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Background
International travelers are at high risk of acquiring travelers’ diarrhea. Pre-travel consultation has been associated with lower rates of malaria, hepatitis, and human immunodeficiency virus (HIV) infections. The objective was to study the impact of pre-travel consultation on clinical management and outcomes of travelers’ diarrhea.
Met...
Contexts in source publication
Context 1
... of patients with travelers' diarrhea who did and did not utilize pre-travel consultation are shown in Table 1. Patients who utilized pre-travel consultation were younger and more likely to be students. ...
Context 2
... who utilized pre-travel consultation were younger and more likely to be students. There was a high proportion of Caucasians in both pre-travel and non-pre-travel consultation groups (Table 1). ...
Context 3
... pre-travel consultation group also had a higher rate of typhoid fever vaccine completion: [72% (169/234)] compared to the non-pre-travel consultation group [5% (41/839), p < 0.0001]. Patients who sought pre-travel consultation prior to the index episode of travelers' diarrhea had higher rates of both future and past pre-travel consultations, compared to the non-pre-travel consultation group (Table 1). Duration of travel was recorded as a continuous variable, which was expressed as median (interquartile range). ...
Context 4
... those travelers who seek pre-travel consultation are connected to care with the ID division and may be more likely to seek ID consult- ation for post-travel illness or future travel-related medical issues. This finding is reflected in Table 1, which shows that a greater proportion of patients with travelers' diarrhea and pre-travel consultation utilized ID services post-travel. This specific demographic may have demonstrated more health care-seeking behavior at baseline, possibly due to more comprehensive insurance plans. ...
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Citations
... This is because most organizations, offices, or campuses require all members or participants to undergo pretravel consultation before they engage in activities planned at the destination. [34] The same study by Kwon et al. also reported that in South Korea, although the government has stipulated that all travelers should undergo pre-travel consultation at least 21 days before departure, in reality, most travelers prefer to undergo pre-travel consultation less than 14 days before departure. This makes it so that even though the travelers have undergone pre-travel consultation, their immunity after receiving certain vaccines or therapies is not fully formed. ...
Traveler’s Diarrhea (TD) is a common infectious disease impacting travelers from developed countries who visit developing countries, such as Indonesia. Reporting of Traveler’s Diarrhea (TD) cases in Indonesia is still low, especially in Bali. This study aimed to describe the characteristics of Traveler’s Diarrhea (TD) in foreign travelers visiting beaches in Badung Regency, Bali. This study used cross sectional descriptive method in collecting data. The population was all foreign travelers visiting eight beaches in Badung Regency, Bali. In this study 61 respondents were selected using a purposive sampling technique. Data collection involved a questionnaire and analyzed using univariate statistics. The majority of respondents were European females (70,5%), aged 26-35 (41%), from Germany (11,5%), visiting Bali for tourism (80,3%), their first time in Southeast Asia (47,5%) and Bali (45,9%). Predominant diarrhea characteristics included 3-4 bowel movements per day (75,4%), loose stool consintency (59%) accompanied by abdominal cramps (41%), lasting 1-7 days (96,7%), a single episode (73,8%). Most managed Traveler’s Diarrhea (TD) with medication (63,2%) and continued their travels (80,3%), consumed vegetable salad (50,8%), consumed overnight food (91,8%), consumed raw meat (80,3%) and drank tap water (95,1%). This study suggest that Traveler’s Diarrhea (TD) is prevalent among foreign travelers visiting beaches in Badung Regency, Bali with key factors being the absence of pre-travel consultations, consumption of drinks with ice and vegetables salad. Keywords: Traveler’s Diarrhea, TD, Foreign Traveler, Characteristic
... 7 It is an effective tool that can reduce the morbidity of traveller's diarrhoea and improve health-seeking behaviour, although its uptake has been dismal. 8,9 With increasing accessibility and widespread use of ChatGPT, we anticipate that travellers may turn to chatbots as a convenient option to seek pre-travel advice. As such, we aimed to evaluate pre-travel advice provided by ChatGPT. ...
Highlights
We assessed the accuracy of advice provided by ChatGPT for pre-travel counselling. ChatGPT appears to be complementary to the physical pre-travel consultation, giving appropriate advice and raising awareness. However, the advice lacked specificity, and travel physicians can help to fine-tune the advice provided to an individual’s specific travel needs.
