scholarly journals Retrospective analysis of older travellers attending a specialist travel health clinic

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Milad Darrat ◽  
Gerard T. Flaherty
Keyword(s):  
Medical Condition ◽  
Travel Medicine ◽  
Significant Proportion ◽  
Antihypertensive Agents ◽  
Health Clinic ◽  
Travel Health ◽  
Wide Range ◽  
Health Advice ◽  
Visiting Friends And Relatives ◽  
The Mean

Abstract Background Older people represent a significant proportion of overseas travellers. The epidemiology of older international travellers is not well described in the literature. This study aims to identify demographics, travel characteristics and the medical profile of older travellers seeking pre-travel health advice in a specialist travel medicine clinic. Methods Records of travellers aged 60 years and older attending the Tropical Medical Bureau clinic in Galway, Ireland between 2014 and 2018 were examined. Descriptive and inferential analysis of data was performed. Results A total of 337 older travellers sought pre-travel health advice during the study period. The mean age of the cohort was 65.42 (±10) years. Most of the travellers (n = 267, 80%) had at least one travelling companion. Nearly half of older travellers (n = 155, 46.8%) were travelling with a single companion. Tourism was the main reason for travel for the majority (n = 260, 77.6%), followed by visiting friends and relatives (VFR) (n = 23, 6.9%) travellers. The mean interval remaining before the planned trip was 4.36 (±2) weeks, and the mean duration of travel was 3.16 (±1) weeks. The most popular single country of destination was India with 33 (9.8%) visitors, and South East Asia was the most popular region with 132 (39.2%) older travellers. The majority of travellers (n = 267, 79.2%) had a documented pre-existing medical condition. The most commonly reported medical conditions were hypertension (n = 26, 7.7%), dyslipidaemia (n = 18, 5.3%), diabetes mellitus (n = 12, 3.5%), insect bite sensitivity (n = 11, 3.3%), and hypothyroidism (n = 9, 2.6%). Antihypertensive agents (n = 32, 9.4%) and statins (n = 24, 7.1%) were the most frequently used medications. Typhoid (n = 112, 33.2%) and hepatitis A (n = 84, 24.9%) were the most common vaccinations administered to older travellers at the clinic. Conclusions This study provides an insight into the demographics, travel characteristics, and medical profile of elderly travellers seeking advice at a large travel clinic in Ireland. A wide range of travel destinations, diseases and medication use was reported among this group of travellers, which may enable travel medicine physicians to provide more tailored advice and to more appropriately counsel older travellers.

scholarly journals Better Late Than Never - An Analysis of Last-Minute Travelers Attending a Specialist Travel Medicine Clinic in Ireland

2019 ◽  
Vol 7 (4) ◽  
pp. 123-128
Author(s):  
Gerard Thomas Flaherty ◽  
Muhammad Haziq Hasnol ◽  
Lokman Hakim Sulaiman
Keyword(s):  
Medical History ◽  
Travel Medicine ◽  
Cross Sectional Study ◽  
Health Clinic ◽  
Past Medical History ◽  
Cross Sectional ◽  
Travel Health ◽  
Vaccination History ◽  
The Mean ◽  
Travel Vaccines

Introduction: Last-minute travelers (LMTs) are a vulnerable group, because it may not be possible to adequately vaccinate them against exposure to infectious diseases. The purpose of this retrospective cross-sectional study was to describe the characteristics of LMTs attending a travel health clinic. Methods: The following data was extracted from records of travelers attending the Tropical Medical Bureau (Galway, Ireland) over a 6-year period with less than 2 weeks remaining before their departure: gender, age, occupation, destination(s), purpose of travel, departure date, travel duration, travel group size, accommodation, past medical history, medications, and vaccination history. Results: Of 7555 traveler records, 1296 (17.2%) were of LMTs, of whom 45 (3.5%) were recurrent LMTs. LMTs were equally likely to be male or female. The mean age of this cohort was 32.2 years. The most common travel destination was Asia, and holiday was the most frequent purpose of travel. The mean interval before departure was 7.54 ± 3.65 days, and the mean travel duration was 7.36 ± 2.3 weeks. The majority (n=454, 35.1%) of LMTs traveled in pairs. Approximately 2 in 5 (n=497, 38.4%) travelers reported a past medical history; over half (n=674, 52.0%) had previously received travel vaccinations. The majority (n=1202, 92.8%) of LMTs were unable to complete a scheduled course of pre-travel vaccines. Conclusion: This study provides insight into the characteristics and travel patterns of LMTs. A large proportion of LMTs have pre-existing medical conditions. Further research should focus on the travel health risk-taking behavior of these individuals.

