Article

Pretravel Health Preparation Among US Residents Traveling to India to VFRs: Importance of Ethnicity in Defining VFRs

Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Journal of Travel Medicine (Impact Factor: 1.58). 03/2009; 16(2):112-8. DOI: 10.1111/j.1708-8305.2008.00284.x
Source: PubMed

ABSTRACT

International travelers visiting friends and relatives (VFRs) in lower income countries experience high rates of travel-related infections. We examined demographic characteristics and pretravel preparation practices among US residents traveling to India to determine factors that may contribute to higher infection rates and that would allow for improved prevention strategies.
A cross-sectional study was conducted among US residents traveling to India in departure areas for flights to India at three US international airports during August 2005. Eligible travelers were US residents going to India who were English speaking and >or=18 years. Self-administered questionnaires were used to assess knowledge of and compliance with pretravel health recommendations.
Of 1,574 eligible travelers, 1,302 (83%) participated; 60% were male and the median age was 37. Eighty-five percent were of South Asian/Indian ethnicity and 76% reported VFR as the primary reason for travel. More than 90% of VFRs had at least a college education and only 6% cited financial barriers as reasons for not obtaining travel health services. VFRs were less likely than non-VFR travelers to seek pretravel health advice, to be protected against hepatitis A or typhoid fever, and less likely to be taking appropriate antimalarial chemoprophylaxis. However, when stratified by ethnicity, travelers of South Asian ethnicity were less likely than other travelers to adhere to pretravel health recommendations, regardless of VFR status.
Similar to previous studies, VFR status was associated with pretravel health practices that leave travelers at risk for important infectious diseases. This association differed by ethnicity, which may also be an important marker of nonadherence to pretravel health recommendations. These findings have important implications for identifying at-risk travelers and properly targeting prevention messages.

Download full-text

Full-text

Available from: Phyllis Kozarsky, Jan 25, 2016
  • Source
    • "However, we found migrant Australian travelers to be half as likely to seek pre-travel advice from a health professional and more likely to be traveling to visit friends and relatives than Australian-born travelers. Recent evidence also suggests that ethnicity, in addition to travel to visit friends and relatives, is an important indicator of infectious disease risk during travel [30]. Australian migrants who travel may be at a greater risk of infectious diseases than Australian-born travelers due to their lower uptake of pre-travel health advice, regardless of reason for travel. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health advice than Australian-born travelers. This study highlights differences in health-seeking practices including the uptake of pre-travel health advice by region of residence and country of birth. There is a public health need to identify strategies targeting these travel groups. This includes the promotion of affordable and accessible travel clinics in low resource countries as traveler numbers increase and travel health promotion targeting migrant groups in high resource countries. General practitioners should play a central role. Determining the most appropriate strategies for increasing pre-travel health preparation, particularly for vaccine preventable diseases in travelers is the next stage in advancing travel medicine research.
    Full-text · Article · May 2012 · BMC Public Health
  • Source
    • "It is known that malaria partial immunity in VFRs who are resident outside malarious areas wanes with time resulting, especially after 12 years, in a more serious malaria clinical presentation.9 Several studies demonstrate also a lower use of malaria chemoprophylaxis in VFRs, probably also for socio-economic factors, in order to confirm the higher risk of disease in this particular group of travellers.10–11–12 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Malaria is one of the most widespread infectious diseases of our time, causing 655 000 deaths during 2010 (WHO), most of them in sub-Saharan Africa and under the age of 5. During the last few years an increasing number of imported malaria cases is reported in Europe and Mediterranean countries, probably supported by the increasing number of international travel in association with the important influx of immigrants from malaria-endemic countries. Moreover, the presence of Anopheline vectors in Mediterranean countries, the returned infected travellers as a source of parasite and climate changes may result in the reappearance of malaria in countries where it was previously eradicated, such as Greece in recent years. Several cases of autochthonous malaria have recently been reported to support the need of an ongoing surveillance for mosquito control and an increased vigilance by health professionals. The aim of this paper is to critically review all the available literature about imported malaria in Mediterranean areas and the potential consequences of this.
    Full-text · Article · Jan 2012 · Mediterranean Journal of Hematology and Infectious Diseases
  • Source
    • "According to current data published by the World Tourism Organisation, every year over 150 million travellers visit developing countries, including 52 million travelling to South Asia and Oceania, 31 million to Africa and approximately 37 million to Central and South America [8] [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. According to current data published by the World Tourism Organization, over 150 million travellers have visited developing countries every year during the last decade. Undoubtedly, appropriate knowledge in the field of tropical medicine is important for healthcare professionals, including nurses, who are increasingly exposed to clients/patients travelling to or from tropical countries. Objectives. The purpose of the study was to evaluate the level of knowledge of contagious diseases and tropical medicine among nurses and nursing students in the Podlaskie District of Poland. Material and Methods. The study was based on two self-developed survey questionnaires, one of which was administered to 500 nurses in the Podlaskie District and the other to 500 nursing students at the Medical University in Bialystok. Results. The study showed that one in every nine nurses stated that they have no contact with contagious diseases in their everyday practice. Just over 30% of the nurses surveyed were convinced that their knowledge of contagious diseases and preparation to educate patients in that field is insufficient, and over half of the nurses had never trained patients in those matters. The study showed that almost 90% of the nurses surveyed had never educated patients in topics associated with tropical medicine, and the remaining 10% had done it "sporadically". The study demonstrated that the vast majority of students (90%) had not participated in patient education in tropical medicine. The majority of participating students (64%) believe that education for nurses in the area of tropical medicine is necessary. Conclusions. Nurses' and nursing students' knowledge of contagious and tropical diseases is insufficient; but both groups are interested in broadening their knowledge of contagious diseases and tropical medicine (Adv Clin Exp Med 2011, 20, 4, 461-471).
    Full-text · Article · Jul 2011 · Advances in Clinical and Experimental Medicine
Show more