social distancing and contact avoidance are difficult as pilgrims are required to perform various rituals in close proximity with others, in a sequential manner, either daily or weekly, as per their religious tenets. Over two million pilgrims attend the Hajj pilgrimage in Saudi Arabia annually. Keeping the local and visiting pilgrims safe from crowd crush, sunstroke, skin infections, recurrence of prior medical issues, and contagious diseases requires the Saudi government to allocate huge investments for health communication and prevention programs every year. However, there is no evidence to date that has empirically tested whether Hajj pilgrims' are able to receive such information and are subsequently adopting various health promoting behaviors. This study aims to do that by framing it within the Health Belief Model. Data collected and analyzed from 245 pilgrims in Makkah between September 9th-19th, 2017 suggests that roughly 48% of the pilgrims adopted all five protective measures. However, language barriers, limited health care facilities, and difficulties in purchasing prescription mediciens were cited as impediments to adopting healthy measures. The study concludes with recommendations for the KSA government agencies, Hajj authorities, Mission authorities and pilgrims, during various phases of travel-- i.e. pre-travel, during the pilgrimage and post-travel, in light of new emerging health threats.
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Affiliation(s)
- Hassan Taibah
- Department of Public Administration, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sudha Arlikatti
- Business Continuity Management & Integrated Emergency Management Programs, Rabdan Academy, Abu Dhabi, United Arab Emirates
| | - Simon A Andrew
- Department of Public Administration, University of North Texas, Denton, TX, USA
| | - Praveen Maghelal
- Sustainable Critical Infrastructure, Department of Industrial Systems and Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Bill DelGrosso
- Business Continuity Management & Integrated Emergency Management Programs, Rabdan Academy, Abu Dhabi, United Arab Emirates
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Wirawan IMA, Putri WCWS, Kurniasari NMD, Mulyawan KH, Hendrayana MA, Suharlim C. Geo-mapping of hazards, risks, and travel health services in Bali: Results from the first stage of the integrated travel health surveillance and information system at destination (TravHeSID) project. Travel Med Infect Dis 2020; 37:101698. [DOI: 10.1016/j.tmaid.2020.101698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 01/25/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
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Endale A, Medhin G, Hilo AA, Abegaz WE, Legesse M. Knowledge, Attitude, and Practice of Jinka University Students About Yellow Fever, Ethiopia: A Cross-Sectional Study. Risk Manag Healthc Policy 2020; 13:1225-1236. [PMID: 32884383 PMCID: PMC7443455 DOI: 10.2147/rmhp.s250930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Yellow fever (YF) is endemic in South Omo area of Ethiopia. Although Jinka University (JKU) is located in South Omo Zone, there is no information regarding the level of knowledge, attitude, and practice of students toward YF. The current study aimed to assess knowledge, attitude, and practice of JKU students toward YF and factors associated with the overall knowledge and attitude about the disease. METHODS In this cross-sectional study, a semi-structured self-administered questionnaire was used to collect data from randomly selected regular program JNU students. Data were analyzed using SPSS. Bivariate and multivariable logistic regression analyses were performed to investigate associations of socio-demographic factors with overall knowledge and attitude scores. RESULTS A total of 322 students (61.2% males, mean age of 20.7 years) participated in this study. Of these, 94.1% joined the University from places other than South Omo area and 86.0% (277/322) ever heard about YF. 9.6% were found to have a high level of overall knowledge about YF. High overall knowledge of YF was associated with being born and grown up in South Omo area (AOR=3.91; 95% CI: 1.28, 11.98) and being a student of a social science discipline (AOR=3.52; 95% CI: 1.22, 10.13). 48.8% of the participants had favorable overall attitude toward YF. Being a second-year student (AOR=1.96; 95% CI: 1.14-3.37), being born and grown up in South Omo area (AOR=5.13; 95% CI: 1.32-19.98), and having high overall knowledge of YF (AOR=13.24; 95% CI: 3.69, 47.44) were associated with favorable overall attitude toward YF. On the other hand, only 5.8% of the participants reported that they were vaccinated for YF. CONCLUSION The low level of knowledge and low vaccination coverage of JKU students to YF, especially among those students from other parts of the country, calls for urgent awareness creation during admission and making vaccination available.
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Affiliation(s)
- Adugna Endale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Woldaregay Erku Abegaz
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mengistu Legesse
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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The Role of Social Media in Health Safety Evaluation of a Tourism Destination throughout the Travel Planning Process. SUSTAINABILITY 2020. [DOI: 10.3390/su12166661] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research aims at identifying the role of social media in evaluating the attractiveness of a tourism destination, with special emphasis on the health safety of the destination. Consistent with this objective, a survey has been carried out on a sample of 675 Romanian social media users. The research results led to the development of a model based on structural equation modeling. The model includes nine latent variables that were structured taking into account different behavioral aspects related to the role social media has in travel planning, as well as for evaluating the health safety of a tourism destination. The main findings suggest that the trust in social media for tourism information made people become more interested in communicating through this means and to consider it more useful throughout the travel planning process. When choosing a travel destination, the more involved a tourist is in the decision making process, the greater the attention they pay to social media. The perceived usefulness of social media in travel planning has a significant influence on intentions to choose a tourism destination. As the importance assigned to the health safety of tourism destination increases, social media plays a more active role in travel by creating trust in this means in order to obtain sanitary safety information. People that intend to use social media for finding information on the health safety of a tourism destination are more likely to choose that destination for their vacation. The managerial implications of this paper regard the communication strategies adopted by tourism services suppliers or by some public authorities aimed at stimulating an efficient usage of social media so as to increase the buying intentions for tourism destinations.
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Harel R, Chazan B, Schwartz E. Malaria Disease and Chemoprophylaxis Usage among Israeli Travelers to Endemic Countries. Am J Trop Med Hyg 2020; 102:1351-1357. [PMID: 32274987 PMCID: PMC7253098 DOI: 10.4269/ajtmh.19-0592] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 01/28/2020] [Indexed: 11/07/2022] Open
Abstract
Prevention of malaria in travelers to endemic countries is one of the complex challenges of travel medicine. Israel has a widespread culture of travel to developing countries, but information regarding malaria prevention is limited so far. Our study, conducted in Sheba Medical Center, Israel, during the years 2008-2018 examined malaria chemoprophylaxis usage and malaria cases in a large group of Israeli travelers returning from endemic countries with any medical complaint. Data were collected regarding travel destinations, conditions, duration of stay, and pretravel consultation. Altogether, 4,708 travelers were included in our study. Travel destinations included Asia (51%), Latin America (31%), and sub-Saharan Africa (SSA) (17%). Median travel duration was 26 days. Only 11.9% reported taking malaria chemoprophylaxis. Of the travelers to SSA, 41.3% took prophylaxis as opposed to only 6% outside of Africa. During the study years, 136 cases of malaria were diagnosed; among them, 82 (60%) were infected with Plasmodium falciparum, of whom all but two were from SSA and none adhered to prophylaxis. Malaria chemoprophylaxis usage was found to be negligible in travel to many countries still considered endemic. Higher prophylaxis usage was found among travelers to SSA, but numbers are still lower than recommended. The low number of malaria cases seen in destinations outside SSA, as documented in our cohort, is likely to represent travel to low risk areas and not high prophylaxis usage. We urge re-evaluation of current CDC and Israeli guidelines which still recommend using chemoprophylaxis in many low-risk countries, as focus on high-risk countries may increase adherence.
