Pre-travel Consultation Research Articles

Knowledge, attitude and practices regarding travel medicine among health care workers in a tertiary care centre

Background: International travel whether for business, work or other reasons is increasing very rapidly. Along with this the risk for travel related illness has also increased exponentially as a very few travellers seek pre and post travel advice and our health care workers can play an important role in this field. To access the current knowledge, attitude, practice of travel medicine among health care workers. Methods: The participants were briefed about the purpose of the study prior to its commencement. The questionnaire was framed in 2 sections. Section I covered the demographic profile while section II pertained to knowledge, attitude and practice. The questions were developed focusing on the domains that were already used in similar published literature. A Google form link was sent to the participants and they were given a time span of 2 days to completely fill the Google Form. Results: Nearly all the participants had a fair knowledge regarding travel medicine (52.1%), associated diseases with it (68.6%) and the most common medicines to be prescribed during travel (65.3%). But (71.9%) were still unaware about the recommended guidelines related to travel medicine. A great number of participants (90%) were of the impression to create awareness among HCWs about presentation of illness in travellers. Most of the HCWs (72.7%) were aware of the issues that needed to be addressed in pre-travel consultation which could help to reduce the risk of illness and injury during travel. Most of HCWs (81%) were of the belief to encompass training related to travel medicine to be incorporated in medical curriculum. Conclusion: HCWs has fair knowledge and positive attitude and practices with more trainings in the form of workshops and CMEs on Travel Medicine.

What Do Travelers Know about Traveler's Diarrhea? Impact of a Pre-Travel Consultation in the Lisbon Area, Portugal.

Traveler's diarrhea (TD) is one of the most common travel-related health problems, largely interfering with planned activities and potentially contributing to antimicrobial resistance. This study aimed to characterize the knowledge about TD among pre-travel consultation users of one Portuguese travel clinic and determine the impact of the consultation on knowledge levels. Using a quasi-experimental, separate-sample pretest-posttest design, participants were randomly assigned to two groups: control/pre-consultation group (CG) or experimental/post-consultation group (EG). An anonymous self-administered questionnaire was used. A total of 470 participants were analyzed (227 CG; 243 EG). The EG/post-consultation group showed significant improvement in knowledge, with correct answers increasing from 63% to 75% (p < 0.001). However, knowledge gaps persisted: over 50% were unaware of TD's self-limited nature, 30% did not recognize loperamide as a symptom reliever, and 36% believed all travelers should take antibiotics to prevent TD. The educational level and previous travel outside Europe influenced baseline knowledge; previous travel medicine consultations and information on TD improved knowledge in both groups and made it easier to acquire knowledge on the subject. Thus, a pre-travel consultation effectively increased travelers' TD knowledge. However, post-consultation knowledge levels remained suboptimal, indicating the need for targeted interventions to increase travelers' literacy and optimize pre-travel consultations.

Evaluating Pre-travel Health Consultations for Business and Occupational Travelers: A Systematic Review.

Business and occupational travelers' health is at risk due to the specific itineraries and activities, prolonged stays, work-related stressors, short preparation time, more chances of disease importation, underutilization of vaccination, and chemoprophylaxis. The objective of the review is to assess theeffectiveness of pre-travel health consultation and how it will help travelers prevent health risks. The question is to evaluate how can prolonged stays and underutilization of chemoprophylaxis and vaccination be better managed with pre-travel health consultation. The literature was searched on databases such as PubMed, Google Scholar, Cochrane Library, and Semantic Scholar using Boolean operators with keywords and Medical Subheading (MeSH) terms such as "occupational travelers," "business travelers," "pre-travel health consultation," "effectiveness of consultation," "health risk assessment," "travel illness prevention," "risk management," and "risk assessment" to retrieve relevant published studies. The Cochrane Risk of Bias (ROB) 2.0 tool and Newcastle Ottawa scale (NOS) were utilized to measure the risk of bias. The Grading, Recommendation, Assessment, Development, and Evaluation (GRADE) tool was used to assign evidence strength. In total, a preliminary search yielded 334 articles. One high-quality study and seven studies of moderate quality were included. In conclusion, pre-travel health consultations are a vital tool to prevent travel-related health problems in business and occupational travelers. The current approach needs to be more specific and proactive to address health-specific risks experienced by travelers. However, early comprehensive consultations focusing on preventive measures, region-specific health risks, and timely immunizations are crucial to improving health outcomes. Moreover, enhanced guidance, awareness, and education of health professionals are also necessary to treat the complex medical needs of business and occupational travelers effectively.

