Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TRAVEL”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed2004

Antibiotics for Travelers: What's Good and What's Not.

International travel to exotic destinations continues to increase, as does the risk for illness during travel. Health problems during travel are common. Although many medical problems that travelers incur are noninfectious in origin (eg, injuries, environment-associated illness), travelers often are at risk for acquiring a variety of infections. Many travel-related infections also occur commonly in the developed world, whereas other infections of travelers may be geographically restricted to specific world regions and/or are infrequently encountered in developed nations. Antibiotics play an important role in the treatment and prevention of a variety of bacterial and parasitic infections in travelers. This article reviews antibiotics of particularly high utility to travelers, with emphasis on selected agents that, with appropriate advice from a travel medicine specialist, can be used safely for prophylaxis and self-treatment during travel. The role of antibiotics in selected high-risk travelers also is discussed.

Journal Article↗
PubMed1994

Specialized Travel Consultation Part II: Acquiring Knowledge.

With an increase in travel to tropical countries, the need to improve the disease-risk perceptions of travelers who are either naive or given inappropriate or ineffective advice is becoming increasingly important. More widely available, specialized centers that can provide advice on tropical or travel-related diseases have been established, but their efficacy on travelers' knowledge and health has not been verified. Therefore, this study was undertaken to evaluate the impact of the service provided by a routine travel consultation at the Hospital for Tropical Diseases Travel Clinic, London, England. Self-administered questionnaires were given to 161 preconsultation and 144 postconsultation clients. The consultation included an interview covering travel plans and immunization and medical history, and advice was given on the journey, necessary immunizations, and prophylaxis. Data were analyzed using the Statistical Analytic System software and the mean differences in knowledge between pre- and postconsultation scores were correlated using the nonparametric Mann-Whitney procedure. The control of mutually confounding factors was maintained by multiple regression using the Mantel-Haenszel summary chi-square and the General Linear Model procedures. Comparison of the entry and exit scores showed a significantly improved overall knowledge of travel-related diseases in the exit, postconsultation group. Subanalysis revealed that this difference was due to an increased knowledge of malaria and its prevention and perceived risk of cholera. Knowledge about the management of diarrhea or fever, however, was not significantly improved by a consultation. Inexperienced travelers taking packaged or organized trips, and those from socioeconomic groups I and II showed the largest increase in knowledge following consultation. Our results show that a face-to-face interview for an average of 18 minutes by trained staff is an effective way of improving travelers' knowledge on certain topics. The slight improvements overall are explained by the levels of experience of travel and previously acquired knowledge of the clients in our study. Effective advice on malaria prevention and some health risks is given during an average consultation; however, there is still a need for improvement in giving information on the management of diarrhea, fever, and other travel diseases.

Journal Article↗
PubMed2006

Validation of travel times to hospital estimated by GIS.

BACKGROUND: An increasing number of studies use GIS estimates of car travel times to health services, without presenting any evidence that the estimates are representative of real travel times. This investigation compared GIS estimates of travel times with the actual times reported by a sample of 475 cancer patients who had travelled by car to attend clinics at eight hospitals in the North of England. METHODS: Car travel times were estimated by GIS using the shortest road route between home address and hospital and average speed assumptions. These estimates were compared with reported journey times and straight line distances using graphical, correlation and regression techniques. RESULTS: There was a moderately strong association between reported times and estimated travel times (r = 0.856). Reported travel times were similarly related to straight line distances. Altogether, 50% of travel time estimates were within five minutes of the time reported by respondents, 77% were within ten minutes and 90% were within fifteen minutes. The distribution of over- and under-estimates was symmetrical, but estimated times tended to be longer than reported times with increasing distance from hospital. Almost all respondents rounded their travel time to the nearest five or ten minutes. The reason for many cases of reported journey times exceeding the estimated times was confirmed by respondents' comments as traffic congestion. CONCLUSION: GIS estimates of car travel times were moderately close approximations to reported times. GIS travel time estimates may be superior to reported travel times for modelling purposes because reported times contain errors and can reflect unusual circumstances. Comparison with reported times did not suggest that estimated times were a more sensitive measure than straight line distance.

Adult↗
PubMed2006

Temporal variability in winter travel patterns of Yellowstone bison: the effects of road grooming.