Malaria prevention in the older traveller: a systematic review

2019 ◽  
Vol 26 (7) ◽  
Author(s):  
Viola Del Prete ◽  
Alberto Mateo-Urdiales ◽  
Aurora Bueno-Cavanillas ◽  
Pietro Ferrara
Keyword(s):  
Travel Medicine ◽  
Population Group ◽  
Malaria Prevention ◽  
Limited Attention ◽  
Prevention Measures ◽  
Travel Health ◽  
Age Related ◽  
Wide Range ◽  
Health Advice

Abstract Older travellers are at higher risk of malaria-related morbidity and mortality compared with younger people. Yet, prevention of malaria in this specific group of travellers is a long-standing issue in travel medicine. The aim of this research was to synthetize the existing evidence about this important topic, highlighting older travellers’ attitudes and practises toward malaria prevention. Searches were performed on PubMed, Embase, EuropePMC, Web of Science, WHOLIS and LILACS databases for relevant studies reporting malaria prevention measures in older travellers. To measure malaria prevention in the older traveller population, the main information outcomes were obtained from the ABCD framework that included travellers’ ‘Awareness’ towards pre-travel health advice, their utilisation of ‘Bite-prevention measures’ and adherence to ‘Chemoprophylaxis’. Data on ‘Diagnosis’-related outcomes were excluded for not being measures of malaria prevention. Three evaluators independently selected studies, extracted data and assessed the quality of the included articles. The research protocol was registered with PROSPERO (protocol number CRD42019124202). Out of the 899 titles and abstracts screened, 13 articles were included in this review synthesis. These studies included a wide range of interventions for malaria prevention: no relevant differences in pre-travel healthcare attendance were found depending on age; older travellers were found to be less likely to comply with bite-prevention measures; three high-quality studies reported that adherence to chemoprophylaxis significantly increased with age, while three studies did not find age-related differences in travellers’ adherence. Overall, prevention of malaria in the older traveller has received limited attention from the scientific community. Older travellers seem to be less likely to comply with bite-prevention measures, but there was high heterogeneity across the reports. This population group demands particular attention and tailored health advice before travelling to malaria endemic areas. More research is required on how to improve malaria prevention in the older traveller.

scholarly journals Pre-travel health care attendance among migrant travellers visiting friends and relatives (VFR): a 10-year retrospective analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Pietro Ferrara ◽  
Cristina Masuet-Aumatell ◽  
Josep Maria Ramon-Torrell
Keyword(s):  
Health Care ◽  
Large Scale ◽  
Travel Medicine ◽  
Health And Safety ◽  
Malaria Prevention ◽  
Prevention Measures ◽  
Vaccination Rates ◽  
Travel Health ◽  
Health Advice ◽  
Visiting Friends And Relatives

Abstract Background Travellers visiting friends and relatives (VFR) define a specific population of travellers exposed to higher risks for health and safety than tourists. The aim of this study was to assess differentials in pre-travel health care in VFR travellers compared to other travellers. Methods A retrospective cohort study was performed including attendees of the Travel Medicine Clinic of the Hospital Universitari de Bellvitge, Barcelona, Spain, between January 2007 and December 2017. Results Over the 10-year period, 47,022 subjects presented to the travel clinic for pre-travel health care, 13.7% of whom were VFR travellers. These showed higher rates of vaccination against yellow fever and meningococcus, but lower rates for hepatitis A, hepatitis B, influenza, rabies, cholera, polio, typhoid IM vaccine and tetanus vaccine boosters. Regarding malaria prevention measures, results highlighted that VFR travellers, when compared with tourists, were more likely to be prescribed with chemoprophylaxis, particularly with mefloquine, than with atovaquone/proguanil. Conclusions Findings from this large-scale study indicated differences in vaccination rates and completion, as well as in chemoprophylaxis for malaria, between VFR and non-VFR travellers, fostering specific interventions for promoting adherence to pre-travel health advice among migrant travellers.