... Finally, our study deliberately assessed the KAP of recruited participants on a selected set of immunizations, but women of childbearing age could be targeted by other interventions of some occupational interest, including but not limited to vaccines for Neisseria meningitidis and Mycobacterium tuberculosis (i.e., BCG) for healthcare workers, Hepatitis A virus, typhoid vaccines, and tick-borne encephalitis vaccine for workers traveling to parts of the world where these pathologies are common, and even rabies vaccines for professionals involved in laboratory and veterinary practice [30,31,[121][122][123][124][125][126][127]. Moreover, workplaces may represent an appropriate setting for improving the acceptance of immunizations with a more limited occupational interest, such as pneumococcus, and mostly human papillomavirus (HPV) vaccines. ...
Citation: Riccò, M.; Baldassarre, A.; Cerviere, M.P.; Marchesi, F. Vaccine Hesitancy in Women of Childbearing Age and Occupational Physicians: Results from a Cross-Sectional Study (Italy, 2022). Women 2023, 3, 237-262. Abstract: Italian occupational physicians (OPs) are instrumental in promoting vaccination practice in occupational settings, and this study aims to characterize their attitudes, knowledge, and practices (collectively, KAP) towards immunization practice in women of childbearing age. A convenience sample of 120 OPs (50.8% males, mean age of 48.2 ± 5.9 years old) completed a structured online questionnaire (potential recipients: 2034; response rate: 5.9%) assessing their understanding of official recommendations, their general knowledge of vaccine practice, their attitudes towards vaccines, and their risk perception about vaccine-preventable infectious diseases. The sampled OPs exhibited a good understanding of official recommendations, and they were largely favorable towards vaccination of pregnant women. Knowledge status was relatively good (potential range 0 to 100%, average score 22 74.5% ± 18.2), while risk perception towards sampled disorders was heterogenous: the greatest was the one for SARS-CoV-2 (52.7% ± 32.9), followed by seasonal influenza (45.3% ± 31.6), and pertussis (37.8% 24 ± 28.2). The main predictors for promoting vaccination were higher knowledge about seasonal influenza vaccine (SIV; adjusted Odds Ratio [aOR] 102.2, 95% Confidence Interval [95%CI] 9.68-1080.26), tetanus-diphtheria-acellular pertussis vaccine (Tdap; aOR 12.34, 95%CI 2.62; 58.22) 27 and SARS-CoV-2 vaccine (aOR 14.76, 95%CI 2.74-79.69). A better attitude towards SIV was positively associated with previous vaccination of the respondent (aOR 4.90, 95%CI 1.19-20.14), while higher risk perception towards SIV was characterized as a negative predictor (aOR 0.04, 95%CI 30 0.01-0.35), as was working as an OP in healthcare facilities (aOR 0.03, 95%CI 0.01-0.43). Tdap was positively associated with male gender of respondents (aOR 10.22, 95%CI 2.60 to 40.24) and higher risk perception about pertussis (aOR 10.38, 95%CI 1.47 to 73.47). Overall, our data suggest that improving the understanding of OPs about the health burden of frequently encountered pathogens could be instrumental in increasing their involvement in the promotion of vaccine practice. Because of the low rate of response to our survey, our conclusions remain tentative.
... When dealing with overseas workers, an appropriate pre-travel consultation represents a major opportunity to educate the worker about health risks at the destination and how to mitigate them [58], eventually improving travelers' health status [59,60], representing and increasingly important field of intervention not only for GP [26,59,61] but also for OP [58,62]. Although the substantial health burden represented by TD in international travelers [1,2,47,63,64], including occupational settings and overseas workers [45], very little is known about the KAP of OP. Interestingly, even the share of OP actively involved in pre-travel consultation is largely undefined. ...
Even though Italian Occupational Physicians (OP) are increasingly involved in the managing of overseas workers, their knowledge, attitudes, and practices (KAP) in travel medicine are mostly undefined. We, therefore, permed a KAP study specifically targeting the management of travelers’ diarrhea (TD) by OP. A total of 371 professionals (43.4% males; mean age 40.8 ± 10.9 years) completed in 2 rounds (2019 and 2022) a specifically designed web questionnaire that inquired participating OP on their knowledge status (KS), risk perception, and management of TD through pre- and post-travel advice and interventions. Multivariable odds ratios (aOR) for predictors of a better knowledge status were calculated through regression analysis. Eventually, the majority of participants (53.4%) had participated in the management of cases of TD in the previous months, but only 26.4% were reportedly involved in pre-travel consultations. The overall knowledge status was unsatisfying (potential range: 0–100%, actual average of the sample 59.6% ± 14.6), with substantial uncertainties in the management of antimicrobial treatment. Interestingly, only a small subset of participants had previously prescribed antimicrobial prophylaxis or treatment (3.5% and 1.9%, respectively). Main effectors of a better knowledge status were: having a background qualification in Hygiene and Public Health (aOR 14.769, 95%CI 5.582 to 39.073), having previously managed any case of (aOR 3.107, 95%CI 1.484 to 6.506), and having higher concern on TD, reported by acknowledging high frequency (aOR 8.579, 95%CI 3.383 to 21.756) and severity (aOR 3.386; 95%CI 1.741 to 6.585) of this disorder. As the adherence of participating OP to official recommendations for TD management was unsatisfying, continuous Education on Travel Medicine should be improved by sharing up-to-date official recommendations on appropriate treatment options for TD.