Effect of Studying Abroad on Catch-Up Vaccination in Young Adults: A Study Using the Japan Pretravel Consultation Registry1

PurposeTo investigate the effect of studying abroad on catch-up vaccination coverage for measles, rubella, mumps, varicella, and tetanus during the pretravel consultation among young adult travelers. MethodsThis retrospective cohort study analyzed data from the Japan Pretravel Consultation Registry (J-PRECOR) on individuals aged 18–21 years with childhood vaccination records. Propensity score weighting was used to estimate the average treatment effect on the proportion of participants receiving catch-up vaccination. ResultsAmong 1,091 eligible participants, the catch-up vaccination need was highest for mumps (65.7%) and varicella (49.0%) and lowest for measles (9.9%) and rubella (14.0%). In the unadjusted analysis, the catch-up vaccination rate was 70.6% for tetanus, 50.9% for measles, 47.7% for rubella, 40.0% for mumps, and 23.9% for varicella. In the weighted analysis, the study-abroad group had significantly higher catch-up vaccination rates for measles (54.6% vs. 29.8%, P = 0.039), rubella (53.0% vs. 22.1%, P < 0.001), and varicella (26.8% vs. 10.9%, P = 0.002), whereas the non-study-abroad group had a higher catch-up vaccination rate for tetanus (62.4% vs. 78.4%, P = 0.024). ConclusionCompared with other travelers, the catch-up vaccination rate among travelers studying abroad was higher for measles, rubella, and varicella, but lower for tetanus. In clients planning to study abroad, vaccinations required for travel should be recommended in addition to those required by the host institution, and vaccination against highly infectious diseases with potential for complications, such as measles, rubella, mumps, and varicella, should be recommended to clients traveling for reasons other than studying abroad.

Imported malaria in a non-endemic country: sixteen years of cases in a hospital in the South of Madrid, Spain

PurposeMalaria keeps on being a serious global health threat, especially in many tropical countries, where it is endemic. Also in non-endemic countries, like Spain, malaria is an issue that requires attention due to the presence of imported cases.MethodsThis is a retrospective study, including all patients diagnosed with malaria at Severo Ochoa University Hospital from 2006 to 2022, being classified according to: (I) their type of stay in an endemic area as visiting friends and relatives (VFR), migrants of recent arrival (MRA), or tourism and business (T&B), and (II) the mode of presentation as microscopic (MM) or submicroscopic (SMM) malaria.ResultsIn this study, 132 patients (23.7% of all suspected) were diagnosed with malaria. The PCR was the most sensitive technique (99.2%), followed by antigen detection (78.8%) and microscopy (75%), with Plasmodium falciparum being the predominant species (94.7%). VFR was the largest group infected with malaria (69.7%), mostly symptomatic (98.2%) and presenting MM (90.2%). Instead, MRA patients (25%) presented milder (47.4%) or no symptoms (31.6%) and higher cases of SMM (42.4%). Coinfection with another imported pathogen was present in 19 patients (14.4%), being MRA more frequently coinfected (30.3%)ConclusionThis study shows the need for establishing systems for VFRs to attend pre-travel consultations to reduce malaria imported risk. In the case of MRA, screening for imported diseases should be conducted upon their arrival. Finally, we highlight two cases of co-infection with imported viruses, showing that presence of symptoms resembling malaria from another imported pathogen does not exclude malaria.

Implementation of ChatGPT to enhance pre-travel consultation in a specialist tertiary centre in Singapore.

We designed and implemented an interactive artificial intelligence tool based on ChatGPT to complement the pre-travel consultation in a specialist tertiary centre that cares for a range of travellers including those who have undergone solid organ or bone marrow transplantation, as well as persons living with HIV.