scholarly journals Relationship of altitude mountain sickness and smoking: a Catalan traveller’s cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017058 ◽  
Author(s):  
Alba Sánchez-Mascuñano ◽  
Cristina Masuet-Aumatell ◽  
Sergio Morchón-Ramos ◽  
Josep M Ramon
Keyword(s):  
Smoking Status ◽  
Medical Advice ◽  
Health Clinic ◽  
Travel Health ◽  
Systemic Corticosteroids ◽  
The Mean ◽  
Mountain Sickness ◽  
Relationship Of ◽  
The Relationship ◽  
Chronic Use

ObjectivesThe aim of this study is to analyse the relationship between smoking andaltitude mountain sicknessin a cohort of travellers to 2500 metres above sea level (masl) or higher.SettingTravel Health Clinic at the Hospital Universitari de Bellvitge, in Barcelona, Spain.ParticipantsA total of 302 adults seeking medical advice at the travel clinic, between July 2012 and August 2014, before travelling to 2500 masl or above, who agreed to participate in the study and to be contacted after the trip were included. Individuals who met the following criteria were excluded: younger than 18 years old, taking carbonic anhydrase inhibitors for chronic use, undergoing treatment with systemic corticosteroids and taking any medication that might prevent or treat altitude mountain sickness (AMS) prior to or during the trip. The majority of participants were women (n=156, 51.7%). The mean age was 37.7 years (SD 12.3). The studied cohort included 74 smokers (24.5%), 158 (52.3%) non-smokers and 70 (23.2%) ex-smokers. No statistical differences were observed between different sociodemographic characteristics, constitutional symptoms or drug use and smoking status.OutcomesThe main outcome was the development of AMS, which was defined according to the Lake Louise AMS criteria.ResultsAMS, according to the Lake Louise score, was significantly lower in smokers; the value was 14.9%, 95% CI (6.8 to 23.0%) in smokers and 29.4%, 95% CI (23.5 to 35.3%) in non-smokers with an adjusted OR of 0.54, 95% CI (0.31 to 0.97) independent of gender, age and maximum altitude reached.ConclusionsThese results suggest that smoking could reduce the risk of AMS in non-acclimated individuals. Further studies should be performed in larger cohorts of travellers to confirm these results. Despite the results, smoking must be strongly discouraged because it greatly increases the risk of cardiorespiratory diseases, cancer and other diseases.

Geographical Pattern of Infectious Diseases and Infection Prevention for Travellers

2019 ◽  
Author(s):  
Desmond Hsu ◽  
Zahir Osman Eltahir Babiker
Keyword(s):  
Infectious Diseases ◽  
Migratory Birds ◽  
Sunshine Duration ◽  
The United States ◽  
International Travel ◽  
Travel Health ◽  
Health Advice ◽  
Visiting Friends And Relatives ◽  
Main Determinants ◽  
Key Aspects

Infectious diseases are transmitted either directly from person to person via direct contact or droplet exposure, or indirectly through a vector organism (mosquito or tick) or a non-biological physical vehicle (soil or water). Vector-borne infectious diseases are highly influenced by climate factors such as temperature, precipitation, altitude, sunshine duration, and wind. Therefore, climate change is a major threat for the emergence and re-emergence of infectious diseases, e.g. re-emergence of dengue fever in some parts of southern Europe. The natural reservoirs of infectious diseases are either humans (anthroponoses) or animals (zoonoses). Population movement due to travel or civil unrest risks introducing non-immune populations to regions that are endemic for certain infectious diseases. By contrast, global trade contributes to the movement of animals or arthropods across the world and this poses a major risk for introducing infectious diseases to previously non-endemic settings, e.g. rats on board commercial ships and the global spread of hantaviruses; international trade in used car tyres and the risk of introducing flavivirus-infected mosquitoes into non-endemic settings; and the contribution of migratory birds to the introduction and the spread of West Nile virus in the United States. The unprecedented growth of international travel facilitates the swift movement of pathogens by travellers from one region to another. The main determinants of travel-related infections are destination country, activities undertaken during travel, and pre-existing morbidities. Therefore, the pre-travel consultation aims to assess potential health hazards associated with the trip, give advice on appropriate preventative measures, and educate the traveller about their own health. Attitudes towards seeking pre-travel health advice vary by the type of traveller. For example, those visiting friends and relatives (VFRs) in their country of origin are less likely to seek pre-travel health advice compared to tourists and therefore stand a higher chance of presenting with preventable infections such as malaria. The key aspects of a pre-travel consultation include: ● comprehensive risk assessment based on the demographic and clinical background of the traveller as well as the region of travel and itinerary.