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Affiliation(s)
- Reut Harel
- Internal Medicine C, Emek Medical Center, Afula, Israel
| | - Bibiana Chazan
- Infectious Diseases Unit, Emek Medical Center, Aflua, Israel
| | - Eli Schwartz
- Center for Geographic Medicine, Sheba Medical Center, Ramat Gan, Israel
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Assessing the Travel Health Knowledge of Australian Pharmacists. PHARMACY 2020; 8:pharmacy8020094. [PMID: 32486440 PMCID: PMC7356681 DOI: 10.3390/pharmacy8020094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 11/17/2022] Open
Abstract
Worldwide, the numbers of travellers are increasing, with pharmacists having the potential to play a significant role in the provision of pre-travel health services to a large number of these travellers. However, studies examining whether pharmacists have the travel health knowledge to provide these services are limited. This study thus aimed to explore the travel health knowledge of Australian pharmacists. Surveys assessing pharmacists’ knowledge of travel health were distributed through the Pharmaceutical Society of Australia and community pharmacies for self-completion. Overall, the travel health knowledge of participants was found to be good. However, although the majority of participants were aware of the common causes of morbidity and mortality in travel health, some slightly overestimated the prevalence of malaria and were less knowledgeable about the global distribution of some diseases. Most participants also demonstrated an ability to give appropriate advice on the management of traveller’s diarhoea, the selection of appropriate items for inclusion in travel first aid kits, vaccinations, and malarial chemoprophylaxis for travellers visiting endemic areas. This study highlights that Australian pharmacists have the knowledge to deliver travel health advice, with the potential to improve both access and outcomes for travellers.
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SteelFisher GK, Caporello H, Blendon RJ, Ben-Porath EN, Lubell K, Friedman AL, Holton K, Smith BJ, McGowan E, Schafer T. Views and Experiences of Travelers from US States to Zika-Affected Areas. Health Secur 2020; 17:307-323. [PMID: 31433283 PMCID: PMC11308926 DOI: 10.1089/hs.2019.0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Travelers to areas with Zika virus transmission are at risk of infection and of transmitting the virus after returning home. While protective behaviors during and after travel can reduce these risks, information about traveler practices or underlying views is limited. We examined these issues using data from the first representative poll of travelers from US states to Zika-affected areas, including US territories and Miami, Florida, conducted December 1 to 23, 2016. We analyzed results among all travelers (n = 1,285) and 2 subgroups at risk for pregnancy-related complications: (1) travelers in households where someone was pregnant or considering pregnancy (n = 72), and (2) other travelers of reproductive age (n = 631). We also examined results among those with different levels of awareness and knowledge about Zika virus. Results show that in households where someone was pregnant or considering pregnancy, awareness of Zika in the destination, concern about infection, and adoption of protective behaviors was relatively high. That said, sizable shares of travelers as a whole did not know information about asymptomatic and sexual transmission or post-travel behaviors. Further, concern about getting infected during travel was low among travelers as a whole, including other travelers of reproductive age. Few travelers consistently adopted protective behaviors during or after travel. Even among travelers who were aware of Zika in their destination and knew how to protect themselves, adoption of protective behaviors was only slightly higher. Findings from this poll suggest communications may be more effective if tailored to different levels of true and perceived risk. To address gaps in knowledge about transmission and post-travel protective behaviors, messaging should include facts and acknowledge the complexities of novel information and social context. Consideration should also be given to emphasizing other benefits of Zika protective behaviors or prioritizing behaviors that are most feasible.
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Affiliation(s)
- Gillian K SteelFisher
- Gillian K. SteelFisher, PhD, MSc, is Senior Research Scientist and Director of Global Polling, Harvard Opinion Research Program; Hannah Caporello is Program Manager, Harvard Opinion Research Program; and Robert J. Blendon, ScD, is Richard L. Menschel Professor of Public Health, Professor of Health Policy and Political Analysis, and Senior Associate Dean for Policy Translation and Leadership Development; all in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Hannah Caporello
- Gillian K. SteelFisher, PhD, MSc, is Senior Research Scientist and Director of Global Polling, Harvard Opinion Research Program; Hannah Caporello is Program Manager, Harvard Opinion Research Program; and Robert J. Blendon, ScD, is Richard L. Menschel Professor of Public Health, Professor of Health Policy and Political Analysis, and Senior Associate Dean for Policy Translation and Leadership Development; all in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Robert J Blendon
- Gillian K. SteelFisher, PhD, MSc, is Senior Research Scientist and Director of Global Polling, Harvard Opinion Research Program; Hannah Caporello is Program Manager, Harvard Opinion Research Program; and Robert J. Blendon, ScD, is Richard L. Menschel Professor of Public Health, Professor of Health Policy and Political Analysis, and Senior Associate Dean for Policy Translation and Leadership Development; all in the Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Eran N Ben-Porath
- Eran N. Ben-Porath, PhD, is Executive Vice President, Public Opinion Research, SSRS, Glen Mills, PA
| | - Keri Lubell
- Keri Lubell, PhD, is a Behavioral Scientist and Lead, Research and Evaluation Team, Emergency Risk Communication Branch, Division of Emergency Operations, Center for Preparedness and Response; Allison L. Friedman, MS, is a Health Communication Specialist, Travelers' Health Branch, Division of Global Migration & Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; and Kelly Holton is Chief Communications Officer, Travelers' Health Branch, Division of Global Migration & Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; all at the Centers for Disease Control and Prevention, Atlanta, GA
| | - Allison L Friedman
- Keri Lubell, PhD, is a Behavioral Scientist and Lead, Research and Evaluation Team, Emergency Risk Communication Branch, Division of Emergency Operations, Center for Preparedness and Response; Allison L. Friedman, MS, is a Health Communication Specialist, Travelers' Health Branch, Division of Global Migration & Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; and Kelly Holton is Chief Communications Officer, Travelers' Health Branch, Division of Global Migration & Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; all at the Centers for Disease Control and Prevention, Atlanta, GA
| | - Kelly Holton
- Keri Lubell, PhD, is a Behavioral Scientist and Lead, Research and Evaluation Team, Emergency Risk Communication Branch, Division of Emergency Operations, Center for Preparedness and Response; Allison L. Friedman, MS, is a Health Communication Specialist, Travelers' Health Branch, Division of Global Migration & Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; and Kelly Holton is Chief Communications Officer, Travelers' Health Branch, Division of Global Migration & Quarantine, National Center for Emerging and Zoonotic Infectious Diseases; all at the Centers for Disease Control and Prevention, Atlanta, GA
| | - Belinda J Smith
- Belinda J. Smith, MPH, is a Health Communication Specialist, McKing Consulting Corporation, Atlanta, GA
| | - Ericka McGowan
- Ericka McGowan, MS, is Director, Infectious Disease Preparedness, Association for State and Territorial Health Officials, Arlington, VA
| | - Thomas Schafer
- Thomas Schafer is Project Director, National Public Health Information Coalition, Marietta, GA
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Knowledge of the Sexual Transmission of Zika Virus and Preventive Practices Against Zika Virus Among U.S. Travelers. J Community Health 2020; 44:377-386. [PMID: 30478625 DOI: 10.1007/s10900-018-0594-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Individuals are often at increased risk of acquiring infectious disease while traveling. We sought to understand knowledge, attitudes and practices (KAP) regarding Zika virus among travelers from the United States. A total of 1043 study participants were recruited from a probability-based internet panel. Participants self-reported their knowledge of Zika infection and modes of transmission, and identified actions they had taken to prevent Zika infection and transmission including actions to prevent unintentional pregnancy since becoming aware of the Zika virus. Logistic regression was used to model the odds of taking preventive actions against Zika infection with adjustment for potential confounding factors. Knowledge of the sexual transmissibility of Zika virus significantly increased the odds of taking a preventive action against Zika infection, especially condom use or sexual abstention. Participants reported preferences for receiving information about Zika from private doctors and from the Internet. Discrepancies between where travelers seek information about Zika and how they would like to receive information regarding Zika were also found. These findings suggest that improving targeted messaging through online media may increase awareness of the sexual transmissibility of Zika as well as improve health communications with U.S. travelers. Travelers who are unaware of potential disease risks are less likely to adopt personal protective measures to protect themselves and reduce disease spread. Thus, future work should focus on improving communication and providing education to adopt effective prevention strategies while traveling.