The influence of winter recreation on wildlife in Yellowstone National Park (YNP), Wyoming and Montana, USA, is a controversial issue. In particular, the effects of road grooming, done to facilitate snowmobile and snowcoach travel, on bison (Bison bison) ecology are under debate. We collected data during winters, from 1997 to 2005, on bison road use, off-road travel, and activity budgets to quantify temporal trends in the amount of bison road and off-road travel and to identify the ecological factors affecting bison movements and use of the groomed road system in the Madison-Gibbon-Firehole (MGF) area of YNP. Using model comparison techniques, we found bison travel patterns to be influenced by multiple, interacting effects. Road travel was negatively correlated with road grooming, and we found no evidence that bison preferentially used groomed roads during winter. Snow water equivalent, bison density, and the springtime melt period were positively correlated with both bison road and off-road travel. From behavioral scans on 68,791 bison, we found that travel is only a small percentage (11%) of all bison activity, with foraging comprising 67% of observations. Also, only 7% of traveling bison and 30% of foraging bison were displacing snow, and we suggest foraging, rather than traveling, is likely the major energetic cost to bison in winter. Bison utilize their own trail network, connecting foraging areas using stream corridors, geothermal pathways, and self-groomed travel routes. Our results indicate that temporal patterns in bison road travel are a manifestation of general travel behavior and that groomed roads in the MGF do not appear to be a major factor influencing bison ecology and spatial redistribution. We suggest that the changes in bison spatial dynamics during the past three decades have likely been the result of the natural phenomenon of density-dependent range expansion, rather than having been caused by the anthropogenic influence of road grooming.

Animals↗
PubMed1994

Leaving patches: Effects of travel requirements.

Five pigeons were trained in an analogue foraging procedure in which, by completing a travel requirement, they entered a "patch" in which a reinforcer might be available after an unpredictable time. They also had the opportunity, by emitting a defined response, to exit the patch and travel to another patch. Prey availability in a patch was not signaled. Data were collected on the length of time that subjects stayed in patches before exiting (residence times) as a function of various travel requirements: travel for a fixed time in blackout, fixed-interval schedule traveling, fixed-time traveling with an added response required to terminate traveling, and fixed-ratio traveling. For each of these conditions, the required amount of travel (time or responses) was varied over a wide range. As previously reported, residence times increased with increases in fixed-time traveling, as they did with increasing fixed-interval or fixed-ratio traveling. There was no evidence that adding response or work requirements systematically affected residence time except via increased travel time, although 3 of the 5 birds stayed longer in a patch under higher fixed-ratio values. A "threshold-maximization" model described the data well with a single parameter that was consistent across subjects, procedures, and experiments.

Journal Article↗
PubMed2002

Disturbed sleep-wake patterns during and after short-term international travel among academics attending conferences.

OBJECTIVES: To examine variations in sleep and wakefulness associated with international travel. METHODS: Ten academics in Japan were studied while traveling abroad to participate in conferences. Wrist activity and a daily log were recorded continuously for 1 week before, during, and for 1 week after travel. Destinations included the USA and Canada to the east (8 to 11-h time difference; mean stay of 6.8 days) and Europe to the west (7 to 8-h time difference; mean stay of 6.0 days). RESULTS: For eastward-traveling subjects, the total sleep time was shorter and the mean activity during sleep was greater at the destinations than before departure. These sleep disruptions persisted until the 2nd day after the subjects had returned home. The sleep patterns then recovered in a zigzag manner. No significant disruptions in the main sleep were found in westward travelers, although these subjects took a longer nap immediately after their return. The beginning and end of sleep occurred earlier until the 2nd day after the subjects had returned from eastward trips, but occurred later until the 5th day after return from westward trips. CONCLUSIONS: In academics, short-term international travel causes sleep disturbances both during and at home after eastward travel and a delay in the sleep timing at home after westward travel. Although the subjects in this study might be atypical of business travelers, the current data suggest that strategies are needed to facilitate recovery from disturbed sleep-wake patterns at home after travel, i.e., redesign of post-travel work schedules.

Adult↗
PubMed2003

Preparing the traveller.

The four steps for giving travellers the foundation for healthy journeys are to assess their health, analyse their itineraries, select vaccines, and provide education about prevention and self-treatment of travel-related diseases. This process takes time. Since there is a risk of information overload, travellers should leave the clinic with some written advice for reinforcement. The order of these steps can be tailored to what best suits the travel clinic, but vaccinating early in the process allows monitoring for adverse reactions. Face-to-face discussion is vital for explaining the use and side-effects of medications. Those who provide a travel medicine service should be seeing many travellers and should seek specialist training. In 2003, the International Society of Travel Medicine introduced a certificate of knowledge examination in travel medicine. We cannot make travellers bullet-proof but it is possible to make them bullet-resistant. The pre-travel visit should minimise health risks specific to the journey, give travellers the capability to handle most minor medical problems, and allow them to identify when to seek local care during the trip or on return.

