#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Preventive measures, risk behaviour and the most common health problems in Czech travellers: a prospective questionnaire study in post-travel clinic outpatients


Authors: V. Grebenyuk 1,2;  J. Lhoťan 2;  T. Rudová 2;  L. Richterová 3,4,5;  H. Roháčová 2;  F. Stejskal 1,2,6,7;  M. Trojánek 1,2,8
Authors‘ workplace: Klinika infekčních nemocí, 2. lékařská fakulta, Univerzita Karlova, Praha 1;  Klinika infekčních, parazitárních a tropických nemocí, Nemocnice Na Bulovce, Praha 2;  Oddělení klinické mikrobiologie, Nemocnice Na Bulovce, Praha 3;  Klinika infekčních a tropických nemocí, 1. lékařská fakulta, Univerzita Karlova, Praha 4;  Ústav laboratorní diagnostiky, 3. lékařská fakulta, Univerzita Karlova, Praha 5;  Ústav imunologie a mikrobiologie, 1. lékařská fakulta, Univerzita Karlova, Praha 6;  Infekční oddělení, Krajská nemocnice Liberec, Liberec 7;  Katedra infekčního lékařství, IPVZ, Praha 8
Published in: Epidemiol. Mikrobiol. Imunol. 70, 2021, č. 1, s. 32-41
Category: Original Papers

Overview

Objective: The aim of this study was to evaluate attitudes towards the available preventive measures, risk behaviour and health problems in Czech travellers to tropical and subtropical regions.

Materials and methods: The prospective study included patients of all ages with a history of recent travel to risky countries who presented to the post-travel clinic of the Hospital Na Bulovce in Prague within two months after return, from February 2009 to June 2018. The data were collec­ted through a questionnaire survey and from electronic medical records.

Results: Nine hundred and thirty-four patients (473 M and 461 F, age median of 32 years, IQR 27-39) participated in the study. The most frequent destinations were South-East Asia (332; 35.5%), South Asia (176, 18.8%), and Sub-Saharan Africa (172; 18.4%). The most common reasons for tra­vel were tourism (772; 82.7%) and business (111; 11.9%). An underlying chronic disease was reported by 317 patients (33.9%). Pre-travel health consultation was sought by 415 travellers (44.4%); however, only 312 (33.4%) of the respondents were properly vaccinated. Preventive malaria chemoprophylaxis was indicated in a total of 151 travellers (16.2%) but was only received by 44/151 patients (29.1%). Risky eating or drinking behaviour was admitted by 832 (89.1%) respondents and low standard accommodation by 525 (56.2 %) travellers. The most commonly reported clinical syndromes were acute and chronic diarrhoea (266; 28.5%), febrile illness (240; 25.7%) and skin lesions (166; 17.8%). A total of 199 patients presented with tropical infection (21.3%) and 63 with a vaccine-preventable infection or malaria (6.7%). 

Conclusions: The study shows that the adherence of Czech travellers to preventive measures is relatively low, and along with risky behaviours, has a significant impact on travel-related morbidity. However, vaccine-preventable infections only accounted for a small fraction of travel-related illness, which is in accordance with other epidemiological studies and points out the need for a more comprehensive interdisciplinary approach to pre-travel health consultations.

Keywords:

travel medicine – vaccination – Antimalarials – travel-related illness


Sources

1.      World Tourism Organisation. UNWTO Tourism Highlights: 2018 Edition [online]. Madrid, UNWTO, Aug 2018 [cit. 2019-12-26]. Dostupné na www:< https://www.e-unwto.org/doi/pdf/10.18111/9789284419876>.

2.      World Tourism Organization. European Union Tourism Trends, Madrid, UNWTO, Apr 2018 [cit. 2019-12-26]. Dostupné na www: https://www.e-unwto.org/doi/book/10.18111/9789284419470.

3.      Ryan ET, Wilson ME, Kain KC. Illness after international travel. N Engl J Med, 2002; 347:505–516.

4.      Angelo KM, Kozarsky PE, Ryan ET, et al. What proportion of international travellers acquire a travel-related illness? A review of the literature. J Travel Med, 2017;24(5):1–8. 

5.      Griffiths KM, Savini H, Brouqui P, et al. Surveillance of travel-associated diseases at two referral centres in Marseille, France: a 12-year survey. J Travel Med, 2018;25(1):1–9.

6.      Chen LH, Wilson ME, Davis X, et al. Illness in long-term travelers visiting GeoSentinel clinics. Emerg Infect Dis, 2009;15(11):1773–1782.

7.      Han CT, Flaherty G. Profile of Travelers with Preexisting Medical Conditions Attending a Specialist Travel Medicine Clinic in Ireland. J Travel Med, 2015;22(5):312–317.

8.      Winer L, Alkan M. Incidence and Precipitating Factors of Morbidi­ty among Israeli Travelers Abroad. J Travel Med, 2006;9(5):227–232. 

9.      Rack J, Wichmann O, Kamara B, et al. Risk and spectrum of diseases in travelers to popular tourist destinations. J Travel Med, 2005;12(5):248–253.

10.    Schlagenhauf P, Weld L, Goorhuis A, et al. Travel-associated infection presenting in Europe (2008–2012): An analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation. Lancet Infect Dis, 2015;15(1):55–64.

11.    Hill DR. Health Problems in a Large Cohort of Americans Traveling to Developing Countries. J Travel Med, 2006;7(5):259–266.