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Volkman HR, Walz EJ, Wanduragala D, Schiffman E, Frosch A, Alpern JD, Walker PF, Angelo KM, Coyle C, Mohamud MA, Mwangi E, Haizel-Cobbina J, Nchanji C, Johnson RS, Ladze B, Dunlop SJ, Stauffer WM. Barriers to malaria prevention among immigrant travelers in the United States who visit friends and relatives in sub-Saharan Africa: A cross-sectional, multi-setting survey of knowledge, attitudes, and practices. PLoS One 2020; 15:e0229565. [PMID: 32163426 PMCID: PMC7067457 DOI: 10.1371/journal.pone.0229565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/10/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Despite achievements in the reduction of malaria globally, imported malaria cases to the United States by returning international travelers continue to increase. Immigrants to the United States from sub-Saharan Africa (SSA) who then travel back to their homelands to visit friends and relatives (VFRs) experience a disproportionate burden of malaria illness. Various studies have explored barriers to malaria prevention among VFRs and non-VFRs-travelers to the same destinations with other purpose for travel-but few employed robust epidemiologic study designs or performed comparative analyses of these two groups. To better quantify the key barriers that VFRs face to implement effective malaria prevention measures, we conducted a comprehensive community-based, cross-sectional, survey to identify differences in malaria prevention knowledge, attitudes, and practices (KAP) among VFRs and others traveling to Africa and describe the differences between VFRs and other types of international travelers. METHODS AND FINDINGS Three distinct populations of travelers with past or planned travel to malaria-endemic countries of SSA were surveyed: VFRs diagnosed with malaria as reported through a state health department; members of the general VFR population (community); and VFR and non-VFR travelers presenting to a travel health clinic, both before their pretravel consultation and again, after return from travel. A Community Advisory Board of African immigrants and prior qualitative research informed survey development and dissemination. Across the three groups, 489 travelers completed surveys: 351 VFRs and 138 non-VFRs. VFRs who reported taking antimalarials on their last trip rated their concern about malaria higher than those who did not. Having taken five or more trips to SSA was reported more commonly among VFRs diagnosed with malaria than community VFRs (44.0% versus 20.4%; p = 0.008). Among travel health clinic patients surveyed before and after travel, VFR travelers were less successful than non-VFRs in adhering to their planned use of antimalarials (82.2% versus 98.7%; p = 0.001) and employing mosquito bite avoidance techniques (e.g., using bed nets: 56.8% versus 81.8%; p = 0.009). VFRs who visited the travel health clinic were more likely than VFR respondents from the community to report taking an antimalarial (83.0% versus 61.9%; p = 0.009), or to report bite avoidance behaviors (e.g., staying indoors when mosquitoes were out: 80.9% versus 59.5%; p = 0.009). CONCLUSIONS We observed heterogeneity in malaria prevention behaviors among VFRs and between VFR and non-VFR traveler populations. Although VFRs attending the travel health clinic appear to demonstrate better adherence to malaria prevention measures than VFR counterparts surveyed in the community, specialized pretravel care is not sufficient to ensure chemoprophylaxis use and bite avoidance behaviors among VFRs. Even when seeking specialized pretravel care, VFRs experience greater barriers to the use of malaria prevention than non-VFRs. Addressing access to health care and upstream barrier reduction strategies that make intended prevention more achievable, affordable, easier, and resonant among VFRs may improve malaria prevention intervention effectiveness.
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Affiliation(s)
- Hannah R Volkman
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Emily J Walz
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St Paul, MN, United States of America
| | | | | | - Anne Frosch
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- Hennepin Healthcare, Minneapolis, MN, United States of America
| | | | - Patricia F Walker
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- HealthPartners Institute, Bloomington, MN, United States of America
| | - Kristina M Angelo
- Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Christina Coyle
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, United States of America
| | - Mimi A Mohamud
- Minnesota Department of Health, St Paul, MN, United States of America
| | - Esther Mwangi
- Minnesota Department of Health, St Paul, MN, United States of America
| | | | - Comfort Nchanji
- Minnesota Department of Health, St Paul, MN, United States of America
| | - Rebecca S Johnson
- Sierra Leone Community in Minnesota, Minneapolis, MN, United States of America
| | - Baninla Ladze
- Minnesota Cameroon Community, Minneapolis, MN, United States of America
| | - Stephen J Dunlop
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
- Hennepin Healthcare, Minneapolis, MN, United States of America
| | - William M Stauffer
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States of America
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Dicle M, Gorpelioglu S, Aypak C. Knowledge, Attitude and Behavior Levels of University Students About Hepatitis A, Hepatitis B and Hepatitis C. EURASIAN JOURNAL OF FAMILY MEDICINE 2019. [DOI: 10.33880/ejfm.2019080401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: The aim of this study is to reveal the knowledge, attitude and behaviors of the university students about Hepatitis A, Hepatitis B and Hepatitis C.
Methods: This study was done among 1048 students from different faculties of five different universities in Ankara, was carried out between October 2012 and July 2013. A questionnaire was prepared by the authors by rewieving the literature and the participants were asked to fill this questionnaire. Knowledge level of participants was scored from 1 to 5 out of 100 according to the answers given about Hepatitis A, B and C.