Adult↗
PubMed2003

[Management of vaccinations and prophylaxis of international travellers from community pharmacy (VINTAF study)].

OBJECTIVES: To improve and evaluate the travel advice by community pharmacists. DESIGN: Cross-sectional and prospective study. SETTING: Community pharmacies from Asturias, Barcelona, Madrid and Valencia. PARTICIPANTS: 483 travellers to high health risk countries who visit the community pharmacies and were agreed with the aims of the study. METHOD: Community pharmacists gave information regarding immunization and prophylaxis about travel-related disease according to the destination, type and duration of travel and other features of the tourist (age, taking medicines, diseases, etc.). MAIN MEASUREMENTS: Destination, adherence to the prophylaxis and vaccinations recommended, adverse effects and diseases the tourists have in the travel and one month after they are back. RESULTS: Only 6.3% of the travellers were effective vaccinated and took prophylaxis (all vaccines and prophylaxis according to the destination). 36.2% of the travellers experienced an illness while abroad. The commonest disease were travellers' diarrhoea (15.7%). The pharmacists were the only source of information about sunscreens, repellents, and other sanitary goods. CONCLUSIONS: The community pharmacists can give accurate information regarding immunization and prophylaxis about international travels. It is necessary to improve the communication between family physician, the tropical travel clinic and community pharmacists in order to improving compliance. It is necessary keep the bureaucratic barriers away to get this kind of drugs. The international tourists still travel without the necessary vaccines and prophylaxis to the high health risk areas.

Adult↗
PubMed2002

Drug use, travel and HIV risk.

A study was conducted to examine the travel experiences of a community sample of 160 drug users and 44 non-users recruited as part of a study of HIV risk. Of the sample, 47% (96/204) reported intercity travel in the previous ten years. Results showed that men were more likely to travel than women, Anglos more than minorities, and young persons more than old. When travellers testing HIV-seropositive (n = 13) were compared with seronegative travellers, HIV-positive travellers reported more sex while travelling than HIV-negative persons, but virtually all of the difference reported involved sex with condoms. There were no significant differences in sex risk behaviours while travelling between drug users and non-drug users, or in sex risk behaviors between drug injectors and non-injectors. Travellers had fewer injection partners while travelling than they had while at home. There was also a significant difference in number of sex partners with whom a condom was not used, with fewer sex partners while travelling.

Adult↗
PubMed1998

Health problems of corporate travelers: risk factors and management.

BACKGROUND: Numerous studies have been done regarding health problems experienced by tourists in developing countries; however, little data exist about these health risks and illnesses experienced by corporate travelers. METHODS: The authors examined by electronic survey the health risks encountered, compliance with pretravel health recommendations, and illnesses and injuries experienced by employees of the Coca-Cola Company who travel internationally. RESULTS: Two hundred twenty-six travelers responded. Although most travelers ate meals at their hotels and chose foods that were cooked and still hot, over half also ate foods that remained at room temperature for prolonged periods and/or ate from cold salad bars. Almost half drank untreated tap water. Thirty-five percent of travelers developed diarrhea and 29% reported respiratory illnesses, with 12% seeking medical attention for their problems. Forty-three percent of those traveling to malarious regions admitted to noncompliance with antimalarial recommendations. Health kits provided were used by only 51% of travelers. CONCLUSIONS: Although many corporate travelers followed pretravel health recommendations, some did not. Injuries, fever, and illnesses such as diarrhea and respiratory infections occurred. Strategies to improve access to the travel clinic and the acquisition of health information and travel health kits are being implemented. The health risks and behaviors of corporate travelers, including the potential impact of psychosocial stressors, need greater attention.

Acute Disease↗
PubMed1999

Microsporidiosis in travelers with diarrhea from the tropics.