12.    Belderok SM, van den Hoek A, Kint JA, et al. Incidence, risk factors and treatment of diarrhoea among Dutch travellers: Reasons not to routinely prescribe antibiotics. BMC Infect Dis, 2011;11(1):295.

13.    Leroy H, Arvieux C, Biziragusenyuka J, et al. A retrospective study of 230 consecutive patients hospitalized for presumed travel-related illness (2000-2006). Eur J Clin Microbiol Infect Dis, 2008;27(11):1137–1140.

14.    La Dahlgren A, DeRoo L, Steffen R. Prevention of travel-related infectious diseases: Knowledge, practices and attitudes of Swedish travellers. Scand J Infect Dis, 2006;38(11–12):1074–1080.

15.    Jelinek T, Haditsch M, ed. CRM Handbuch Reisemedizin. Ausgabe 55. Düsseldorf: CRM Centrum für Reisemedizin, 2018. ISBN 978-3-941386-26-6.

16.    Al-Abri SS, Abdel-Hady DM, Al-Abaidani IS. Knowledge, attitudes, and practices regarding travel health among Muscat Internatio­nal Airport travelers in Oman: Identifying the gaps and addressing the challenges. J Epidemiol Glob Health, 2016;6(2):67–75.

17.    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.

18.    Wilder-Smith A, Khairullah NS, Song JH, et al. Travel Health Knowledge, Attitudes and Practices among Australasian Travelers. J Travel Med, 2004;11(1):9–15.

19.    Rolling T, Mühlenpfordt M, Addo MM, et al. Pre-travel advice at a crossroad: Medical preparedness of travellers to South and Southeast-Asia – The Hamburg Airport Survey. Travel Med Infect Dis, 2017;18:41–45.

20.    Steffen R, Behrens RH, Hill DR, et al. Vaccine-preventable travel health risks: What is the evidence – What are the gaps? J Travel Med, 2015;22(1):1–12.

21.    Jentes ES, Blanton JD, Johnson KJ, et al. The global availability of rabies immune globulin and rabies vaccine in clinics providing direct care to travelers. J Travel Med, 2013;20(3):148–158.

22.    Sibunruang S, Tepsumethanon S, Raksakhet N, et al. Rabies immunization of travelers in a Canine rabies endemic area. J Travel Med, 2013;20(3):159–164.

23.    Chen LH, Leder k, Barbre KA, et al. Business travel-associated illness: A GeoSentinel analysis. J Travel Med, 2018;25(1):1–10.

24.    Bühler S, Rüegg R, Steffen R, et al. A profile of travelers – An analy­sis from a large Swiss travel clinic. J Travel Med, 2014;21(5):324–331.

25.    Selcuk EB, Kayabas U, Binbasioglu H, et al. Travel health attitudes among Turkish business travellers to African countries. Travel Med Infect Dis, 2016;14(6):614–620.

26.    Darrat M, Flaherty GT. Retrospective analysis of older travellers attending a specialist travel health clinic. Trop Dis Travel Med Vaccines, 2019;5(1):1–8.

27.    Stienlauf S, Streltsin B, Meltzer E, et al. Chronic illnesses in travelers to developing countries. Travel Med Infect Dis, 2014;12(6):757–763.

28.    Hochberg NS, Barnett ED, Chen LH, et al. International travel by persons with medical comorbidities: Understanding risks and providing advice. Mayo Clin Proc, 2013;88(11):1231–1240.

29.    Wieten RW, Leenstra T, Goorhuis A, et al. Health risks of travelers with medical conditions-a retrospective analysis. J Travel Med, 2012;19(2):104–110.

30.    Avni C, Stienlauf S, Meltzer E, et al. Region-specific, life-threate­ning diseases among international travelers from Israel, 2004–2015. Emerg Infect Dis, 2018;24(4):790–793. 

31.    Dam Larsen F, Jespersen S, Wejse C, et al. One-sixth of inpatients in a Danish infectious disease ward have imported diseases: A cross-sectional analysis. Travel Med Infect Dis, 2017;20:43–48.

32.    Ansart SS, Perez L, Vergely O. Illnesses in travelers returning from the tropics: a prospective study of 622 patients. J Travel Med, 2005;12(6):312–318.

33.    Freedman DO, Weld LH, Kozersky PE, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med, 2006;354(2):119–130

34.    Marks M, Armstrong M, Whitty CJM, Doherty JF. Geographi­cal and temporal trends in imported infections from the tropics requiring inpatient care at the Hospital for Tropical Diseases, London – A 15 year study. Trans R Soc Trop Med Hyg, 2016;110(8):456–463.

35.    Wadhwaniya S, Hyder AA. Pre-Travel Consultation Without Injury Prevention Is Incomplete. J Travel Med., 2013;20(4):217–220.

36.    Stewart BT, Yankson IK, Afukaar F, et al. Road Traffic and Other Unintentional Injuries Among Travelers to Developing Countries. Med Clin North Am., 2016;100(2):331–343.

37.    Hargarten SW, Baker TD, Guptill K. Overseas fatalities of United States citizen travelers: An analysis of deaths related to international travel. Ann. Emerg. Med., 1991;20(6):622–626.

Labels
Hygiene and epidemiology Medical virology Clinical microbiology

Article was published in

Epidemiology, Microbiology, Immunology

Issue 1

2021 Issue 1

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#