Results: When the average points of knowledge about hepatitis A, B and C is considered, it is seen that the knowledge points of males according to females and the knowledge points of the students who study in medical faculties according to the other faculties are higher. Participants were found to have a risky attitude with respect to the spread of Hepatitis A, B and C infections. While males had more risky behaviors, it was seen that there was no significant difference between the students of medical faculties according to other faculties.
Conclusion: Despite advances in technology and health, Hepatitis A, B and C infections continue to be an important public health problem today. This study showed that even university students, whose education and intellectual levels are considered to be high according to society, have low level of knowledge about viral hepatitis and exhibit risky attitudes and behaviors, necessity of individual and social education. The most effective way to protect against these diseases is to increase the knowledge and awareness levels of the society and prevent the transmission of these diseases.
Keywords: hepatitis, knowledge, attitude, behavior, vaccines
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Affiliation(s)
- Murat Dicle
- Department of Family Medicine, University of Health Sciences Dışkapı Training and Research Hospital
| | - Suleyman Gorpelioglu
- Department of Family Medicine, University of Health Sciences Dışkapı Training and Research Hospital
| | - Cenk Aypak
- Department of Family Medicine, University of Health Sciences Dışkapı Training and Research Hospital
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Akodu BA, Ogwu FO, Abiola AHO. Knowledge, attitude and compliance towards travel vaccines among Nigerian travellers at an international airport. Afr J Prim Health Care Fam Med 2019; 11:e1-e9. [PMID: 31714125 PMCID: PMC7081832 DOI: 10.4102/phcfm.v11i1.2063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/03/2019] [Accepted: 07/17/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The risk of contracting a travel-related disease does not only depend on the destination of travel and length of the trip, but also on the traveller's own health status. Travel vaccines avert the increase of communicable disease. Awareness of traveller's behaviours and their attitudes concerning infectious diseases can inform policy aimed at protecting the individual travellers, their contacts and the communities into which they travel. AIM This study on travel vaccine was aimed to determine the level of knowledge, attitude and compliance to travel vaccines. SETTING This study was conducted among Nigerian travellers at Murtala Mohammed International Airport, Ikeja, Nigeria. METHODS It was a cross-sectional descriptive study using systematic sampling technique, with the aid of interviewer-administered questionnaire to select 198 respondents for the study. The statistical software EPI-Info 7 was used for data analysis. RESULTS The mean age of respondents was 35.34 + 9.91 years and majority (58.1%) of the respondents were men. Majority (54.0%) were married and (43.4%) had tertiary education. About 35.9% were travelling to other African countries, 9.6% to Middle Eastern countries, 16.2% to Europe, 13.6% to North America and 7.6% to Australia. Their main purpose of travel was for employment or working (22.2%), business activities (20.7%), touring (16.2%) and visiting families and relatives (15.7%). About a half (41.4%) had good knowledge of travel vaccines, majority (83.8%) had positive attitude and majority (66.2%) had been vaccinated for yellow fever before travel. CONCLUSION Significant associations exist between tribe, religion, education and knowledge of travel vaccines.
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Affiliation(s)
- Babatunde A Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos.
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30
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Lee EH, Miller RH, Masuoka P, Schiffman E, Wanduragala DM, DeFraites R, Dunlop SJ, Stauffer WM, Hickey PW. Predicting Risk of Imported Disease with Demographics: Geospatial Analysis of Imported Malaria in Minnesota, 2010-2014. Am J Trop Med Hyg 2019; 99:978-986. [PMID: 30062987 PMCID: PMC6159573 DOI: 10.4269/ajtmh.18-0357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although immigrants who visit friends and relatives (VFRs) account for most of the travel-acquired malaria cases in the United States, there is limited evidence on community-level risk factors and best practices for prevention appropriate for various VFR groups. Using 2010–2014 malaria case reports, sociodemographic census data, and health services data, we explored and mapped community-level characteristics to understand who is at risk and where imported malaria infections occur in Minnesota. We examined associations with malaria incidence using Poisson and negative binomial regression. Overall, mean incidence was 0.4 cases per 1,000 sub-Saharan African (SSA)–born in communities reporting malaria, with cases concentrated in two areas of Minneapolis–St. Paul. We found moderate and positive associations between imported malaria and counts of SSA- and Asian-born populations, respectively. Our findings may inform future studies to understand the knowledge, attitudes, and practices of VFR travelers and facilitate and focus intervention strategies to reduce imported malaria in the United States.
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Affiliation(s)
- Elizabeth H Lee
- The Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Robin H Miller
- The Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Penny Masuoka
- The Henry M Jackson Foundation, Bethesda, Maryland.,The Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | | | - Robert DeFraites
- The Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Stephen J Dunlop
- University of Minnesota, Minneapolis, Minnesota.,Hennepin County Medical Center, Minneapolis, Minnesota
| | | | - Patrick W Hickey
- The Uniformed Services University of the Health Sciences, Bethesda, Maryland
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31
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Low adherence with national travel medicine recommendations in Belgian expatriate children: A retrospective analysis. Travel Med Infect Dis 2019; 32:101424. [PMID: 31085332 DOI: 10.1016/j.tmaid.2019.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/04/2019] [Accepted: 05/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Expatriates (expats) from European countries regularly migrate to low-income countries where infectious diseases are more prevalent. Little evidence exists however on pediatric expatriates' compliance with preventive measures related to infectious diseases. This study aims to evaluate compliance in Belgian expat-children. METHODS Data of 135 Belgian expat-children, visiting the Institute of Tropical Medicine (Antwerp, Belgium), were collected from clinical notes, laboratory results and from a web-based immunization-register. Information on routine vaccinations, yellow fever, hepatitis A, rabies, typhoid fever, meningococcal ACW135Y, Japanese encephalitis, BCG vaccine and anti-malaria chemoprophylaxis was collected. RESULTS Overall, 87% of expat-children were up-to-date with their routine vaccinations. Although all children were eligible for hepatitis A, typhoid and rabies vaccination, only 8-21% were fully vaccinated. Only 29 and 61% of eligible children were vaccinated against meningococcal (ACW135Y) or yellow fever respectively. Finally, only 10% of children who lived in malaria-endemic-areas, reported chemoprophylaxis-use. CONCLUSION Although routine vaccination coverage in expat-children seems adequate, additional preventive measures are often needed. Whether this is due to lack of high-quality health care-access, fear of side-effects or insufficient knowledge about the risks/available preventive measures, remains elusive. Nevertheless, expats seem to constitute a separate risk-group for infectious diseases and destination-related health issues.