BACKGROUND: Microsporidia are protozoa which mainly affect severely immunodepressed AIDS patients in developed countries as well as those in developing ones. Traveler's diarrhea affects approximately 40% of people traveling from industrialized countries to developing ones, and no pathogens are identified in many of those patients on their returning, suggesting that known enteropathogens escape detection or entirely new ones could be responsible. Very few reports of travel-related microsporidiosis have been described. METHODS: Between January, 1996 and January, 1998, a total of 40 European travelers from the tropics with a clinical picture of protected diarrhea (three or more loose stools per day lasting for more than 3 weeks) were evaluated. Weber's trichrome modified by Kokoskin stain for microsporidial spores were performed in stool samples of every patient. Microsporidial DNA extraction and PCR amplification were attempted in every stool sample where microsporidial spores were observed. RESULTS: Four cases of imported Enterocytozoon bieneusi were detected: one HIV-infected short term traveler, a pregnant long term traveler, and two immunocompetent short term travelers. Diarrhea was self-limited, and the spores cleared from the stools in all HIV-non infected travelers, but showed a chronic course in the HIV-infected one. CONCLUSIONS: Available data is too limited to affirm that residence or travel in tropical countries increases the risk for microsporidial infection, but the cases presented here suggest that E. bieneusi could be a cause of self-limited diarrhea in immunocompetent travelers returning from the tropics or could chronically affect immunocompromised HIV-infected travelers.

Adult↗
PubMed1999

Knowledge of travel medicine providers: analysis from a continuing education course.

BACKGROUND: With millions of international travelers, there has been an increase in the scope and variability of travel medicine providers. A study was conducted to measure the baseline knowledge of providers, determine factors affecting this knowledge, and assess acquisition of knowledge after a continuing education course. METHODS: A one-day continuing medical education course was held for health care professionals interested in travel medicine. Prior to the course, attendees completed a test determining knowledge in malaria chemoprophylaxis, traveler's diarrhea management, vaccines, jet lag, the returned traveler, and other areas. An identical test was given after completion of the course. Performance on the test was analyzed by profession, area of specialty training, and experience in travel medicine. RESULTS: Seventy-seven attendees completed the precourse test. Forty-eight percent were physicians and 47% were nurses; 29% specialized in infectious diseases, 22% in occupational medicine and student health, and 18% in family or internal medicine; 60% had >/= 1 year of travel medicine experience while 20% had no experience. The precourse test score for all participants was 62.7% 6 6.5 (sd). Analysis by profession found that physicians scored the highest (71%). Providers with >/= 1 year of travel medicine experience scored higher than those with no experience (67% vs 53%, p <.01). Statistically significant correlations were found between precourse exam results and profession (+.432, p <.001) and travel medicine experience (+.365, p =.002). No significant correlation was found between precourse exam and area of specialty training. Combined mean score on the postcourse exam improved to 81.8% 6 4.5, an increase of 17.2% over the precourse score for those who took both tests (p <.001). CONCLUSIONS: The profession of the provider and the duration of experience in travel medicine were the most important correlations of baseline knowledge in travel medicine. All groups improved their knowledge following the course.

Clinical Competence↗
PubMed1999

Travel advice given by pharmacists.

BACKGROUND: In 1993 more than 1 million Swiss residents traveled to a tropical or subtropical country. Although most pretravel advice is given by general practitioners, a number of travelers also seek advice from pharmacists. Little is known about the quantity and quality of travel advice given or the sources of information used by this group. METHODS: One-hundred and twenty randomly selected pharmacists from three Swiss cantons were first interviewed in a cross-sectional study on the telephone. All study participants subsequently received a pretested questionnaire, in which most of the questions asked on the phone were repeated, with additional questions regarding the sources of information used for travel advice and the cooperation of general practitioners. Included in both parts of the study were two scenarios of fictive travelers seeking health advice for destinations frequently visited by Swiss tourists (Thailand and Kenya). RESULTS: Of 136 pharmacists approached, all who said they sometimes gave travel advice, agreed to participate (88%). Fifty-six percent of them give travel advice regularly (mean 2-3 times per month). General knowledge on the main health hazards was good, but for treatment of travelers' diarrhea, only 59% spontaneously mentioned the need for increased fluid intake, whereas 100 % recommended antidiarrheal drugs. Protection from the sun was mentioned only by 10 % of the respondents, and only 8 % said that the traveler should seek advice from a medical doctor. Over 95% could name the three most important measures against mosquito bites, although up to 20% still recommend Vitamin B1 as well. On the telephone, only 19% (for Thailand) and 31% (for Kenya) gave accurate advice on malaria protection, and 13% (for Thailand) and 3% (for Kenya) could make correct recommendations about vaccination. However, more than 50% said that in practice they would consult documentation before giving any advice, with the Bulletin of the Federal Office of Health (BFOH) being the most commonly used source of information. In the questionnaire interview, where documentation was used, the accuracy of advice increased, especially for malaria protection (74% correct for Thailand and 93% for Kenya). CONCLUSIONS: The overall knowledge of Swiss pharmacists on travel medicine issues is satisfactory. Specific questions need further attention, such as treatment of travelers' diarrhea, sun protection and advice on malaria prophylaxis and vaccinations. For the latter two, clients should also consult a medical doctor. Collaboration between doctors and pharmacists, and the consistency of the advice given, are important in improving compliance. Reliable information sources are available in pharmacies and are used.

