Compliance of Austrian tourists with prophylactic measures
Institute of Specific Prophylaxis and Tropical Medicine, University of Vienna, Austria. European Journal of Epidemiology
(Impact Factor: 5.34).
04/1992; 8(2):243-51. DOI: 10.1007/BF00144808
Physicians dealing with prophylactic measures for tourists going to developing countries will often not be able to foresee the outcome of their recommendations. Therefore an open study with 2,627 Austrian tourists on their flight home from a tropical destination was carried out to evaluate the behaviour of typical short-term travellers with respect to different kinds of precautionary measures. 94.1% of all tourists informed themselves before travelling abroad, but a high proportion of travellers tends to contact only their travel agency or their personal friends, this leading to inadequate information. Regarding the individual performance of precautionary measures the results indicate a few principal conclusions: Among the recommended inoculations the vaccinations against typhoid fever, poliomyelitis and tetanus are widely underestimated, the latter two in particular for adults, while compliance with the passive immunization against Hepatitis A is generally good (more than 80% of all travellers receive Hepatitis A immunoglobulins prophylactically). The most crucial point seems to be the chemoprophylaxis against malaria in as much as a) there seems to be a considerable lack of information about malaria endemic areas among phycisians, b) tourists tend to use the most simple applicable drug unaware of epidemiological considerations and c) the regular intake of chemoprophylaxis declines significantly with the complexicity of the intake procedure.
In addition, tourists are in general well informed about nutritional risks, but only half of them will receive adequate information on the risk of sexually transmitted diseases and a basic medical travel kit.
Available from: Marianna Diomidous
- "In many cases vaccination is considered essential for specific destination countries. Vaccination criteria are age, sex, underlying pathological diseases as well as the frequency of diseases in the host country (8). "
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ABSTRACT: There is an increasing number of people who travel around the world. Every traveler is exposed to nearly all infectious risks which may occur during his travel time. Some of the main risk factors can be water quality, temperature and high humidity and the exposure to multi-resistant microorganisms. To tackle the upcoming problem there is an imperative need to develop a new branch of medicine with the name of travel medicine.
A consultation prior to departure for an upcoming trip is required, focusing to a personalized healthcare plan, based on international scientific protocols and epidemiological studies.Travelers must acquire essential information about the prevailing hygiene conditions and climatic differentiations that occur in the region. Additionally there are several health risks upon the arrival at destination. A scheduled visit to a health professional is necessary, especially in the case of travelers suffering from chronic diseases or those taking medication, while vaccination is considered essential for specific destination countries. Healthcare professionals should be able to inform travelers and evaluate their needs. According to research studies on notion and attitudes travelers' specific risks, only few of them are well-informed during a trip. While most studies indicate that travelers have some kind of pre travel medical consultation, not all of them proceed to the required vaccinations and medications.
Travelling for business or leisure around the world may be unhealthy. The importance of proper preparation prior to the travel requires to be adequately informed by specialized healthcare professionals, and to receive appropriate vaccinations and medications, when required. The results of the review of notions and attitudes of travelers during the trip indicate not only the need for further development of the branch of travel medicine but especially the need for the expansion and the availability of health services.
Available from: Michael P Muehlenbein
- "Many travelers do not utilize pretravel preventive health strategies, including physician advice and chemoprophylaxes (Crockett and Keystone, 2005; Van Herck et al., 2003). A significant proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses (Lopez-Velez and Bayas, 2007; Prazuck et al., 1998; Schunk et al., 2001; Van Herck et al., 2004), and a majority of these travelers demonstrate poor recall of actual vaccination status (Falvo et al., 1996; Kollaritsch and Wiedermann, 1992; Wilder-Smith et al., 2004). Many do not understand basic risks of infection, nor are able to recognize common sources and causes (Van Herck et al., 2004; Wilder-Smith et al., 2004; Zuckerman and Steffen, 2000). "
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ABSTRACT: Anthropozoonotic (human to nonhuman animal) transmission of infectious disease poses a significant threat to wildlife. A large
proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses, and a majority of these
travelers demonstrate poor recall of actual vaccination status. Here we characterize self-perceived vaccination status among
a large sample of ecotourists at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. Despite their recognized travel
itinerary to view endangered animals, tourists at wildlife sanctuaries are not adequately protected against vaccine-preventable
illnesses. Of 633 surveys, over half reported being currently vaccinated against tuberculosis, hepatitis A, hepatitis B, polio,
and measles. Fewer participants reported current vaccination status for influenza, rabies, and chickenpox. Despite the fact
that the majority of visitors to Sepilok are from temperate regions where influenza is relatively more prevalent, 67.1% of
those surveyed with medical-related occupations reported not being currently vaccinated for influenza. Ecotourists concerned about environmental
protection are themselves largely unaware of their potential contribution to the spread of diseases to animals. The risks
of negatively affecting animal populations must be communicated to all concerned parties, and this may begin by urging travelers
to examine their actual vaccination status, particularly as the ecotourism industry continues its rapid expansion, and is
seen increasingly as a possible tool to save great ape populations from extinction.
Available from: Frank Cobelens
- "Among travellers to endemic areas, compliance regarding malaria chemoprophylaxis is generally poor, ranging from 32 to 74% depending on the definitions used (Phillips-Howard et al. 1986; Lobel et al. 1987, 1990; Coole et al. 1989; Steffen et al. 1990; Kollaritsch & Wiedermann 1992; Gyorkos et al. 1995). Malaria chemoprophylaxis has been shown to have a low costto-benefit ratio compared to other prophylactic interventions in travellers (Behrens & Roberts 1994), and several studies suggested increased risks of malaria in non-compliant travellers (Lobel et al. 1987; Gyorkos et al. 1995; Phillips-Howard et al. 1990; Behrens & Curtis 1993). "
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ABSTRACT: Self-reported compliance with a malaria chemoprophylaxis regimen of proguanil (PG) plus chloroquine (CQ) was assessed in a cohort of 547 Dutch travellers who visited a single travel clinic when travelling to various areas endemic for falciparum malaria. 503 (92%) had taken PG/CQ prophylaxis, but only 326 (60%) reported regular and uninterrupted use throughout the journey and 4 weeks afterwards. Compliance differed by travel destination and was 45% in South America, 52% in West Africa, 53% in South-east Asia, 60% in the Indian Subcontinent and 78% in East Africa. Parasitologically confirmed falciparum malaria occurred in 5 travellers (0.9%), including 3 of 24 non-compliant travellers to West Africa (12.5%). Apart from destination, independent risk factors for non-compliance were young age, extensive travel experience and adventurous travel. Compliance with protection against mosquito bites was 80% for wearing long-sleeved shirts and long-legged trousers after sunset, 73% for use of repellents, 56% for sleeping under bed nets and 37% for keeping the sleeping quarters free of mosquitoes. Although 440 travellers (80%) reported to have taken two or more of these measures at least once, only 88 (16%) had done so on a daily basis. Daily use of bed nets was reported more frequently among subjects who were non-compliant with chemoprophylaxis. Compliance regarding malaria chemoprophylaxis should be improved, particularly in high-risk areas such as Sub-saharan Africa, with extra attention to young, adventurous travellers. More emphasis should be placed on prevention of Anopheles bites.
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