Behavior and Knowledge of Outgoing Thai Travelers Related to Medicinal Use

Consultation with a healthcare professional before to travel is the basis of travel medicine. Those who received pre-travel advice from health experts exhibited lower risk behavior. This study aimed to identify outgoing Thai travelers’ behavior and knowledge regarding medicinal use when traveling. A cross-sectional survey of Thai nationals traveling abroad was conducted via a self-administered online questionnaire. The analyzed data was collected from February 2020 to June 2020. A descriptive statistic was used for the data analysis. Seven hundred people agreed to take part in this study. Most of them were female and aged 51-60 years old. The most popular destinations among the respondents were located in Asia, followed by Europe. The top five destination countries were Japan, China, Vietnam, Laos and Germany. A preferred source of information on pre-travel health consultation was the internet (43.51%). Most of the respondents did not have travel vaccinations (82.29%). Over-the-counter drugs were the most common medication carried by the respondents. Many of the outgoing Thai travelers had a good (41.29%) to excellent (46.86%) level of behavior related to medicinal use both before and during their journeys. Many participants reported that they checked the expiration date and the appearance of the medicine. Age exhibited a significant relationship with respondents’ behavior. Numerous respondents had an excellent level of knowledge related to medicinal use in terms of their medicines’ stability and storage, its use and administration, and medical laws. Gender, marital status, income, and immunization before travel had a significant relationship with the respondents' knowledge. Most of respondents obtained health-related information prior to their travels via the internet. Most participants had great level of health behavior and medicinal use knowledge.

Exploring the utilization and perceptions of pre-travel health consultations in primary care settings in Saudi Arabia: a cross-sectional study

BackgroundInternational travel exposes individuals to diverse health risks, necessitating proactive pre-travel health preparations. Saudi Arabia has witnessed increased outbound travel. This study addresses a critical gap in knowledge by investigating the utilization and perceptions of pre-travel health consultations among adults in the Eastern Province of Saudi Arabia.MethodsThis cross-sectional study surveyed patients at the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University during January 2024 to explore perceptions of pre-travel health consultations among the Saudi Arabian population. Adults aged 18 years or older in the waiting area were invited to complete a self-administered questionnaire.ResultsOf the 772 participants, 624 (80.8%) engaged in international travel within the last year. However, 593 (76.8%) had never sought pre-travel health consultations. Age, gender, and education level significantly influenced the pursuit of pre-travel health advice, with older individuals, females, and those with higher educational attainment more likely to seek consultations. Participants perceived vaccination recommendations (597, 77.4%) and disease prevention information (678, 87.8%) as crucial parts of pre-travel health consultations. However, barriers to seeking advice included perceived low risk (445, 74.8%), lack of awareness (215, 36.3%), time constraints (128, 21.6%), and cost concerns (92, 15.5%).ConclusionThe low prevalence of pre-travel health consultations among travelers highlights the need for targeted educational campaigns and the integration of travel health services into primary healthcare. Addressing the identified barriers and leveraging preferred information sources are crucial steps towards enhancing the uptake of pre-travel health consultations, ultimately improving the health and safety of international travelers from the region.

Clinical profile and management of a Spanish single-center retrospective cohort of patients with post-chikungunya associated complications