scholarly journals The COVID-19 pandemic offers a key moment to reflect on travel medicine practice

2020 ◽  
Vol 27 (8) ◽  
Author(s):  
Christoph Hatz ◽  
Silja Bühler ◽  
Andrea Farnham
Keyword(s):  
Infectious Diseases ◽  
Travel Medicine ◽  
Evidence Based ◽  
Medicine Research ◽  
Travel Health ◽  
Health Advice

COVID-19 provides an opportunity to review travel health advice priorities. Infectious and non-infectious diseases are key for travel medicine, Research is warranted to stimulate an evidence-based balance in what travel medicine experts communicate to their clients

scholarly journals Quality of Travel Health Advice in a French Travel Medicine and Vaccine Center: A Prospective Observational Study

2012 ◽  
Vol 19 (2) ◽  
pp. 76-83 ◽  
Author(s):  
Marie‐Anne Bouldouyre ◽  
Nathalie Colin De Verdière ◽  
Juliette Pavie ◽  
Nathalie De Castro ◽  
Diane Ponscarme ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Travel Medicine ◽  
Travel Health ◽  
Health Advice

Ebola 2018 – Implications for travel health advice and relevance for travel medicine

2018 ◽  
Vol 24 ◽  
pp. 1-3 ◽  
Author(s):  
Martin P. Grobusch ◽  
Frieder Schaumburg ◽  
Thomas Weitzel ◽  
Camilla Rothe ◽  
Thomas Hanscheid ◽  
...  
Keyword(s):  
Travel Medicine ◽  
Travel Health ◽  
Health Advice

scholarly journals The health behaviour of black hypertensive patients at a chronic diseases clinic in a depressed socio-economic area of Johannesburg, South Africa

1999 ◽  
Vol 55 (1) ◽  
pp. 11-17 ◽  
Author(s):  
A. V. Stewart ◽  
C. J. Eales ◽  
K. Shepard
Keyword(s):  
Blood Pressure Level ◽  
Pressure Level ◽  
Health Clinic ◽  
Structured Interviews ◽  
Hypertensive Patients ◽  
Health Care Practitioners ◽  
Economic Area ◽  
Health Advice ◽  
The Mean ◽  
Community Health Clinic

A sample of hypertensive patients and the health care practitioners at an urban community health clinic were studied to identify their health status and behaviours. Barriers to compliance with health advice were also investigated. A descriptive qualitative approach was used consisting of semi-structured interviews, observations and the analysis of patients’ records. Themes were generated from the coded data. The data revealed that the patients’ compliance was poor (66% attendance at the clinic), the mean blood pressure level was 157/99 and they were often symptomatic. Patients’ understanding of hypertension was fragmented and they did not see it as a silent, chronic disease. They were beset by financial and family worries and stresses. The staff found that it was increasingly difficult to educate the patients as the numbers of patients at the clinic were increasing.

scholarly journals Pre-travel health advice for human immunodeficiency virus-infected travelers, from Rio de Janeiro

2009 ◽  
Vol 42 (3) ◽  
pp. 260-263 ◽  
Author(s):  
Ricardo Pereira Igreja
Keyword(s):  
Human Immunodeficiency Virus ◽  
Rio De Janeiro ◽  
Travel Medicine ◽  
Temperate Climate ◽  
Health Clinic ◽  
Infected People ◽  
Travel Health ◽  
Endemic Diseases ◽  
Health Clinics ◽  
Immunodeficiency Virus

Counseling for human immunodeficiency virus infected travelers is becoming increasingly specialized. Previous studies have reported the experience of HIV-infected travelers from temperate-climate countries but little is known about HIV-infected travelers from tropical countries. A retrospective study was conducted on HIV-infected travelers presenting at a travel health clinic in Rio de Janeiro. Eleven journeys by ten people were recorded. Brazil (Amazon region and Northeast) was the destination for six journeys. Other destinations were Peru, Angola, Europe and Asia. Nine attendees were undergoing antiretroviral therapy. Few HIV-infected people from Rio de Janeiro consulted a travel medicine specialist before traveling. Since they travel to destinations in Brazil and abroad where there are endemic diseases not encountered in Rio de Janeiro, careful pre-travel planning needs to be undertaken. Strategies for increasing the frequency of pre-travel consultations need to be developed, such as closer collaboration between HIV clinics and travel health clinics.

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