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Economic impact of malaria-related hospitalizations in the United States, 2000-2014. J Infect Public Health 2019; 12:424-433. [PMID: 30630763 DOI: 10.1016/j.jiph.2018.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/08/2018] [Accepted: 11/28/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Despite its elimination in the early 1950s, about 1700 cases of malaria are reported in the US every year. Few studies have quantified the direct and indirect costs of imported malaria in the US. METHODS Disparities in the mean and total hospital days, hospital charges, and hospital costs for malaria-related hospitalizations in the US by demographic, clinical, species, financial, geographic, and institutional characteristics were examined using the 2000-2014 Nationwide Inpatient Sample (NIS). Trends and potential predictors for length of stay and hospital charges and costs were identified using negative binomial regression and linear regression, respectively. RESULTS From 2000 to 2014, 22,029 malaria cases resulted in 95,948 hospital days for malaria-related hospitalizations, $176,391,466 in total hospital costs, and $555,435,849 in total charges. Mean charges increased significantly over the study period. Males, Blacks, and patients aged 25-44years accounted for the highest direct and indirect costs. Older age and having severe malaria was associated with a longer length of stay. Older age, severe malaria, HIV infection, and longer lengths of stay were associated with higher charges and costs. CONCLUSIONS Malaria resulted in substantial direct and indirect costs in the US. Primary and secondary prevention measures should be prioritized among high-risk groups to reduce the economic burden.
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Pharmacy-Based Travel Health Services in the United States. PHARMACY 2018; 7:pharmacy7010005. [PMID: 30591674 PMCID: PMC6473888 DOI: 10.3390/pharmacy7010005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/09/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022] Open
Abstract
The aim of this paper is to review pharmacy laws and regulations, pharmacist training, clinic considerations, and patient care outcomes regarding pharmacy-based travel health services in the United States. Pharmacists and pharmacies in the United States are highly visible and accessible to the public, and have long been regarded as a source for immunization services. As international travel continues to increase and grow in popularity in this country, there is a pressing need for expanded access to preventative health services, including routine and travel vaccinations, as well as medications for prophylaxis or self-treatment of conditions that may be acquired overseas. In the United States, the scope of pharmacy practice continues to expand and incorporate these preventable health services to varying degrees on a state-by-state level. A literature review was undertaken to identify published articles on pharmacist- or pharmacy-based travel health services or care in the United States. The results of this paper show that pharmacists can help to increase access to and awareness of the need for these services to ensure that patients remain healthy while traveling abroad, and that they do not acquire a travel-related disease while on their trip. For those pharmacists interested in starting a travel health service, considerations should be made to ensure that they have the necessary training, education, and skill set in order to provide this specialty level of care, and that their practice setting is optimally designed to facilitate the service. While there is little published work available on pharmacy or pharmacist-provided travel health services in the United States, outcomes from published studies are positive, which further supports the role of the pharmacist in this setting.
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Heslop IM, Speare R, Bellingan M, Glass BD. Australian Pharmacists' Perceptions and Practices in Travel Health. PHARMACY 2018; 6:pharmacy6030090. [PMID: 30135400 PMCID: PMC6165192 DOI: 10.3390/pharmacy6030090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/14/2018] [Accepted: 08/20/2018] [Indexed: 11/27/2022] Open
Abstract
Worldwide, pharmacists are playing an increasing role in travel health, although legislation and funding can dictate the nature of this role, which varies from country to country. The aim of this study was to explore the current and potential future practices in travel health for pharmacists in Australia, as well as the perceived barriers, including training needs, for the provision of services. A survey was developed and participation was sought from a representative sample of Australian pharmacists, with descriptive statistics calculated to summarise the frequency of responses. A total of 255 participants, predominantly female (69%), below 50 years (75%) and registered less than 30 years completed the survey. Although over two-thirds (68%) provided travel-related advice in their current practice, the frequency of advice provision was low (less than 2 travellers per week) and limited to responding to travellers questions. Although Australian pharmacists are currently unable to administer travel vaccines and prescription only medications without prescription, they still consider travel health to be an appropriate role and that their clients would seek travel health advice from pharmacies if offered. Currently, key roles for Australian pharmacists are advising travellers who do not seek advice from other practitioners, reinforcing the advice of other health practitioners and referring travellers needing vaccinations and antimalarials. In order to expand these services, the barriers of workload, time, staffing and the need for training in travel health need to be addressed. In summary, the travel health services provided by pharmacies in Australia still have a way to go before they match the services offered by pharmacies in some other countries, however Australian pharmacist are keen to further develop their role in this area.
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Affiliation(s)
- Ian M Heslop
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
| | - Richard Speare
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia.
| | - Michelle Bellingan
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
| | - Beverley D Glass
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia.
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Schultz JS, Atherly AJ, Henao-Martínez AF. A Deadly Wait for U.S. Health Insurance Coverage-Sitting on the Couch with Malaria. Am J Trop Med Hyg 2018; 99:24-26. [PMID: 29761755 DOI: 10.4269/ajtmh.18-0010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care. He also had limited access to affordable pretravel consultation and prophylactic medications and did not take them because he had no insurance. Average fees for a malaria hospitalization cost $25,789; however, this patient accumulated fees nearing $300,000-and his care was reimbursed by emergency Medicaid with $39,000, because his newly accepted insurance did not cover his hospitalization. This patients' experience in the U.S. health-care system with a deadly tropical disease exemplifies the need for affordable universal coverage of pretravel consultation and malaria prophylaxis. In this uncertain political time and the recent removal of the health insurance mandate, along with the White House and Congress wanting to reform health care, this case supports the American Society of Tropical Medicine and Hygiene (ASTMH) statements showing the need for funding of tropical medicine education, research, and public health services for travelers, not cuts to important agencies and insurances that keep our country safe from imported deadly tropical diseases.
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Affiliation(s)
- Jonathan S Schultz
- Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Denver, Aurora, Colorado.,Department of Internal Medicine, University of Colorado School of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Adam J Atherly
- Department of Health Systems, Management and Policy, School of Public Health, University of Colorado Denver, Aurora, Colorado
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Aurora, Colorado
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Aziz MM, Abd El-Megeed HS, Abd Ellatif MAM. Pre-travel health seeking practices of Umrah pilgrims departing from Assiut International Airport, Egypt. Travel Med Infect Dis 2018; 23:72-76. [PMID: 29689385 DOI: 10.1016/j.tmaid.2018.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/12/2018] [Accepted: 04/20/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES to assess the health seeking practices and their determinants among Umrah pilgrims departing from Assiut international Airport. METHODS We interviewed 300 pilgrims departing from Assiut International Airport while they were in the departure lounge, using a semi-structured questionnaire. RESULTS Only 60%, 46.3% and 46.3% of Umrah pilgrims believed in importance of pre-travel vaccination, seeking health information, and health examination, respectively. The most frequently practiced pre-travel health related behaviour was getting vaccinated (56.3%), as compared to much lower frequencies of seeking health information (24%) or having a clinical health examination (26.7%). Private clinics, internet and the tourism companies were the main sources of health information of the pilgrims. Positive attitude of pilgrims about health seeking practices, the perception of health risk of travelling to Hajj/Umrah and having a chronic disease were the predictors of pre-travel health practices. CONCLUSION Raising awareness among Hajj/Umrah pilgrims about the importance of seeking professional pre-travel health advice and communicating the risk of exposure to travel-related diseases to pilgrims could be important strategies to improve the uptake of preventive measures. Training of general practitioners in the public health sector about the travel health information would promote the travel health services.
