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At least 253 records · Page 14Linked to original sources
PubMed2006

Malaria prevention and stand-by emergency treatment among Japanese travelers.

BACKGROUND: While chemoprophylaxis remains the safest option for most travelers to malaria high-risk areas, stand-by emergency treatment (SBET) may also be a sensible option especially for travelers to low-risk areas, due to the possible adverse effects (AEs) of prophylactic antimalarials. However, studies on the suitability of SBET actually implemented by travelers are scarce, especially those targeting Japanese travelers. We investigated to what extent malaria prevention measures are taken and how effectively SBET is used by Japanese travelers to malaria-endemic areas. MATERIALS AND METHODS: A questionnaire study was conducted targeting Japanese travelers who visited quarantine stations for pre-travel health advice and who had previously visited malaria-endemic areas as defined by the World Health Organization (N = 160). RESULTS: The results showed that only a minority (13%) of travelers to malaria-endemic areas took chemoprophylaxis. Although most (89%) of the SBET users (N = 9) took antimalarial drugs when they experienced both fever and chills, characteristic of clinical malaria, there were several problems related to SBET. Some (22%) of the subjects conducted SBET less than 7 days after entering the area, most (89%) of them did so when a medical facility was readily accessible, and many (56%) failed to seek medical attention soon after SBET or did not at all. CONCLUSIONS: Japanese travelers to malaria-endemic areas seemed less protected with the use of chemoprophylaxis. Furthermore, problems related to SBET among Japanese travelers were identified. These should be taken into full consideration when educating both travelers and travel health professionals to avoid risks of malaria and possible AEs of antimalarial drugs.

Adolescent↗
PubMed2002

Pre-travel advice: an overview.

The message of the pre-travel provider is necessarily paradoxic. First the provider lists a score of causes of illness and premature demise, and then states, "But it sounds like a great trip and I think you'll have fun." Pre-travel providers need to walk a fine line: they must encourage patients to be cautious but not paranoid, optimistic but realistic. This discussion is complicated further by the fact that risk reduction is not the only consideration; if it were, practitioners would advise patients to remain in the developed world and foray from their homes only to visit health clubs and the fruit-and-vegetable section of grocery stores. A tacit assumption in travel medicine is that some degree of acceptance of heightened risk is tolerated for the benefit of improved quality of life offered by travel abroad. The amount of risk that is reasonable to accept for a given benefit in quality of life yielded by travel cannot be quantified, however. Providers must render judgments on what is "reasonable" and what is not, and this complex decision is based on equal parts medical knowledge and intuition. At one extreme, mountaineers in Nepal have been found to have a 2.4% mortality rate per expedition [83,84]. The travel provider might make the reasonable decision to counsel these travelers to avoid that activity. These travelers most likely will ignore that advice, at which point the provider must endeavor to reduce risk to the extent possible. Other situations in which the provider should advise a change in itinerary or activities include counseling parents who plan to take an infant to high altitude or a pregnant woman who plans to scuba dive. If travelers remain cloistered in their hotel rooms, eating all meals from room service and watching CNN, then it could be suggested that they are overly risk-adverse and might consider foraying out of the hotel, despite the potential associated increased risks to health. Conversely, if travelers find themselves on motorcycles after a few drinks with a new love interest, they are perhaps not sufficiently risk-adverse; however, the "point of optimal risk acceptance" between these two extremes is a matter of conjecture. Risks associated with travel can never be eliminated; however, appropriate advice and immunizations can tilt the odds in travelers' favor.

Developing Countries↗
PubMed2000

Risk of infection with Mycobacterium tuberculosis in travellers to areas of high tuberculosis endemicity.

