Recognition of Imported Tropical Infectious Disease in Returned Travelers in a University Hospital Emergency Department

Abstract

Objective: Healthcare workers practising in Ireland may encounter tropical illness in the re- turned traveler. This study aimed to establish the awareness of tropical diseases in front-line healthcare professionals working in an Irish hospital. Methods: A questionnaire was administered to doctors and nurses working in an Irish univer- sity teaching hospital. The respondents' ability to obtain a travel history, to recognize tropical illness in returned travelers and to demonstrate awareness of the geographical distribution of tropical diseases was evaluated. Results: Fifty clinicians completed the survey (29 doctors and 21 nurses), most of whom had not previously worked in the tropics and had not received formal training in tropical or travel medicine. The following items were not routinely included in their travel histories: illness in traveling companions, water and food consumption, insect and animal bites. Tropical illness was infrequently considered in patients presenting with a variety of common symptoms. There was a poor level of familiarity of several tropical infectious diseases. There was a tendency for doctors to underestimate the prevalence of dengue infection. A substantial proportion of doctors were not confident in their ability to manage a patient with malaria. The educational activities preferred by the majority of respondents were tropical disease manuals, workshops and wall charts. Conclusion: This study highlights a low level of knowledge of tropical medicine among a sample of healthcare workers who may be called upon to assess the returned tropical traveler. Opportunities for training in tropical medicine should be provided to emergency department clinicians.