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Affiliation(s)
- Mirette M Aziz
- Department of Public Health & Community Medicine, Assiut University, Egypt.
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37
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Houle SKD. Pharmacy travel health services: current perspectives and future prospects. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2018; 7:13-20. [PMID: 29721445 PMCID: PMC5919161 DOI: 10.2147/iprp.s142982] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers' diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.
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Hsu SH, Huang HL, Lu CW, Cheng SY, Lee LT, Chiu TY, Huang KC. Tour leaders with detailed knowledge of travel-related diseases play a key role in disease prevention. Medicine (Baltimore) 2018; 97:e9806. [PMID: 29419678 PMCID: PMC5944686 DOI: 10.1097/md.0000000000009806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In Taiwan, group tours are a popular mode of international travel; hence, group tour leaders must ensure traveler safety and health. This study identified factors influencing tour leaders' willingness to recommend pretravel medical consultation and vaccination.A cross-sectional questionnaire survey was administered to tour leaders from January 2011 to December 2012. Multivariate logistic regression analyses were performed to estimate the odds ratios of having a positive attitude and willingness based on different knowledge scores of the tour leaders after adjustments for age, sex, education level, and seniority.Tour leaders with a more detailed knowledge of both travel-related infectious and noninfectious diseases demonstrated a higher willingness to receive vaccination. They believed that consultation at travel clinics before travel can improve travelers' health (P < .05).This study supports the importance and effectiveness on educating tour leaders' knowledge about travel-related diseases to improve health care for travelers.
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Affiliation(s)
- Shu-Hua Hsu
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | | | - Chia-Wen Lu
- Department of Family Medicine, National Taiwan University Hospital
| | - Shao-Yi Cheng
- Department of Family Medicine, National Taiwan University Hospital
| | - Long-Teng Lee
- Department of Family Medicine, National Taiwan University Hospital
| | - Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei
| | - Kuo-Chin Huang
- Department of Family Medicine, National Taiwan University Hospital
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei
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Hurley-Kim K, Snead R, Hess KM. Pharmacists' scope of practice in travel health: cregulations. J Am Pharm Assoc (2003) 2018; 58:163-167.e2. [PMID: 29342432 DOI: 10.1016/j.japh.2017.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The primary objective of this study was to assess pharmacists' authority to provide travel health services in each state and Washington, DC. Secondary objectives were to determine the need for collaborative practice agreements (CPAs), protocols, or prescriptions for this type of pharmacy practice and to identify jurisdictions where pharmacists are able to practice as travel health providers independent of CPAs or individual physician protocols. METHODS An online survey was developed to assess pharmacists' authority to administer travel immunizations, furnish travel-related medications, and order travel-related laboratory tests. Open-ended items on scope of practice, training requirements, and pending legislation or regulations were also included. The survey was distributed to state pharmacy association executives. A member of the research team searched pharmacy laws to clarify missing or inconsistent responses. Data were analyzed using descriptive statistics. RESULTS The survey response rate was 76.5% (n = 39). Missing (n = 12) or conflicting (n = 6) response issues were resolved. Thus, data were available for 100% of jurisdictions. In most jurisdictions, pharmacists were able to provide one or more components of this service. In 44 jurisdictions (86.3%), pharmacists were allowed to administer travel immunizations. Twenty-seven jurisdictions (52.9%) allowed pharmacists to furnish travel medications. Pharmacists in 23 jurisdictions (43.1%) could order travel health-related laboratory tests. Pharmacists can practice independently in 1 state, but CPAs or individual physician protocols are required elsewhere. CONCLUSIONS To the authors' knowledge, this study represents the first national pharmacists' travel health scope-of-practice analysis. While pharmacists in many jurisdictions can provide some components of travel health services, only one, New Mexico, currently allows pharmacists to practice all aspects independently. Thus, pharmacists continue to have an opportunity to expand scope of practice in travel health. Additional research may help to drive increased access to and use of travel health care.
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40
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Winnicka L, Abdullah A, Yang T, Norville K, Irizarry-Acosta M. Yellow Fever in an Unvaccinated Traveler to Peru. Open Forum Infect Dis 2017; 4:ofx205. [PMID: 29308400 PMCID: PMC5740984 DOI: 10.1093/ofid/ofx205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 11/16/2017] [Indexed: 11/29/2022] Open
Abstract
We present a case of an unvaccinated traveler who traveled from New York to Peru and contracted yellow fever. He likely acquired the infection while visiting the Amazon River, with a point of exit of Lima, Peru. Our case illustrates the dramatic course that yellow fever may take, as well as the importance of pretravel vaccination.
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Affiliation(s)
- Lydia Winnicka
- Department of Internal Medicine, Guthrie Clinic, Sayre, Pennsylvania
| | | | - Tsujung Yang
- Department of Internal Medicine, Guthrie Clinic, Sayre, Pennsylvania
| | - Kim Norville
- Department of Internal Medicine, Guthrie Clinic, Sayre, Pennsylvania
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41
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42
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Torresi J, Steffen R. Redefining priorities towards graded travel-related infectious disease research. J Travel Med 2017; 24:4359791. [PMID: 29088486 DOI: 10.1093/jtm/tax064] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Indexed: 01/01/2023]
Abstract
Our knowledge of the health problems and infections encountered by international travellers has evolved considerably in the past decades. The growth of global networks such as the GeoSentinel Surveillance network, TropNet Europe, EuroTravNet and networks based in North America have provided valuable information on the frequency of a wide array of travel-related diseases and accidents, including details on the destination of travel and trends over time. The information gained from these network studies has provided important data for the practice of travel medicine and in some instances for the development of practice guidelines. However, network data due to a lack of denominators usually cannot serve as a basis for a GRADE approach to guideline development. Although epidemiological network studies will continue to serve an important role in travel medicine we encourage an additional strong focus towards translational scientific research questions and towards the broader use of novel techniques to obtain more accurate epidemiological analyses to address the many unanswered questions in our field.