BackgroundThis study aims to describe post-chikungunya complications chronically developed cases in returning travelers from some epidemic/endemic regions, and the variables that are associated with the progression of acute or subacute cases to the chronic phase. MethodsThis single-center retrospective cohort study included chikungunya fever cases treated at La Paz-Carlos III University Hospital in Madrid, Spain, April 2014 to September 2016, when the chikungunya outbreak in Latin America started through the time of its greatest impact. ResultsThe analysis included 119 cases. Of these, 67.2 % were male, with a median age of 41.0 years [IQR 16.0 to 76.0] years. Only 25.6 % of the patients attended a pre-travel advice consultation. Most patients reported arthralgias, which significantly impacted their daily quality of life (86 %). The mean duration of joint symptoms was 129.4 days, with a median of 90 days [IQR 0 to 715]. Factors found to be associated with chronic arthralgia include female sex, country of infection, age at diagnosis, previous diseases, symptoms during the acute phase, pain in previously injured tendons/joints, acute phase severity, and various laboratory markers such as hemoglobin, hematocrit, total serum bilirubin, and creatinine. Progression to chronic arthralgia significantly increased the need for changes in daily activity. Furthermore, 42.6 % of patients with chronic arthralgia reported recurrence of symptoms once they felt they had disappeared. Targeted treatment regimens led to significant improvements in these patients. ConclusionsThe results of this study underscore the need for: (1) comprehensive pre-travel advice; (2) effective management of patients in specialized units, alongside early diagnosis and treatment, to prevent trivialization of these viral infections; and (3) the development of interdisciplinary recommendations to assist physicians in treating patients and enhancing outcomes.

Advising the immunocompromised traveller: a review of immunocompromise at The London Hospital for Tropical Diseases Travel Clinic between 1st April 2019 and 30th April 2020.

Immunocompromised travellers (ICTs) face greater infectious and non-infectious travel-associated risks than their immunocompetent counterparts. Increasing travel and emergence of novel immunosuppressants poses great challenges for travel medicine practitioners to confidently provide up-to-date evidence-based risk management advice and pre-travel care for ICTs. We reviewed the records of ICTs attending the London Hospital for Tropical Diseases (HTD) Travel Clinic between 1st April 2019 and 30th April 2020 with the aim to describe demographic and travel characteristics, type, and severity of immunocompromise, the degree of risk associated with intended travel and evaluate travel advice. Of the 193 ICTs identified, immunocompromise was due to physiological reasons (42%), chronic infection (17.1%) and immunosuppressive therapy (16.6%). Median age was 38 (range 9 months to 84 years) and male to female ratio 0.75 (83:110). Travel was intended to 80 countries for a median of 16 days (range 2 to 3167), predominantly for leisure (53%), non-medical work (17%) and visiting friends and relatives (12%). Live vaccine safety dominated discussion in the pre-travel consultation. Existing guidelines arguably fell short in dealing with travel risks associated with hyper-specific conditions, targeted immunosuppressants and non-vaccine preventable infections. Our cohort represents a wide spectrum of immunocompromise, for whom we arguably need more measurable ways to approach travel-associated risks. We propose prospective qualitative participatory research to inform our unit of the priorities of ICTs in the pre-travel consultation. We further recommend the formation of a repository of specialists and formulary of complex cases to direct subsequent informative systematic review and prospective risk studies.

Travel Health-Related Preparation Practices of Institutions of Higher Education and Occurrence of Health-Related Events among Undergraduate Students Studying Abroad, 2018-2021.

Knowledge of specific health-related events encountered by students studying abroad and the availability and use of pre-travel healthcare for these students is lacking. Anonymous web-based questionnaires were sent to study abroad offices, student health centers, and undergraduate students after studying abroad at eight institutions of higher education in the United States and Ireland from 2018-2021. Analyses were descriptive; relative risks and 95% confidence intervals were calculated for health-related events. One study abroad office required a pre-travel consultation. All student health centers had pre-travel counseling available. Among 686 students, there were 307 infectious and 1,588 non-infectious health-related issues; 12 students (2%) were hospitalized. Duration of travel and timing of a pre-travel consultation impacted the risk of health-related events. Certain mental health conditions were associated with increased risk of alcohol and drug use. Future studies should address the optimal timing and best practices to optimize health for students studying abroad.

