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Nopiyani NMS, Januraga PP, Wirawan IMA, Bakta IM. Comprehensive Travel Health Education for Tour Guides: Protocol for an Exploratory Sequential Mixed Methods Research. JMIR Res Protoc 2022; 11:e33840. [PMID: 35604754 PMCID: PMC9171602 DOI: 10.2196/33840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Tourists are at risk of experiencing health problems during their travel. However, even though tour guides have the potential to become travel health promoters, their participation has not been optimal.
Objective
This study aims to develop a comprehensive travel health education model to help tour guides improve health information delivery to tourists.
Methods
This is an exploratory sequential mixed methods research. The first phase consisted of a qualitative study with an informed grounded theory design. In-depth interviews were carried out with tour guides from all language divisions and policymakers of the Indonesian Tour Guide Association Bali Branch or Himpunan Pramuwisata Indonesia Daerah Bali (HPI Bali). The interview guidelines were developed based on the theory of planned behavior and identity theory. Qualitative data were analyzed thematically. In the interim phase, a travel health education model and questionnaire were developed based on the qualitative findings. The initial model and its instruments were finetuned after consultation with travel medicine and health promotion experts. Furthermore, the validity and reliability of the questionnaire were tested on 30 tour guides. The second phase consisted of a quantitative study with a randomized pretest-posttest control group design. A total of 76 tour guides in the intervention group received comprehensive travel health education, while 76 in the control group received no specific intervention. Outcome variables (ie, attitudes, subjective norms, perceived behavioral control, actual behavioral control, role identity, and behavioral intention) were measured at baseline (T0), after the online training (T1), before information sharing via WhatsApp (T2), a month after the start of the WhatsApp intervention (T3), and at the end of the WhatsApp intervention (T4). The mean difference of each outcome variable before and after the intervention will be compared between the intervention and control groups. Thereafter, the quantitative and qualitative findings will be integrated into a joint display.
Results
The qualitative phase was conducted through in-depth interviews with 21 informants who included tour guides and policymakers from HPI Bali from May to June 2021. The education model, educational materials, and questionnaire were developed based on the qualitative findings and consultation with experts. The education model consists of online training and information sharing through WhatsApp and was trialed with tour guides from November 2021 to February 2022. As of April 2022, this study is in the quantitative data analysis stage.
Conclusions
A travel health education model was developed based on qualitative findings and consultation with experts. The model was tested with tour guides, and a series of self-administered questionnaires were completed. This study is in the quantitative data analysis stage and will continue by integrating qualitative and quantitative findings into a joint display.
Trial Registration
ClinicalTrials.gov NCT04961983; https://clinicaltrials.gov/ct2/show/NCT04961983
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Affiliation(s)
- Ni Made Sri Nopiyani
- Doctoral Program of Medical Sciences, Faculty of Medicine, Udayana University, Denpasar, Indonesia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Pande Putu Januraga
- Doctoral Program of Medical Sciences, Faculty of Medicine, Udayana University, Denpasar, Indonesia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - I Md Ady Wirawan
- Doctoral Program of Medical Sciences, Faculty of Medicine, Udayana University, Denpasar, Indonesia
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - I Made Bakta
- Doctoral Program of Medical Sciences, Faculty of Medicine, Udayana University, Denpasar, Indonesia
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Ren J, Chen Z, Ling F, Huang Y, Gong Z, Liu Y, Mao Z, Lin C, Yan H, Shi X, Zhang R, Guo S, Chen E, Wang Z, Sun J. Epidemiology of Indigenous Dengue Cases in Zhejiang Province, Southeast China. Front Public Health 2022; 10:857911. [PMID: 35493348 PMCID: PMC9046573 DOI: 10.3389/fpubh.2022.857911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Autochthonous transmission of the dengue virus (DENV) occurred each year from 2014 to 2018 in Zhejiang province, and became an emerging public health problem. We characterized the autochthonous transmission of the DENV and traced the source of infection for further control and prevention of dengue. Methods Descriptive and spatiotemporal cluster analyses were conducted to characterize the epidemiology of autochthonous transmission of the DENV. Molecular epidemiology was used to identify the infection source. Results In total, 1,654 indigenous cases and 12 outbreaks, with no deaths, were reported during 2004-2018. Before 2017, all outbreaks occurred in suburban areas. During 2017-2018, five out of eight outbreaks occurred in urban areas. The median duration of outbreaks (28 days) in 2017-2018 was shortened significantly (P = 0.028) in comparison with that in 2004-2016 (71 days). The median onset-visiting time, visiting-confirmation time, and onset-confirmation time was 1, 3, and 4 days, respectively. The DENV serotypes responsible for autochthonous transmission in Zhejiang Province were DENV 1, DENV 2, and DENV 3, with DENV 1 being the most frequently reported. Southeast Asia was the predominant source of indigenous infection. Conclusions Zhejiang Province witnessed an increase in the frequency, incidence, and geographic expansion of indigenous Dengue cases in recent years. The more developed coastal and central region of Zhejiang Province was impacted the most.