BACKGROUND: No data exist on risks of infection with Mycobacterium tuberculosis in travellers. We studied incidences of and risk factors for tuberculin skin-test conversion among Dutch long-term travellers to countries of high tuberculosis endemicity. METHODS: In a multicentre, prospective cohort study based in travel and tuberculosis clinics in the Netherlands, 1072 BCG-naive immunocompetent travellers to countries with an estimated annual risk of M. tuberculosis infection of at least 1% were skin tested before departure with 1 tuberculin unit purified protein derivative (PPD) of M. tuberculosis in Tween-80. Those with results less than 2 mm were retested 2-4 months after their return with simultaneous testing for cross-sensitivity to environmental mycobacteria (1 tuberculin unit PPD of M. scrofulaceum in Tween-80). M. tuberculosis infection was defined as a post-travel M. tuberculosis tuberculin skin-test result of at least 10 mm that was 3 mm or more larger than the M. scrofulaceum result. FINDINGS: Post-travel skin-test results were available for 656 (66%) of 988 individuals who were eligible for follow-up. Among these, 12 M. tuberculosis infections were identified (1.8%). The overall incidence rate was 3.5 per 1000 person-months of travel (95% CI 2.0-6.2), and 2.8 per 1000 person-months of travel (1.2-5.5) after exclusion of health-care workers. Two had active tuberculosis at the time of testing (incidence rate 0.6 per 1000 person-months of travel [0.3-2.3]). Work in patient care abroad was an independent risk factor (adjusted rate ratio 5.34, p=0.015). INTERPRETATION: The risk of M. tuberculosis infection in long-term travellers to high-endemicity countries, even if not engaged in health-care work, is substantial and of similar magnitude to the average risk for the local population. BCG vaccination or post-travel tuberculin skin-testing of high-risk travellers should be considered.

Adult↗
PubMed2003

A review of combined hepatitis A and hepatitis B vaccination for travelers.

BACKGROUND: Hepatitis A virus (HAV) and hepatitis B virus (HBV) are the 2 most common vaccine-preventable diseases for which travelers are at risk. These viruses are a significant public health concern, as both HAV and HBV cause substantial morbidity and both can be fatal. OBJECTIVE: This article provides the practitioner with the facts about hepatitis and travel, including why travelers are at risk, which travelers are at greatest risk, and how travelers can protect themselves from both HAV and HBV through vaccination. METHODS: A review of the English-language literature published from 1966 to 2002 was conducted through the PreMedline and MEDLINE databases with the search terms hepatitis A, hepatitis B, and travelers. Reference lists from relevant articles were also searched, and abstracts presented at recent conferences were evaluated. Articles containing information from the past 2 decades were used to reference this article. RESULTS: Travelers need protection against both hepatitis A and B. In addition to making travelers aware of a number of behavior modifications, vaccination should be provided. Tolerable and effective monovalent vaccines are available that can prevent these viruses. In addition, a combination HAV/HBV vaccine is available that is well tolerated and decreases the time to immunity. CONCLUSIONS: Travelers are often unaware of the risk factors for acquiring hepatitis A and B while traveling, such as the degree of endemicity at the travel destination, the length of stay in the endemic area, and the extent and frequency of contact with the local population. Because these risk factors and areas for endemicity of both hepatitis A and hepatitis B overlap, health care providers can protect travelers from both of these diseases by providing a combination vaccine, thus affording a lifetime of protection against both diseases.

Endemic Diseases↗
PubMed2002

[Infections and diseases after travelling].

BACKGROUND AND OBJECTIVE: With intensifying international travel numbers of travel associated infections and diseases will increase. Systematic studies on infections and diseases with regard to the travel destination in tropical and subtropical areas are scarce in Germany. PATIENTS AND METHODS: Data regarding travel destination, reason, type and duration of travel, symptoms, clinical findings, laboratory results as well as diagnoses of 2024 patients (male 1010, mean age 35 years; female 1014, mean age 33 years) presenting at the outpatient clinic of the Institute of Tropical Medicine Berlin after returning from travel to tropical or subtropical areas were assessed. RESULTS: The most frequent reasons for consultation were diarrhea (33 %), fever (17 %) and skin affections (14 %). A definitive diagnosis was established in 31 % (635). Significant differences were found for prevalences of infectious diseases with regard to travel destinations. 1.5 % of the travellers had contracted malaria. Only 34% of the returnees from malaria-endemic areas had taken chemoprophylaxis; in case of travel to Africa and Asia, chemoprophyplaxis corresponded to international standards in only 48 % and 23%, respectively. Giardia lamblia was the most frequently detected intestinal pathogen. Blastocystis hominis was found to be significantly associated with diarrhea. CONCLUSIONS: Most of the travel-associated infections are self-limited. In case of fever, malaria and potentially hemorrhagic fever should be excluded and be followed by a stepwise investigation on the cause of fever. In case of diarrhea, parasitologic investigations should be performed by an experienced laboratory and fresh stool samples should be used. Intensive co-operation will be necessary between physician, pharmacists and others active in the field of travel medicine in order to address the shortcomings in chemoprophylaxis for malaria. An increasing need for expertise in tropical and travel medicine, especially among private physicians is expected.