Machine learning approach to identify malaria risk in travelers using real-world evidence

BackgroundPre-travel consultation and chemoprophylaxis measures for malaria are a key component in the prevention of imported malaria in travelers. In this study we report a predictive tool for assessing personalized malaria risk in travelers based on the analysis of electronic medical records from travel consultations. The tool aims to guide physicians in the recommendation of appropriate prophylaxis prior to their trip. We also provide best-practice recommendations for pre-processing noisy and highly sparse real world evidence data. MethodsWe leveraged a large EMR dataset, containing demographic information about travelers and their destination. The data has been previously preprocessed using various strategies to handle missing and unbalanced data. We compared multiple machine learning approaches to assess the risk of malaria acquisition in travelers during their travels. Additionally, a feature importance analysis was performed using SHAP (SHapley Additive Explanations) values to identify patterns associated with malaria risk. ResultsOur study revealed that our XGB models achieved high predictive capacity (AUC >0.80). The most significant features predicting malaria infection during travel included travel destinations with low malaria risk, vaccination history, number of countries visited, age, and trip duration. Remarkably, we were able to obtain a reduced model with only five features. When comparing this model with a population of travelers recommended for malaria chemoprophylaxis, we observed that it was deemed necessary in only 40% of these travelers. This suggests that 60% received chemoprophylaxis despite having a low personalized risk of malaria. ConclusionWe have developed an algorithmic tool that utilizes a concise survey to generate a personalized travel risk assessment, effectively minimizing the prescription of unnecessary malaria chemoprophylaxis. Through the identification of patterns linked to predictions, our model significantly enhances the efficacy of pre-travel consultations.

Characteristics of Traveler’s Diarrhea in Foreign Traveler’s Visiting Beaches in Badung Regency, Bali

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

Integrating sexual and reproductive health into pre-travel consultations.

Casual sex during travel is a major preventable factor in the global transmission of sexually transmissible infections (STI). Pre-travel consults present an excellent opportunity for practitioners to educate travellers about sexual and reproductive health (SRH) and safety. This scoping review aims to explore and understand the extent to which SRH is included in pre-travel consultations. PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, Medline and Web of Science were systematically searched for primary research articles exploring whether health care practitioners (HCP) included SRH in pre-travel consultations. Extracted findings were synthesized and presented in narrative form. Findings across 13 articles suggest HCPs infrequently broached SRH in pre-travel consultations with HCP discomfort, and lack of time and resources presented as key barriers. Urban practice settings, HCP experience, training in travel medicine and traveller characteristics such as sexual orientation were positively associated with discussions about SRH. SRH advice reported was general in nature, primarily focusing on safer sex, condoms or unspecified STI advice. Risk assessments based solely on age or stereotypes around sexual preferences led to key aspects of SRH care being missed for some (e.g. SRH was less likely to be discussed with older travellers). HCPs frequently miss opportunities to integrate SRH into pre-travel consultations. Strategies to promote HCP confidence and awareness present a promising means to boost the frequency and quality of SRH advice disseminated. Integrating culturally safe and responsive SRH history-taking and advice into pre-travel consultations may contribute to global reductions in STI transmission and promote traveller SRH well-being.

Chikungunya infection in returned travellers: results from the geosentinel network, 2005-2020.

Chikungunya is an important travel-related disease because of its rapid geographical expansion and potential for prolonged morbidity. Improved understanding of the epidemiology of travel-related chikungunya infections may influence prevention strategies including education and vaccination. We analysed data from travellers with confirmed or probable chikungunya reported to GeoSentinel sites from 2005 to 2020. Confirmed chikungunya was defined as a compatible clinical history plus either virus isolation, positive nucleic acid test or seroconversion/rising titre in paired sera. Probable chikungunya was defined as a compatible clinical history with a single positive serology result. 1202 travellers (896 confirmed and 306 probable) with chikungunya were included. The median age was 43years (range 0-91; interquartile range [IQR]: 31-55); 707 (58.8%) travellers were female. Most infections were acquired in the Caribbean (28.8%), Southeast Asia (22.8%), South Central Asia (14.2%) and South America (14.2%). The highest numbers of chikungunya cases reported to GeoSentinel were in 2014 (28.3%), 2015 (14.3%) and 2019 (11.9%). The most frequent reasons for travel were tourism (n = 592; 49.3%) and visiting friends or relatives (n = 334; 27.7%). The median time to presentation to a GeoSentinel site was 23days (IQR: 7-52) after symptom onset. In travellers with confirmed chikungunya and no other reported illnesses, the most frequently reported symptoms included musculoskeletal symptoms (98.8%), fever/chills/sweats (68.7%) and dermatologic symptoms (35.5%). Among 917 travellers with information available, 296 (32.3%) had a pretravel consultation. Chikungunya was acquired by international travellers in almost 100 destinations globally. Vector precautions and vaccination where recommended should be integrated into pretravel visits for travellers going to areas with chikungunya or areas with the potential for transmission. Continued surveillance of travel-related chikungunya may help public health officials and clinicians limit the transmission of this potentially debilitating disease by defining regions where protective measures (e.g. pretravel vaccination) should be strongly considered.