Cross-Sectional Studies↗
PubMedDate not supplied

Illness in returned travelers and immigrants/refugees: the 6-year experience of two Australian infectious diseases units.

BACKGROUND: Data comparing returned travelers and immigrants/refugees managed in a hospital setting is lacking. METHODS: We prospectively collected data on 1,106 patients with an illness likely acquired overseas who presented to two hospital-based Australian infectious diseases units over a 6-year period. RESULTS: Eighty-three percent of patients were travelers and 17% immigrants/refugees. In travelers, malaria (19%), gastroenteritis/diarrhea (15%), and upper respiratory tract infection (URTI) (7%) were the most common diagnoses. When compared with immigrants/refugees, travelers were significantly more likely to be diagnosed with gastroenteritis/diarrhea [odds ratio (OR) 8], malaria (OR 7), pneumonia (OR 6), URTI (OR 3), skin infection, dengue fever, typhoid/paratyphoid fever, influenza, and rickettsial disease. They were significantly less likely to be diagnosed with leprosy (OR 0.03), chronic hepatitis (OR 0.04), tuberculosis (OR 0.05), schistosomiasis (OR 0.3), and helminthic infection (OR 0.3). In addition, travelers were more likely to present within 1 month of entry into Australia (OR 96), and have fever (OR 8), skin (OR 6), gastrointestinal (OR 5), or neurological symptoms (OR 5) but were less likely to be asymptomatic (OR 0.1) or have anaemia (OR 0.4) or eosinophilia (OR 0.3). Diseases in travelers were more likely to have been acquired via a vector (OR 13) or food and water (OR 4), and less likely to have been acquired via the respiratory (OR 0.2) or skin (OR 0.6) routes. We also found that travel destination and classification of traveler can significantly influence the likelihood of a specific diagnosis in travelers. Six percent of travelers developed a potentially vaccine-preventable disease, with failure to vaccinate occurring in 31% of these cases in the pretravel medical consultation. CONCLUSIONS: There are important differences in the spectrum of illness, clinical features, and mode of disease transmission between returned travelers and immigrants/refugees presenting to hospital-based Australian infectious diseases units with an illness acquired overseas.

Adolescent↗
PubMedDate not supplied

Risk of exposure to hepatitis B and other blood-borne viruses among Australians who travel abroad.

BACKGROUND: European studies indicate that up to 67% of travelers traveling abroad participate in activities that put them at risk of exposure to hepatitis B. Australians are increasingly traveling to destinations where hepatitis B is highly endemic, such as Asia, and are likely to have similar levels of involvement in activities with an associated risk of hepatitis B exposure. METHOD: A series of annual telephone surveys of approximately 500 randomly selected Australian overseas travelers have been conducted under the auspice of the Travel Health Advisory Group over the years 2001 to 2003. The surveys examined the extent to which travelers seek pretravel health advice, what immunizations they receive and what risks they are exposed to during travel including the risk of hepatitis B and other blood-borne virus acquisition. RESULTS: In the 2003 survey, 281 (56%) of the 503 people interviewed had visited at least one country with high or medium hepatitis B endemicity on their most recent overseas trip in the past two years. Approximately a third of travelers undertook one or more activities that were considered to be associated with increased risk of potential hepatitis B exposure. Less than half the travelers (46%) had been vaccinated against hepatitis B. CONCLUSIONS: The results have implications for the individual traveler, as well as to the broader community. Infected travelers can be an important source of hepatitis B into their own home communities. Improved advice and clear recommendations for hepatitis B vaccination are needed to avoid infection.

Adolescent↗
PubMed2004

Clinical pharmacy travel medicine services: a new frontier.