Adult↗
PubMed2004

Malaria in travelers: a review of the GeoSentinel surveillance network.

BACKGROUND: Malaria is a common and important infection in travelers. METHODS: We have examined data reported to the GeoSentinel surveillance network to highlight characteristics of malaria in travelers. RESULTS: A total of 1140 malaria cases were reported (60% of cases were due to Plasmodium falciparum, 24% were due to Plasmodium vivax). Male subjects constituted 69% of the study population. The median duration of travel was 34 days; however, 37% of subjects had a travel duration of < or =4 weeks. The majority of travellers did not have a pretravel encounter with a health care provider. Most cases occurred in travelers (39%) or immigrants/refugees (38%). The most common reasons for travel were to visit friends/relatives (35%) or for tourism (26%). Three-quarters of infections were acquired in sub-Saharan Africa. Severe and/or complicated malaria occurred in 33 cases, with 3 deaths. Compared with others in the GeoSentinel database, patients with malaria had traveled to sub-Saharan Africa more often, were more commonly visiting friends/relatives, had traveled for longer periods, presented sooner after return, were more likely to have a fever at presentation, and were less likely to have had a pretravel encounter. In contrast to immigrants and visitors of friends or relatives, a higher proportion (73%) of the missionary/volunteer group who developed malaria had a pretravel encounter with a health care provider. Travel to sub-Saharan Africa and Oceania was associated with the greatest relative risk of acquiring malaria. CONCLUSIONS: We have used a global database to identify patient and travel characteristics associated with malaria acquisition and characterized differences in patient type, destinations visited, travel duration, and malaria species acquired.

Africa↗
PubMed2000

The assessment of fitness to travel.

The majority of health problems encountered in association with travel stem from pre-existing, perhaps latent, illness in the individual which may be exacerbated by the rigours and hazards of travel. It is essential that the advising physician understands the hazards that are likely to be encountered during travel in order that they may develop informed decisions regarding fitness for travel and give appropriate advice. In an occupational health setting, the employer has a responsibility to safeguard the health of their employees whilst travelling on behalf of the organisation and will also have to fund any treatment abroad or the cost of repatriation. The dictating factor in determining fitness to travel will often be fitness to travel by air, consequent to the reduced partial pressure of oxygen and pressure changes in-flight. The majority of significant health problems encountered during travel are attributable to coronary heart disease and detailed guidance exists to determine fitness for travel. For many health problems little if any evidence based guidance exists and decisions will therefore have to be based on an understanding of the hazards likely to be encountered during travel. Access to appropriate standards of medical care abroad and the difficulties and expense of repatriation, should this be necessary, are also important factors to consider in addition to the basic determination of fitness for travel itself. This paper outlines the main factors to be considered when assessing fitness to travel and also examines available guidance for some of the more commonly encountered conditions.

Aerospace Medicine↗
PubMed2002

Sexual behavior of international travelers visiting Peru.