Characteristics of Polish travellers admitted at the University Centre of Maritime and Tropical Medicine in Poland, 2023.

After COVID-19 restrictions were lifted, people started to travel again. Each year, thousands of Poles travel internationally, and many travel to tropical or subtropical destinations in Asia, Africa or South America. The aim of this article was to describe the characteristics of Polish travellers based on the information from a retrospective 12-month review of the medical records of Polish patients seeking pre-travel advice at the largest diagnostic and treatment travel medicine centre in Poland in 2023. The retrospective study was based on the analysis of medical records of 2,147 patients seeking pre-travel advice at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland, between January and December 2023. The study focused on the analysis of the following patients' variables: age, sex, travel details (purpose of travel, length of travel, departure month, continents and countries to be visited). It also aimed to evaluate the range of prevention measures which were either recommended or administered to patients seeking pre-travel advice at the clinic (preventive vaccinations, chemoprophylaxis). In addition, it assessed the health status of the patients presenting at the travel medicine clinic; retrospective health assessments were based on the information from the interviews with the patients. Patients who sought pre-travel advice were mostly aged 36-65 years (49.5%), they were travelling for tourism purposes (78.3%), for a maximum period of 4 weeks (79.0%), mostly in November (15.2%) or in January (14.9%). Most travellers planned to visit Asia (55.5%) or Africa (29.0%); mainly Thailand (21.5%), Vietnam (8.5%), Kenya (8.3%) or India (8.2%). The most frequently administered immunoprophylaxis included vaccinations against typhoid fever and hepatitis A. Other commonly recommended/prescribed prevention measures included: insect repellents (69.3%), sunscreen (58.3%), antimalarials (35.8%), antithrombotic drugs (32.6%), and antidiarrheal drugs (25.6%). The analysis of patient interviews demonstrated that 61.8% of the travellers consulted at the clinic had no pre-existing medical conditions, while 38.2% required the use of chronic medications, mainly for allergies (14.3%), thyroid disorders (13.6%), cardiovascular diseases (9.3%), or psychiatric disorders (5.5%). A large number of Polish travellers visit destinations where the risk of infectious and non-infectious diseases is high. Providing patients with professional advice during a pre-travel consultation will help protect against travel-associated health problems.

The provision of sexual and reproductive health information and services to travellers: an exploratory survey of Australian travel medicine clinicians.

International travel can increase the risk of exposure to infectious diseases including sexually transmissible infections (STI). Pre-travel medical consultation provides an opportunity for travel-related health risk assessments and advice. This study explored how travel medicine clinicians integrate sexual and reproductive health (SRH) services into clinical practice. A convenience sample of travel medicine clinicians completed a cross-sectional survey online or via hard-copy disseminated at an annual national Australian travel medicine conference. Of the 67 respondents, most (n, 51; 76.1%) had a postgraduate qualification relevant to travel medicine and 55.2% (n, 37) had worked in travel medicine for over 10years. Only 22.4% (n, 15) reported conducting a SRH history/STI risk assessment for all travel patients. STI testing pre-departure was conducted on patient request (48, 71.6%), if symptomatic (32, 47.8%) or based on risk history (28, 41.8%). SRH information pre-departure was most frequently provided if prompted by patient questions (n, 42; 62.7%), or based on the patient's history (n, 37; 55.2%). Over half the sample (n, 40; 59.7%) expressed interest in further training in SRH. Providing and engaging with additional training may assist travel medicine clinicians to take a more proactive approach to SRH consultations and STI testing. Additional research is needed to explore models of care that will allow comprehensive SRH and STI services to be integrated into standard pre- and post-travel care.