... The study would be in line with what the literature suggests: travel medicine needs constant testing to identify areas of strengths and weaknesses (Schlagenhauf et al.,2015). Pre-trip interview assessment studies by travelers can provide information on the impact of the Tab. 1 -Breakdown of PICOS applications for the follow-up of the international travelerinterview and on the disorders / illnesses that arose during or after thetravel(Tan et al., 2018). ...
Travel health promotion aims to inform about the risks associated with international travel and ways to prevent them. At the U.O. Hygiene and Health Public of the Local Health Authority of Romagna, there are dedicated clinics that offer consultancy and vaccine prophylaxis. There is currently no follow-up on the return of the traveler who has gone to the clinic. In light of the above, a prospective observational study was prepared through the administration of an anonymous online questionnaire, drawn up on the basis of the available literature and aimed at international travelers who presented themselves for a pre-trip interview at the U.O. Hygiene and Public Health of the USL Company of Romagna A.T. of Rimini in the period between October 2019 and July 2020, in order to follow the traveler back to Italy and provide useful elements to guide and improve the pre-trip interview. To complete the study, data was collected on the activity of the Rimini clinic for travelers for the period 2013-2019 and an analysis of the cases of imported infectious diseases reported in the province of Rimini in the period January 2015 -July 2020. The traveler is informed about the health risks of the trip (94.1%), satisfied / very satisfied with the interview (92.1%) and with the information received (70.6%). The most frequently administered vaccinations to travelers are those against hepatitis A, yellow fever and typhoid fever. Malaria is the most frequently reported import disease, followed by hepatitis A and dengue. In 54.5% of cases, the reason for the trip was a visit to relatives or friends, data in line with the literature.
... The study would be in line with what the literature suggests: travel medicine needs constant testing to identify areas of strengths and weaknesses (Schlagenhauf et al.,2015). Pre-trip interview assessment studies by travelers can provide information on the impact of the Tab. 1 -Breakdown of PICOS applications for the follow-up of the international travelerinterview and on the disorders / illnesses that arose during or after thetravel(Tan et al., 2018). ...
Travel health promotion aims to inform about the risks associated with international travel and ways to prevent them. At the U.O. Hygiene and Health Public of the Local Health Authority of Romagna, there are dedicated clinics that offer consultancy and vaccine prophylaxis. There is currently no follow-up on the return of the traveler who has gone to the clinic. In light of the above, a prospective observational study was prepared through the administration of an anonymous online questionnaire, drawn up on the basis of the available literature and aimed at international travelers who presented themselves for a pre-trip interview at the U.O. Hygiene and Public Health of the USL Company of Romagna A.T. of Rimini in the period between October 2019 and July 2020, in order to follow the traveler back to Italy and provide useful elements to guide and improve the pre-trip interview. To complete the study, data was collected on the activity of the Rimini clinic for travelers for the period 2013-2019 and an analysis of the cases of imported infectious diseases reported in the province of Rimini in the period January 2015 -July 2020. The traveler is informed about the health risks of the trip (94.1%), satisfied / very satisfied with the interview (92.1%) and with the information received (70.6%). The most frequently administered vaccinations to travelers are those against hepatitis A, yellow fever and typhoid fever. Malaria is the most frequently reported import disease, followed by hepatitis A and dengue. In 54.5% of cases, the reason for the trip was a visit to relatives or friends, data in line with the literature.
... However, there were major differences between groups in addition to heavy potential risks of bias. 16 A retrospective cohort study published in 2014 demonstrated statistically significant differences in rates of travellers' diarrhea and insect bites between those participants who received a pretravel consult and those who did not. There was a nonsignificant difference in malaria rates between the 2 groups; however, the frequency of illness was low (3 patients in the control group vs 0 in the case group). ...
... Concerning the most important microbiological causes described for travelers with this profile in this study, our approach to travelers with diarrhoea could change, as antiparasitic treatments could be considered to be given in specific situations instead of antibacterial. However, given the increase in drug resistance among different pathogens, these recommendations should still be prudent [36]. ...
Background
The aim of the study is to describe the epidemiological, clinical, and microbiological characteristics of patients with diarrhoea after their return from a trip to tropical and subtropical areas.