BACKGROUND: Sexual behavior of travelers to Latin America and the sexual behavior of US travelers in general are poorly characterized. GOAL: The goal of the study was to evaluate sexual risk factors of travelers to Peru. STUDY DESIGN: Anonymous written questionnaires were administered to 442/507 (87%) of the individuals approached in the international departures area of the Lima airport. RESULTS: Of the 442 respondents, 54 (12.2%) had new sex partners during their stay. Sex with a local partner (35/52; 67.3%) was more frequent than sex with other travelers (18/52; 34.6%) or with sex workers (4/52; 7.7%). Risk factors for a new sex partner included male sex (relative risk, 1.94), single marital status (relative risk, 2.59), duration of stay longer than 30 days (relative risk, 5.05), traveling alone or with friends (relative risk, 2.88), and bisexual orientation (relative risk, 4.94). Frequency of sexual activity among US travelers was greater than that among travelers from other countries (15.2% [22/145] versus 10.6% [30/282]; NS). Condoms were consistently used by 12/50 (24%) and sometimes used by 10/50 (20%), including 8/20 United States travelers and 13/29 travelers from other countries. CONCLUSION: Behaviors and risk factors are similar to those described for travelers to Africa, Asia, and Eastern Europe. Behavior of US travelers did not differ from that of other travelers.

Adolescent↗
PubMed1999

Common health problems in HIV-infected travelers to the (sub)tropics.

BACKGROUND: A study was conducted to estimate the incidence of health problems in HIV-infected travelers with various degrees of immunodeficiency to the (sub)tropics. METHODS: A retrospective questionnaire-based study among HIV-infected patients attending the outpatient department of a university hospital during three months in 1996 with a history of travel to (sub)tropical destinations in the proceeding 12 months. The outcome measures were incidences of and medical consultation rates for common travel-associated illnesses. RESULTS: Of 293 HIV-infected patients, 59 (20%) had traveled during the preceding 12 months; of these 36 (61%) responded. Ten (28%) had traveled more than once during this period. There were no significant differences between travelers and nontravelers regarding CD4 count and age. Fifteen respondents (42%) used cotrimoxazole (CTX) for PCP prophylaxis; 22 (61%) had sought pretravel health advice. Median duration of travel was 3 weeks. Respiratory infections were recorded by two respondents (6%, 95% confidence intervals 1-19%) and skin problems by 10 (28%, 14-45%). Of 31 respondents without diarrhea on departure, 10 recorded diarrhea (32%, 19-57%). The overall rate of medical consultation for travel-related complaints ws 5% abroad and 28% after return, respectively. There was no association between the risk of diarrhea and CD4 count or CTX prophylaxis, even after adjustment for differences in age, duration of travel and travel experience. CONCLUSIONS: Although numbers in this study are small, HIV-infected travelers tend to have a high rate of medical consultation for (possibly) travel-related illness. Diarrhea is the most frequent complaint, but shows no strong association with degree of immunodeficiency.

Adult↗
PubMedDate not supplied

Hepatitis A, typhoid and malaria among travelers--surveillance data from Québec (Canada).

Analysis of epidemiological data on health problems related to international travel helps put into perspective preventive interventions for travelers. To document the epidemiological context of travel health interventions in Québec, we reviewed surveillance data for three infectious diseases. The analysis included data collected in the notifiable diseases surveillance system for hepatitis A, typhoid, and malaria cases reported from 2000 to 2002. Additional data were obtained from the provincial hepatitis risk factor database as well as from regional public health departments. More than 40% of cases of hepatitis A for which risk factor information is available are associated with international travel; 20% of these cases were contracted in Mexico and 22% in the West Indies. The risk of acquiring hepatitis A seems to be higher among travelers under 35 years of age; also, given the number of Quebecers traveling to all regions of the world, this risk is proportionally higher in Africa. Data gathered for typhoid indicate that the risk to travelers from Québec is proportionately higher for Quebecers traveling to the Indian subcontinent and whose purpose is to visit family and friends, and for those who stay abroad for 4 weeks or longer. The risk of malaria is greater in Africa (where contracted cases are mostly caused by Plasmodium falciparum). Over half of malaria cases involve individuals traveling abroad for business (including volunteerism), and almost 75% contracted the disease during a stay of a month or more. Nearly half of the cases had not taken chemoprophylaxis. Available data have limitations for infectious disease surveillance among Québec travelers: imprecise number of cases (underdiagnosis and underreporting), imprecise denominators (number of travelers), and lack of data on the characteristics of trips taken. However, despite its limitations, this profile of infectious diseases among travelers from Québec provides interesting data for preventive intervention.

Adolescent↗
PubMed2006

Travel-related venous thrombosis: results from a large population-based case control study (MEGA study).