International health regulations and pre-travel health practices of international travelers at Nigerian airport: a cross-sectional study

BackgroundInternational Health Regulations (IHR) were developed by the World Health Organization (WHO) to curb the trans-border spread of epidemics. To our knowledge, no airport-based studies have assessed travelers’ health practices against a combination of diseases subject to IHR 2005. Therefore, we aimed to generate and describe the baseline travelers’ pre-travel health practices towards Cholera, Yellow Fever (YF), and Plague at Murtala Muhammed International Airport (MMIA) in Nigeria.MethodsA cross-sectional study was employed to collect data from 486 international travelers using a multistage sampling technique. Pre-travel health practices (a combination of pre-travel consultation, pre-travel vaccination, and preventive measures against insect bites) were assessed using an interviewer-administered questionnaire. Logistic regression models were used to estimates the association between selected variables and pre-travel health practices. Statistical significance level was set at 5%.ResultsA total of 479 complete questionnaires were analyzed. The median age of respondents was 34.0 years Interquartile range (IQR) = 28.0, 44.0). Of the total respondents, 311 (64.3%) were aware of pre-travel health consultation and sources of information, amongst others, including friends/relatives in 180 (37.6%) travelers, social media/internet in 155 (32.4%) travelers, and health professionals in 102 (21.3%) travelers. Two hundred and seventy-one (56.6%) had pre-travel consultation, 156 (32.6%) had YF vaccination, and 226 (47.2%) were prepared to use preventive measures against insect bites. Only 10.6% had good pre-travel practices against the diseases subject to 2 International Health Regulations (IHR). Travelers with bachelor/college degrees, when compared to those with secondary/high education, had 2.91 times higher odds of having good practices when adjusting for other factors (95% C.I: 1.10, 7.70; p < 0.03). Also, those traveling to destinations endemic for YF infection, when compared to those who are not traveling to endemic countries/areas, had 48% lower odds of having good practices after adjusting for other factors (95% C.I: 1.41, 7.77; p < 0.01).ConclusionsOur study revealed a low prevalence of good pre-travel health practices among participants. Educational level and endemicity of YF at the destination were predictors of pre-travel health practices. Introducing topics on travelers’ health into schools’ curriculums may have a ripple positive effect on health practices among international travelers. Also, there is a need for public enlightenment programs on pre-travel health practices using social media platforms.

Correlation of Knowledge and Attitude with the Use of a Travel Clinic for Pre-Travel Consultation

Utilization of tourism clinics, particularly for pre-travel consultations, remains low among domestic tourists. The current study aims to examine the relationship between knowledge level and attitude towards the utilization of tourism clinics for pre-travel consultations in Bali Province. The study sample consisted of 106 domestic tourists who were present in Bali during the period of May-September 2022. Consecutive sampling was used, and the Chi-Square Test was executed for data analysis with the aid of the SPSS version 25.0 program. The research findings indicate that the majority of domestic tourists (50%) originated from Malang. Additionally, the study revealed that women accounted for a greater proportion (62.3%) of domestic tourists. The research results also showed that 60 tourists had a good level of knowledge and utilized the tourism clinic, while 59 tourists had an agreeable attitude towards the utilization of the tourism clinic. The results of the study demonstrate a significant relationship between knowledge level (p&lt;0.001) and attitude (p&lt;0.001) towards the use of tourism clinics for pre-travel consultations in Bali Province. Overall, tourists have a good level of knowledge and agreeable attitude towards the utilization of tourism clinics, indicating a positive trend towards the promotion of tourism clinics for pre-travel consultations.

Learning to safely integrate generative artificial intelligence technology into travel medicine practice.

We have entered an exciting era where generative artificial intelligence is finding multiple applications in everyday life and scientific inquiry. This editorial explores the possibility of integrating this technology into the pre-travel consultation, but with careful consideration of its current capabilities, limitations and potential risks to patient safety.