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Affiliation(s)
- Jiangping Ren
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
- Zhejiang Provincial Station of Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Hangzhou, China
| | - Zhiping Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Feng Ling
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
- Zhejiang Provincial Station of Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Hangzhou, China
| | - Yangmei Huang
- Hangzhou Municipal Center for Disease Control and Prevention, Hangzhou, China
| | - Zhenyu Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
| | - Ying Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhiyuan Mao
- Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Chunping Lin
- The Center for Disease Control and Prevention of Huangyan District, Taizhou, China
| | - Hao Yan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuguang Shi
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rong Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Song Guo
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Enfu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
- Zhejiang Provincial Station of Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Hangzhou, China
| | - Zhen Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Hangzhou, China
- Zhejiang Provincial Station of Emerging Infectious Disease Control and Prevention, Chinese Academy of Medical Sciences, Hangzhou, China
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Imported arboviral infections in New Zealand, 2001 to 2017: A risk factor for local transmission. Travel Med Infect Dis 2021; 41:102047. [PMID: 33819569 DOI: 10.1016/j.tmaid.2021.102047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/14/2020] [Accepted: 03/29/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND/AIMS Over the last decade and following international trends, cases of mosquito-borne arboviral infections, notably dengue fever, chikungunya and Zika, have increased among travellers arriving in New Zealand, but no locally acquired cases have been identified. Imported cases are characterised and examined to identify trends and features that might assist in reducing transmission risk from travellers. METHODS Information on traveller arrivals, notified cases and risk factors for disease acquisition were obtained from national sources. Trends in importation rates, seasonality are described and relationships of notifications with traveller arrivals were examined with a negative binomial regression model. RESULTS There was a significant increase in dengue notifications combined with the emergence of Zika and chikungunya. Most notifications were from arrivals in Auckland from Pacific Islands during summer and early autumn. CONCLUSION/IMPLICATIONS Overseas travel from New Zealand, particularly to the Pacific Islands and Southeast Asia, involves a risk of arboviral infection. The repeated introduction of arboviruses to New Zealand also increases the risk of local transmission in a country that has vector capable and vector potential mosquitoes, as well as an increasingly suitable climate for new vectors to establish.
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Abstract
PURPOSE OF REVIEW Societal lockdowns in response to the COVID-19 pandemic have led to unprecedented disruption to daily life across the globe. A collateral effect of these lockdowns may be a change to transmission dynamics of a wide range of infectious diseases that are all highly dependent on rates of contact between humans. With timing, duration and intensity of lockdowns varying country-to-country, the wave of lockdowns in 2020 present a unique opportunity to observe how changes in human contact rates, disease control and surveillance affect dengue virus transmission in a global natural experiment. We explore the theoretical basis for the impact of lockdowns on dengue transmission and surveillance then summarise the current evidence base from country reports. RECENT FINDINGS We find considerable variation in the intensity of dengue epidemics reported so far in 2020 with some countries experiencing historic low levels of transmission while others are seeing record outbreaks. Despite many studies warning of the risks of lockdown for dengue transmission, few empirically quantify the impact and issues such as the specific timing of the lockdowns and multi-annual cycles of dengue are not accounted for. In the few studies where such issues have been accounted for, the impact of lockdowns on dengue appears to be limited. SUMMARY Studying the impact of lockdowns on dengue transmission is important both in how we deal with the immediate COVID-19 and dengue crisis, but also over the coming years in the post-pandemic recovery period. It is clear lockdowns have had very different impacts in different settings. Further analyses might ultimately allow this unique natural experiment to provide insights into how to better control dengue that will ultimately lead to better long-term control.
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Affiliation(s)
- Oliver Brady
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Annelies Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
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Thevarajan I, Torresi J, Simmons C. Exploring the role of a recently licensed dengue vaccine in Australian travellers. Med J Aust 2020; 212:102-103.e1. [PMID: 31909484 DOI: 10.5694/mja2.50471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Irani Thevarajan
- Victorian Infectious Diseases Services, Melbourne.,Doherty Institute, Melbourne
| | | | - Cameron Simmons
- Institute of Vector-Borne Diseases, Monash University, Melbourne
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