BACKGROUND: Recent studies have indicated an increased risk of venous thrombosis after air travel. Nevertheless, questions on the magnitude of risk, the underlying mechanism, and modifying factors remain unanswered. METHODS AND FINDINGS: We studied the effect of various modes and duration of travel on the risk of venous thrombosis in a large ongoing case-control study on risk factors for venous thrombosis in an unselected population (MEGA study). We also assessed the combined effect of travel and prothrombotic mutations, body mass index, height, and oral contraceptive use. Since March 1999, consecutive patients younger than 70 y with a first venous thrombosis have been invited to participate in the study, with their partners serving as matched control individuals. Information has been collected on acquired and genetic risk factors for venous thrombosis. Of 1,906 patients, 233 had traveled for more than 4 h in the 8 wk preceding the event. Traveling in general was found to increase the risk of venous thrombosis 2-fold (odds ratio [OR] 2.1; 95% confidence interval [CI] 1.5-3.0). The risk of flying was similar to the risks of traveling by car, bus, or train. The risk was highest in the first week after traveling. Travel by car, bus, or train led to a high relative risk of thrombosis in individuals with factor V Leiden (OR 8.1; 95% CI 2.7-24.7), in those who had a body mass index of more than 30 kg/m(2) (OR 9.9; 95% CI 3.6-27.6), in those who were more than 1.90 m tall (OR 4.7; 95% CI 1.4-15.4), and in those who used oral contraceptives (estimated OR > 20). For air travel these synergistic findings were more apparent, while people shorter than 1.60 m had an increased risk of thrombosis after air travel (OR 4.9; 95% CI 0.9-25.6) as well. CONCLUSIONS: The risk of venous thrombosis after travel is moderately increased for all modes of travel. Subgroups exist in which the risk is highly increased.

Adult↗
PubMedDate not supplied

How important a priority is travel medicine for a typical British family practice?

BACKGROUND: Primary care teams have to supply travel health advice to increasing numbers of long haul travelers but there is a shortage of information derived from general practice settings about the risks patients are exposed to. We aimed to determine the numbers of our patients visiting high-risk destinations, to see if they reported complying with health advice, and whether or not they became ill. METHODS: We performed a retrospective study in a typical British, town center, family practice in Mansfield, Nottinghamshire. A postal questionnaire survey was sent to 200 adults, aged between 16 and 76, randomly selected from the practice register, and 351 adults who had attended the practice travel clinic over a 1-year period between 1997-1998. RESULTS: Responses were received from 84% of the random sample and 86% of the travel clinic group. Out of 11,000 patients registered with the practice, we identified 187 patients who had traveled to high-risk destinations such as Africa, Asia, South America or the Caribbean. The majority of these had attended the practice travel clinic. Despite this, 41% became ill (mainly diarrhea), 10% were sufficiently ill to be confined to bed. Fifty-nine percent of patients who required malaria chemoprophylaxis reported they had not complied fully with advice given. Reported illness rates for medium and low risk destinations were 27 and 19% respectively. CONCLUSIONS: The results suggest that giving health advice to long haul travelers should be an important priority for primary care teams. Travelers have a high episode rate of illness and put themselves at risk of acquiring malaria. Most travelers to high-risk destinations do attend the travel clinic for health advice but compliance with that advice is poor. People traveling to lower risk destinations still experience an appreciable rate of illness and are less likely to be seen in the travel clinic.

Adult↗
PubMedDate not supplied

Perception and knowledge about some infectious diseases among travelers from Québec, Canada.