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Affiliation(s)
- Joseph Torresi
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Division of Communicable Diseases, WHO Collaborating Centre for Travellers' Health, University of Zurich, Zurich, Switzerland.,Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA
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43
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Paudel P, Raina C, Zwar N, Seale H, Worth H, Sheikh M, Heywood AE. Risk activities and pre-travel health seeking practices of notified cases of imported infectious diseases in Australia. J Travel Med 2017; 24:3954790. [PMID: 28931134 DOI: 10.1093/jtm/tax044] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND Travellers are at risk of acquiring infectious diseases during travel, with risks differing by destination, travel and traveller characteristics. A pre-travel health consultation may minimize this risk. However, uptake of pre-travel health advice remains low. We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia. METHODS Prospective enhanced surveillance of notified cases of typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014. Details of pre-travel health preparation and disease-specific risk behaviours were collected. RESULTS Among 180 cases associated with international travel, 28% were <18 years, 65% were VFR travellers and 22% were frequent travellers, having travelled ≥5 times in the past 5 years. 25% had sought pre-travel advice from a healthcare provider, and 16% reported a pre-travel vaccine. Seeking pre-travel health advice did not differ by immigrant status ( P = 0.22) or by reason for travel ( P = 0.13) but was more commonly sought by first time travellers ( P = 0.03). Travellers visiting friends and relatives were more likely to report at-risk activities of brushing teeth with tap water ( P < 0.001) and eating uncooked food ( P = 0.03) during travel compared to other travellers. CONCLUSIONS Pre-travel health advice seeking practices and vaccine uptake was suboptimal among cases of notified disease. The results of this study highlight the need for a better understanding of barriers to pre-travel health seeking, particularly among high risk travellers, to reduce the importation of infectious diseases into Australia.
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Affiliation(s)
- Prakash Paudel
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
| | - C Raina
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
| | - Nicholas Zwar
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
| | - Heather Worth
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
| | - Mohamud Sheikh
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
| | - Anita E Heywood
- School of Public Health and Community Medicine, UNSW Sydney, Sydney, New South Wales 2052, Australia
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Khuu D, Eberhard ML, Bristow BN, Javanbakht M, Ash LR, Shafir SC, Sorvillo FJ. Malaria-Related Hospitalizations in the United States, 2000-2014. Am J Trop Med Hyg 2017; 97:213-221. [PMID: 28719326 DOI: 10.4269/ajtmh.17-0101] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Few data are available on the burden of malaria hospitalization in the United States. Study of malaria using hospital-based data can better define the impact of malaria and help inform prevention efforts. U.S. malaria cases identified from hospitalization discharge records in the 2000-2014 Nationwide Inpatient Sample were examined. Frequencies and population rates were reported by demographics, infecting species, clinical, financial, institutional, geographic, and seasonal characteristics, and disparities were identified. Time trends in malaria cases were assessed using negative binomial regression. From 2000 to 2014, there were an estimated 22,029 malaria-related hospitalizations (4.88 per 1 million population) in the United States, including 182 in-hospital deaths and 4,823 severe malaria cases. The rate of malaria-related hospitalizations did not change significantly over the study period. The largest number of malaria-related hospitalizations occurred in August. Malaria-related hospitalizations occurred disproportionately among patients who were male, black, or 25-44 years of age. Plasmodium falciparum accounted for the majority of malaria-related hospitalizations. On average, malaria patients were hospitalized for 4.36 days with charges of $25,789. Patients with a malaria diagnosis were more often hospitalized in the Middle Atlantic and South Atlantic census divisions, urban teaching, private not-for-profit, and large-bed-size hospitals. Malaria imposes a substantial disease burden in the United States. Enhanced primary and secondary prevention measures, including strategies to increase the use of pretravel consultations and prompt diagnosis and treatment are needed.
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Affiliation(s)
- Diana Khuu
- Research, Epidemiology, and Evaluation Unit, Clinical Services and Research Branch, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, Alhambra, California.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Mark L Eberhard
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Benjamin N Bristow
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Lawrence R Ash
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Shira C Shafir
- TOMS Shoes, LLC, Los Angeles, California.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Frank J Sorvillo
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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Muehlenbein MP. Primates on display: Potential disease consequences beyond bushmeat. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2017; 162 Suppl 63:32-43. [PMID: 28105720 DOI: 10.1002/ajpa.23145] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 11/11/2022]
Abstract
Human interactions with nonhuman primates vary tremendously, from daily cultural engagements and food commodities, to pet ownership and tourist encounters. These interactions provide opportunities for the exchange of pathogenic organisms (both zoonoses and anthroponoses). As exposures are not limited to areas where bushmeat usage continues to be a major problem, we must work to understand better our motivations for engaging in activities like owning primates as pets and having direct physical contact with wild primates within the context of nature-based tourism. These topics, and the theoretical potential for pathogen transmission, are reviewed in the present manuscript. This is followed by a case study utilizing 3845 survey responses collected from four international locations known for primate-based tourism, with results indicating that while a majority of people understand that they can give/get diseases to/from wild primates, a surprising percentage would still touch or feed these animals if given the opportunity. Many people still choose to touch and/or own primates, as their drive to bond with animals outweighs some basic health behaviors. Desires to tame, control, or otherwise establish emotional connections with other species, combined with the central role of touch for exploring our environment, necessitate the development of better communication and educational campaigns to minimize risks of emerging infectious diseases.
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Mahadevan SV, Strehlow MC. Preparing for International Travel and Global Medical Care. Emerg Med Clin North Am 2017; 35:465-484. [DOI: 10.1016/j.emc.2017.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hamer DH, MacLeod WB, Chen LH, Hochberg NS, Kogelman L, Karchmer AW, Ooi WW, Benoit C, Wilson ME, Jentes ES, Barnett ED. Pretravel Health Preparation of International Travelers: Results From the Boston Area Travel Medicine Network. Mayo Clin Proc Innov Qual Outcomes 2017; 1:78-90. [PMID: 30225404 PMCID: PMC6135027 DOI: 10.1016/j.mayocpiqo.2017.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective To inform future interventions for advising travelers. Patients and Methods We prospectively collected data on travelers seen at the Boston Area Travel Medicine Network, a Boston area research collaboration of 5 travel medicine clinics. Data from 15,440 travelers were collected from March 1, 2008, through July 31, 2010. We compared traveler and trip characteristics and differences in demographic characteristics and travel plans across the 5 clinics, including an analysis of pretravel preparations for certain high-risk destinations. Results More than half of the 15,440 travelers were female (8730 [56.5]), and 72.4% (10,528 of 14,545) were white; the median age was 34 years, and 29.4% of travelers (3077 of 10,483) were seen less than 2 weeks before their departure date. Substantial variation in racial background, purpose of travel, and destination risk existed across the 5 clinics. For example, the proportion of travelers visiting friends and relatives ranged from 7.6% (184 of 2436) to 39.0% (1029 of 2639) (18.7% [2876 of 15,360] overall), and the percentage of travelers to areas with malaria risk ranged from 23.7% (333 of 1403) to 52.0% (1306 of 2512). Although most clinics were likely to have prescribed certain vaccines for high-risk destinations (eg, yellow fever for Ghana travel), there was wide variability in influenza vaccine use for China travel. Conclusion Substantial differences in clinic populations can occur within a single metropolitan area, highlighting why individual physicians and travel clinics need to understand the specific needs of the travelers they serve in addition to general travel medicine.