Travel to remote destinations has increased dramatically in recent years. The Clinical Pharmacy International Travel Clinic (CPITC) was established in 1991 in the Kaiser Permanente Colorado Region to provide pre-travel advice to members to decrease their risk of travel-related diseases. The CPITC is unique from other travel medicine clinics because it is a pharmacist-run telepharmacy service. The team includes an infectious diseases physician, an infectious diseases clinical pharmacy specialist, 4 clinical pharmacists, and a pharmacy technician. The clinical pharmacists provide consultations via telephone. Both patient- and trip-related information are gathered to assess the traveler's health risks. Recommendations are provided regarding food- and water-borne diseases, insect-borne diseases, sexually transmitted diseases, and diseases related to animal bites. Additionally, detailed information is provided on vaccines that may be needed to protect travelers against various diseases. The travel consult is documented electronically. A copy of the consult, along with a booklet that provides travel information, is mailed to the patient. Success of the CPITC is demonstrated in several ways. The clinic initially served Kaiser Permanente members in the Colorado Region. The service has expanded and now also provides travel consults to Kaiser Permanente members in the Northwest and Ohio Regions. Patient satisfaction is high, and significant cost-savings have been realized secondary to avoiding the use of unnecessary vaccinations and medications. The CPITC allows resources to be leveraged and provides one center where individuals trained in travel medicine provide information to members, thus improving efficiency and decreasing cost.

Ambulatory Care Facilities↗
PubMed2006

Empirical evidence for the effect of airline travel on inter-regional influenza spread in the United States.

BACKGROUND: The influence of air travel on influenza spread has been the subject of numerous investigations using simulation, but very little empirical evidence has been provided. Understanding the role of airline travel in large-scale influenza spread is especially important given the mounting threat of an influenza pandemic. Several recent simulation studies have concluded that air travel restrictions may not have a significant impact on the course of a pandemic. Here, we assess, with empirical data, the role of airline volume on the yearly inter-regional spread of influenza in the United States. METHODS AND FINDINGS: We measured rate of inter-regional spread and timing of influenza in the United States for nine seasons, from 1996 to 2005 using weekly influenza and pneumonia mortality from the Centers for Disease Control and Prevention. Seasonality was characterized by band-pass filtering. We found that domestic airline travel volume in November (mostly surrounding the Thanksgiving holiday) predicts the rate of influenza spread (r(2) = 0.60; p = 0.014). We also found that international airline travel influences the timing of influenza mortality (r(2) = 0.59; p = 0.016). The flight ban in the US after the terrorist attack on September 11, 2001, and the subsequent depression of the air travel market, provided a natural experiment for the evaluation of flight restrictions; the decrease in air travel was associated with a delayed and prolonged influenza season. CONCLUSIONS: We provide the first empirical evidence for the role of airline travel in long-range dissemination of influenza. Our results suggest an important influence of international air travel on the timing of influenza introduction, as well as an influence of domestic air travel on the rate of inter-regional influenza spread in the US. Pandemic preparedness strategies should account for a possible benefit of airline travel restrictions on influenza spread.

Aircraft↗
PubMed1999

Compliance of malaria chemoprophylaxis among travelers to India.

BACKGROUND: Compliance is an important issue in malaria chemoprophylaxis. The objective of the study was to determine reasons for noncompliance with chemoprophylaxis among international travelers to India. METHODS: A group of 452 subjects traveling in the subcontinent were interviewed by directly administered questionnaire at two selected locations in Calcutta during October 1992. Full compliance was defined as the uninterrupted use of drugs, as per the World Health Organization (WHO) schedule, during travel up to the date of interview. RESULTS: Overall, the sample had a male preponderance (61%), with 155 (34%) being business travelers and 56% traveling for more than 3 weeks. Of the 158 (35%) reporting illness during travel, 5 persons tested positive for malaria. Compliance with chemoprophylaxis noted among 320 (71%) respondents in comparison to 21 (5%) found taking inadequate dosage or incorrect medication and 111 (24%) travelers being without any drugs. Backpackers and ethnic travelers as a group reported lower usage. Female, first visit and long-term travelers were less compliant. Inadequacy in pretravel advice, discontinuation due to side effects and active decision despite pretravel advice were common reasons for noncompliance. Past travel experience, concern for side effects, perceived uselessness and confusion arising from alternative regimens were also found to have influenced the decision making. CONCLUSION: We need to address the identified areas of conflict especially during pretravel counseling since improving compliance is our primary goal in malaria prevention among travelers today.

Adult↗