BACKGROUND: Many travelers from Québec visit tourist destinations, thereby becoming at risk of infectious diseases. Within a study of predictors of utilization of travel health consultation by travelers, knowledge about transmission and perception of risk and severity of some infectious diseases was measured. METHODS: A cross-sectional survey was conducted during winter 1999 on travelers 16 years of age and over going to Mexico and the Dominican Republic. A 34-item self-administered bilingual questionnaire was distributed to travelers during seven flights departing from Montréal Airport. RESULTS: The questionnaires were completed by 1,724 passengers (response rate: 75%). The majority (81%) of the 1,416 travelers from the province of Québec considered themselves at greater risk of diarrhea abroad. Risk perception was less important for hepatitis A and B (44% and 41%, respectively). Most travelers considered diarrhea as slightly or not severe, and hepatitis as severe illnesses. A majority had adequate knowledge about transmission of diarrhea but knowledge concerning hepatitis was less accurate. In the multivariate analysis, the most important associations were noted between perception of risk of diarrhea and knowledge about transmission of diarrhea (odds ratio [OR] 3.2); and between perception of risk of hepatitis and perception of severity of hepatitis (hepatitis A: OR 3.9; hepatitis B: OR 5.9). Consultation in a travel clinic before departure was associated with perception of higher risk of hepatitis A and of infectious diseases in general (OR 2.1). CONCLUSION: Despite its limitations, this study indicates that travelers from Québec, going to sun destinations, seem to underestimate their risk of hepatitis related to travel. Knowledge about transmission of hepatitis seems poor. Education of travelers about risks and modes of transmission of infectious diseases should be reinforced. Travel health consultation before departure or for a previous trip appeared to be associated with higher risk perception.

Adolescent↗
PubMedDate not supplied

Knowledge, attitudes and practices of business travelers regarding malaria risk and prevention.

BACKGROUND: This study aimed to determine the knowledge, attitudes and practices of Swiss business travelers with regard to malaria. METHODS: Questionnaires printed in three languages were distributed by employers, travel agencies and tropical medicine specialists to business travelers with destinations in malaria endemic countries. RESULTS: In total, 401 questionnaires were evaluated. Thirty-three percent visited high-risk areas, 27% visited low-risk areas, and 40% visited only malaria-free areas within endemic countries. Among the investigated business travelers, 6% had experienced malaria infection, and 29% had previously had blood smears tested for malaria at least once. Almost all business travelers, 95%, knew that mosquitoes are the main vectors of malaria. The infection risk between dusk and dawn was known to 71%, and the incubation time to 36%. Apart from fever (99%) and headache (63%), other malaria symptoms were known to only 13% to 36% of the travelers. If signs of illness such as fever and headache occurred, 63% would react adequately and seek medical advice within 24 h. Only 16% of the travelers to African high-risk areas followed the recommended behavior concerning anti-mosquito and antimalarial strategies; 31% of those on trips to low-risk areas used an adequate protective strategy. Of the business travelers using chemoprophylaxis during travel, just 50% continued intake post travel, as requested, after leaving the endemic area. CONCLUSIONS: Business travelers are well informed regarding the mode of transmission and the risk of malaria at specific destinations but tend to comply poorly with anti-mosquito and chemoprophylactic strategies. The knowledge, attitudes and practices of business travelers with regard to malaria prevention need to be improved.

Adult↗
PubMedDate not supplied

Imported Plasmodium vivax malaria: demographic and clinical features in nonimmune travelers.

BACKGROUND: Imported malaria is an important problem in nonendemic countries due to increasing travel to and immigration from malaria-endemic countries. Plasmodium vivax malaria is relatively common in travelers but there are few published data regarding the outcome of P. vivax malaria in this group. METHODS: We analyzed 209 cases of P. vivax malaria that were reported to the GeoSentinel network and the VIDS database, Royal Melbourne Hospital. Analyses were performed on data including demographics, pretravel encounter, antimalarial prophylaxis, exposure history, type of travel, countries of recent and past travel, clinical presentation, treatment, outcome and final diagnoses. RESULTS: The majority of patients were travelers (61%), followed by expatriates (13%) and recent immigrants or foreign visitors (12%). Recent travel to Oceania, sub-Saharan Africa, and South and Central America was significantly more likely to be associated with P. vivax malaria than travel to all other regions. The clinical presentation of P. vivax malaria acquired in the Pacific region is indistinguishable from infection with P. falciparum. The use of chloroquine prophylaxis did not prolong the incubation period. Relapse of infection was not infrequent, and the only significant predictor of relapse was travel to Papua New Guinea (PNG), regardless of primaquine dose. Travelers returning from PNG were eight times more likely to relapse after primaquine treatment compared to travelers with P. vivax malaria acquired elsewhere. CONCLUSIONS: We have presented details of the epidemiology, clinical presentation and management of infection with P. vivax malaria in travelers. P. vivax malaria is an important cause of morbidity in travelers, and relapse following primaquine treatment is especially problematic with P. vivax malaria acquired in PNG.