Methods
Retrospective study of patients with travel-related diarrhoea attended International Health referral center. Travel diarrhoea was defined as the presence of three or more liquid stools per day, or liquid stools more often than is normal for the individual, during travel or within two weeks after returning. Epidemiological, clinical and microbiological variables were collected.
Results
669 patients were included, 393 (58.7%) were female, with a mean age of 33 (SD 10.7) years. Abdominal pain was present in 59.6% (n = 399), and fever in 44.7% (n = 299). In 43% (n = 280) cases the etiological agent was found. Giardia duodenalis, Enteropathogenic Escherichia coli, and Enterotoxigenic Escherichia coli were the most frequent identified causative agents. Parasitic cause of the diarrhoea was associated to a longer duration of the travel, longer duration of symptoms, and having received pre-travel counseling.
Conclusions
In our cohort, that represents a group of travellers presenting prolonged symptoms after travel, the most frequent causes of diarrhoea were parasitic infections being the most prevalent Giardia duodenalis. This information could be relevant in order to improve travel-related diarrhoea management protocols in this type of patients.
... The effectiveness of this program can diminish risk behavior and improve the preventive measures of infectious diseases (Al-Abri et al., 2016). Tan, St. Sauver, and Sia (2018) also reported that travelers who had travelers' diarrhea (TD) and did not uptake PTHC would be faced with prolonged hospitalization and lack of capability to comply with medication regimen while diagnosed with TD. ...
Introduction: Travelers may transmit diseases due to their behavior of travel, consequently travelers should consider preventive measurement through pre-travel health consultation seeking behavior. Pre-travel health consultation is a particular preparation ideally conducted by international travelers to obtain risk assessment and management to prevent the transmission of diseases. This study investigates the relationship of socio-demographic characteristics and itinerary on pre-travel health consultation behavior among international travelers in Badung, Bali.Methods: A descriptive-correlative design using a cross-sectional approach employed 125 participants determined by a purposive sampling technique performed in the ten tourist destinations of Badung Regency. Data collection was conducted on February 15th until March 5th, 2020. Data demography, travel plan, and anonymous questionnaires regarding pre-travel health consultation behavior are used in this research. The Gamma coefficient correlation and Kruskal-Wallis statistic tests were performed in the study for bivariate analysis.Results: The results showed that age (p<0.0001; r=-0.650) and past-travel history to Bali (p=0.004; r=-0.475) were significantly correlated with pre-travel health consultation behavior among international travelers in Badung, Bali. Meanwhile sex, nationality, last education, travel duration, and types of the destination visited were not significantly associated with pre-travel health consultation behavior among international travelers in Badung, Bali (p>0.05).Conclusion: The age and past-travel history to Bali seem to be predictors for travelers to uptake pre-travel health consultation, thus nurses should be able to promote the implementation of pre-travel health consultation by utilizing the media promotion appropriately adjusted to the age of travelers and travel experience.
... However, in a retrospective cohort study of international travelers, travel to Africa was associated with a higher likelihood of making a pretravel visit to a travel medicine clinic or primary care provider for consultation regarding traveler's diarrhea. 32 For VFR trips home, variables significantly associated with having a travel-associated illness were travel companions and purpose of travel. Among all trips in this analysis, reported illness was associated with the youngest and oldest agegroups, VFR travelers not going home, and traveling with children. ...
U.S. residents traveling internationally to regions with increased risk of infectious diseases infrequently seek pretravel health care. First- and second-generation immigrants traveling to their countries of origin and visiting friends and relatives (VFRs) have increased risk of certain infectious diseases and are more likely to participate in high-risk activities. In an online survey of 994 U.S. residents with two foreign-born parents who went on at least one international trip to an at-risk country (defined as having a typhoid vaccine recommendation) in the prior 3 years, respondents were questioned about their international travel over the previous 3 years and their knowledge and individual risk of disease. Participants reported infrequently seeking pretravel health information (32% of trips) or consulting a healthcare provider before their trips (15% of trips). Participants reported seeking pretravel health information less often for VFR trips home (22%) than to other regions (30%). Perceived risk of disease was directly associated with seeking pretravel health information (82% for the highest and 13% for the lowest perceived risk), consulting a healthcare provider (55% for the highest and 5% for the lowest perceived risk), and reporting travel-associated illness (54% for the highest and 10% for the lowest perceived risk). Respondents were generally knowledgeable about cholera, hepatitis B, malaria, and rabies but had low knowledge of hepatitis A and typhoid. Understanding where VFR travelers lack understanding of disease transmission and which travelers are ideal targets for interventions has the potential to shape physician recommendations and public health strategy in this vulnerable population.