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Affiliation(s)
- Davidson H Hamer
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA.,Department of Global Health, Boston University School of Public Health, Boston, MA.,Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - William B MacLeod
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA.,Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Lin H Chen
- Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA.,Harvard Medical School, Boston, MA
| | - Natasha S Hochberg
- Department of Epidemiology, Boston University School of Public Health, Boston, MA.,Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Laura Kogelman
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA
| | - Adolf W Karchmer
- Harvard Medical School, Boston, MA.,Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA
| | - Winnie W Ooi
- Travel and Tropical Medicine Clinic, Lahey Clinic, Burlington, MA
| | - Christine Benoit
- Department of Research and Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN
| | - Mary E Wilson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Emily S Jentes
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth D Barnett
- Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA
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Abstract
Importance Travel among US citizens is becoming increasingly common, and travel during pregnancy is also speculated to be increasingly common. During pregnancy, the obstetric provider may be the first or only clinician approached with questions regarding travel. Objective In this review, we discuss the reasons women travel during pregnancy, medical considerations for long-haul air travel, destination-specific medical complications, and precautions for pregnant women to take both before travel and while abroad. To improve the quality of pretravel counseling for patients before or during pregnancy, we have created 2 tools: a guide for assessing the pregnant patient's risk during travel and a pretravel checklist for the obstetric provider. Evidence Acquisition A PubMed search for English-language publications about travel during pregnancy was performed using the search terms "travel" and "pregnancy" and was limited to those published since the year 2000. Studies on subtopics were not limited by year of publication. Results Eight review articles were identified. Three additional studies that analyzed data from travel clinics were found, and 2 studies reported on the frequency of international travel during pregnancy. Additional publications addressed air travel during pregnancy (10 reviews, 16 studies), high-altitude travel during pregnancy (5 reviews, 5 studies), and destination-specific illnesses in pregnant travelers. Conclusions and Relevance Travel during pregnancy including international travel is common. Pregnant travelers have unique travel-related and destination-specific risks. We review those risks and provide tools for obstetric providers to use in counseling pregnant travelers.
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Thomson CA, Gibbs RA, Heyworth JS, Giele C, Firth MJ, Effler PV. Pretravel Health Advice Among Australians Returning From Bali, Indonesia: A Randomized Controlled Trial Protocol. JMIR Res Protoc 2016; 5:e236. [PMID: 27927608 PMCID: PMC5177736 DOI: 10.2196/resprot.6549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/19/2016] [Accepted: 10/22/2016] [Indexed: 11/24/2022] Open
Abstract
Background The effect of pretravel health advice (PTHA) on travel-related illness rates is poorly understood, and to date there are no published randomized controlled trials evaluating the impact of PTHA outcomes. Objective This study aims to determine the effect of an online PTHA intervention on travel-related illness rates in Western Australians visiting Bali, Indonesia. Methods Western Australian travelers to Bali will be recruited online before departure and will be randomly allocated to an intervention or control group by computer algorithm. The intervention in this study is a short animated video, with accompanying text, containing PTHA relevant to Bali. An online posttravel survey will be administered to all participants within two weeks of their return from Bali. The primary outcome is the difference in self-reported travel-related illness rates between control and intervention groups. Secondary outcomes include the difference in risk prevention behaviors and health risk knowledge between the control and intervention groups. Further secondary outcomes include whether individuals in the control group who sought external PTHA differ from those who did not with respect to risk prevention behaviors, health risk knowledge, and health risk perception, as well as the rate of self-reported travel-related illness. Results The study began recruitment in September 2016 and will conclude in September 2017. Data analysis will take place in late 2017, with results disseminated via peer-reviewed journals in early 2018. Conclusions This will be the first randomized controlled trial to examine the effect of a novel PTHA intervention upon travel-related illness. In addition, this study builds upon the limited existing data on the effectiveness of PTHA on travel-related illness. ClinicalTrial Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12615001230549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369567 (Archived by WebCite at http://www.webcitation.org/6m0G7xJg1)
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Affiliation(s)
- Chloe A Thomson
- School of Population Health, Faculty of Medicine and Dentistry, The University of Western Australia, Perth, Australia.,Communicable Disease Control Directorate, Department of Health, Western Australian Government, Perth, Australia
| | - Robyn A Gibbs
- Communicable Disease Control Directorate, Department of Health, Western Australian Government, Perth, Australia
| | - Jane S Heyworth
- School of Population Health, Faculty of Medicine and Dentistry, The University of Western Australia, Perth, Australia
| | - Carolien Giele
- Communicable Disease Control Directorate, Department of Health, Western Australian Government, Perth, Australia
| | - Martin J Firth
- Centre for Applied Statistics, School of Mathematics and Statistics, The University of Western Australia, Perth, Australia
| | - Paul V Effler
- Communicable Disease Control Directorate, Department of Health, Western Australian Government, Perth, Australia.,School of Pathology and Laboratory Medicine, Faculty of Medicine and Dentistry, The University of Western Australia, Perth, Australia
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Chen LH, Han PV, Wilson ME, Stoney RJ, Jentes ES, Benoit C, Ooi WW, Barnett ED, Hamer DH. Self-reported illness among Boston-area international travelers: A prospective study. Travel Med Infect Dis 2016; 14:604-613. [PMID: 27687076 PMCID: PMC5695040 DOI: 10.1016/j.tmaid.2016.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 09/14/2016] [Accepted: 09/16/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND The Boston Area Travel Medicine Network surveyed travelers on travel-related health problems. METHODS Travelers were recruited 2009-2011 during pre-travel consultation at three clinics. The investigation included pre-travel data, weekly during-travel diaries, and a post-travel questionnaire. We analyzed demographics, trip characteristics, health problems experienced, and assessed the relationship between influenza vaccination, influenza prevention advice, and respiratory symptoms. RESULTS Of 987 enrolled travelers, 628 (64%) completed all surveys, of which 400 (64%) reported health problems during and/or after travel; median trip duration was 12 days. Diarrhea affected the most people during travel (172) while runny/stuffy nose affected the most people after travel (95). Of those with health problems during travel, 25% stopped or altered plans; 1% were hospitalized. After travel, 21% stopped planned activities, 23% sought physician or other health advice; one traveler was hospitalized. Travelers who received influenza vaccination and influenza prevention advice had lower rates of respiratory symptoms than those that received influenza prevention advice alone (18% vs 28%, P = 0.03). CONCLUSIONS A large proportion of Boston-area travelers reported health problems despite pre-travel consultation, resulting in inconveniences. The combination of influenza prevention advice and influenza immunization was associated with fewer respiratory symptoms than those who received influenza prevention advice alone.
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Affiliation(s)
- Lin H Chen
- Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Pauline V Han
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary E Wilson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rhett J Stoney
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily S Jentes
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christine Benoit
- Children's Hospitals and Clinics of Minnesota, Department of Research and Sponsored Programs, Minneapolis, MN, USA
| | - Winnie W Ooi
- Travel and Tropical Medicine Clinic, Lahey Clinic Medical Center, Burlington, MA, USA
| | - Elizabeth D Barnett
- Maxwell Finland Laboratory for Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Davidson H Hamer
- Center for Global Health and Development, Boston University School of Public Health, Boston, MA, USA; Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA.
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