Adolescent↗
PubMedDate not supplied

Willingness to pay for preventive travel health measures among Hong Kong Chinese residents.

BACKGROUND: The effectiveness of preventive measures in combating travel-related illnesses is well recognized. However, there is a lack of information on the economic value of any travel-associated preventive measures in the literature. OBJECTIVES: The purpose of this article is to report the values of willingness to pay (WTP) to prevent travel health problems in Hong Kong's travelers. METHODS: A cross-sectional telephone survey for a sample of Hong Kong population was conducted in 1998 using a random digit dialing technique. The sample WTP values were elicited using an open-ended question. Logistic regression was performed to identify predictors of WTP. Mean WTP was estimated using Heckman's sample selection model on log-WTP. RESULTS: Of the subjects interviewed, 77% (285/369) offered positive values of WTP to prevent travel health problems. The observable WTP (zero excluded) had a higher mean (447 Hong Kong dollars) than did the zero-inclusive data (351 Hong Kong dollars). The median values were 200 Hong Kong dollars in both cases because there were a large number of protest responses. Age, travel frequency, ability to assess travel health risk, precautionary behavior, and previous exposure to health protection materials explained one's willingness to pay a positive amount for preventing travel health problems. Age, education level, and precautionary behavior were predictors of the WTP levels. CONCLUSION: The findings of this study suggest that Chinese travelers are willing to pay for the prevention of travel-related illnesses. The predictors of WTP identified could be used to suggest policy changes. However, future studies are needed to explore further the relationship between the experience of travel illnesses, the magnitude of travel health risks, and WTP.

Adolescent↗
PubMed2002

Travel epidemiology. WHO perspective.

International travel is undertaken by large, and ever increasing numbers of people for professional, social, recreational and humanitarian purposes, and this upward trend looks set to continue. Travelers are exposed to a variety of health risks of the unfamiliar environment of the visited area. The risk of exposure is determined by destination, duration of the visit, purpose of the visit, behavior of the traveler and underlying physical and biological status of the traveler. However, most risks can be minimized by suitable precautions taken before, during and after travel. Travelers can themselves, also, easily introduce any infectious agents they may harbor to the visited area. Many infectious diseases have been introduced in many parts of the world through travel and trade. Travel has been identified as a prime factor in the global spread of infectious diseases. In a world of rapid air travel, no country is safe from infectious diseases. An outbreak in one country can easily and rapidly be transmitted across long distances to affect other countries through travel and trade. The World Health Organization devotes great attention to prevention and control of global spread of infectious diseases and minimizing the negative effect of international travel on health. The main strategies of the World Health Organization for minimizing the negative effects of expanding travel on global health security include developing the necessary strategies, rules and regulations; strengthening global communicable diseases surveillance and response; dissemination of related information throughout the world and strengthening national capacity for communicable diseases surveillance and response.

Humans↗
PubMed1990

Malaria incidence and prevention among European and North American travellers to Kenya.

A longitudinal survey was conducted among travellers departing from Nairobi airport to determine the use of malaria prevention measures and assess the risk for malaria while travelling in Kenya. Among 5489 European and North American travellers, 68 different drug regimens were used for prophylaxis, and 48% of travellers used both regular chemoprophylaxis and more than 1 antimosquito measure during travel; 52% of 3469 travellers who used chemoprophylaxis did so without interruption during their travel and for 4 weeks after departure. Compliance was lowest among travellers who visited friends and relatives, who were young, or who stayed more than 3 weeks. Sixty-seven (1%) travellers experienced symptoms of malaria, but the diagnosis could be verified for only 16 of these. Long-stay travellers appeared to be at higher risk for malaria than short-stay travellers, and health information needs to be targeted especially to the former. Similar investigations are needed among international travellers to other malaria-endemic countries. With comparable data available, consistent and effective malaria prevention guidelines can be developed.

Adult↗