Visiting Friends And Relatives Travellers Research Articles

Trends in imported infections among migrants and travellers to Spain: a decade of analysis through the +Redivi network (2012-2022).

High-speed global travel, increased trade, world population growth, migration, urbanisation and climate change have favoured the emergence and spread of pathogens. We aimed to analyse the evolution of imported infections in Spain during 2012-2022 and the potential impact of some of the abovementioned factors on differential morbidity patterns. In this retrospective study (January/2012 to December/2022), we analysed data collected by the +Redivi network across 25 health centres. The network's standardised database records new cases of imported infections, including patient demographics, travel history, pre-travel advice and diagnostic information. To assess outcome rates over time and potential interactions, we constructed penalised weighted models to reduce the bias related to a low event rate and used weighted logistic regression for morbidity outcomes. We recorded 25 632 episodes, comprising 13 913 migrants, 4047 visiting friends and relatives (VFR) immigrants, 392 VFR travellers and 7280 travellers. Most immigrants came from South America (48.3%), Sub-Saharan Africa (28.5%), North Africa (6.6%), South Central Asia (5.4%) and Central America/Caribbean (5.3%). The most common regions visited by travellers were Sub-Saharan Africa (33.5%), South America (24.5%), Central America/Caribbean (13.5%), Southeast Asia (12%) and South Central Asia (10%). The proportion of diagnoses of malaria, strongyloidiasis and unspecified self-limiting febrile syndrome < 3weeks remained unchanged during the study period. An increased frequency of diagnosis was reported for schistosomiasis, blastocystosis, giardiasis, dengue, diarrhoea, new cases of HIV, latent and pulmonary tuberculosis; a decrease was reported for syphilis, chikungunya fever, Chagas disease and eosinophilia. We detected interactions between time and sex or type of participant across the different diagnoses. Our study underscores the importance of epidemiological data in understanding infectious diseases dynamics among travellers and migrants, emphasising how demographic shifts, migration trends and healthcare policies affect disease profiles. Comprehensive data play an essential role in enhancing public health policies and travel advice.

Imported Malaria in Children: A Study Over an 11-Year Period in Brussels.

Malaria is a major global public health concern in endemic countries and imported childhood malaria is increasing in malaria non-endemic countries. This was a retrospective case review of all laboratory-confirmed malaria cases in children 0-16 years admitted between 2009 and 2019 in 2 large university teaching Hospitals in Brussels. A total of 160 children with a median age of 6.8 years (range 5-191 months) were included. We identified 109 (68%) children living in Belgium who had acquired malaria during their visit to malaria-endemic countries to visiting friends and relatives (VFRs), 49 children (31%) visitors or newly installed migrants, and 2 Belgian tourists. Peak seasonal incidence occurred between August and September. Plasmodium falciparum was responsible for 89% of all malaria cases. Almost 80% of children living in Belgium visited a travel clinic for advice, but only one-third reported having taken the prophylaxis schedule according to the recommendations. Based on WHO criteria, 31 children (19.3%) developed severe malaria; most of the patients with severe malaria were VFR travelers and were significantly younger, had higher leukocytosis, had more thrombocytopenia, higher CRP, and lower natremia compared with patients with an uncomplicated course. All children recovered fully. Malaria is a significant cause of morbidity among returning travelers and newly arrived immigrants to Belgium. Most of the children had an uncomplicated disease course. Physicians should educate families about traveling to malaria-endemic areas to correct malaria preventive measures and prophylaxis.

Understanding challenges faced by VFR hosts: A study of Japanese migrant hosts in Australia

Hosting behaviours and experiences have gradually been acknowledged as influential factors in visiting friends and relatives (VFR) travel. However, the challenges facing VFR hosts while hosting VFR travellers have not been well researched, especially for VFR hosts who are migrants from different cultural and language backgrounds. This study aims to explore the challenges of hosting friends and relatives who have different cultural and language backgrounds to the destination country using the case of Japanese migrant VFR hosts in Australia. Qualitative analysis revealed 12 challenges, which were grouped into three areas, leading to some hosts being reluctant and inactive in receiving VFR travellers. These challenges were rooted in communication difficulties, including the language barriers of their VFR travellers and the social obligations of VFR hosts. This study also suggests socio-cultural differences and living environments between VFR hosts living in the migration destination and VFR travellers living in the home country, making these challenges even greater despite sharing cultural backgrounds. Further research is required to uncover the patterns and impacts of each challenge based on the host and traveller types and to support the design of measures to develop the VFR market.

Baby on board - recommendations for pediatric travel consultation

Traveling with babies and children is challenging for parents and the doctor providing travel medicine advice. Especially pediatric VFR (visiting friends and relatives) travelers have a higher risk for infectious diseases due to lower risk perception and higher exposure. Being well prepared helps in exploring the world while staying healthy. Topics to be discussed in pediatric travel consultation are travel vaccinations, mosquito repellents, malaria prophylaxis, thorough sun protection, rehydration for gastroentritis, avoidance of rabies exposure, an agetailored travel pharmacy and more. We provide a guide to the most important topics for pediatric travel consultations.

To return or not to return? Identifying VFR travel constraints during the pandemic

ABSTRACT Despite the prominence of visiting friends and relatives (VFR) travel to show strong resilience in the face of global crises, it has been one of the most underexplored tourism contexts in the literature. This study examined travel constraints of VFR travelers during the pandemic to enrich this tourism context. Using an inductive theory approach, thematic analysis of 167 online posts and 8,403 online comments from prospective Taiwanese VFR travelers living elsewhere unveiled a framework of VFR travel constraints that included six types of travel constraints for VFR tourists who have made travel-related decisions amid COVID-19. Specifically, fourteen travel constraints were identified and situated within a three (individual - family - community) two (tourist generating country - tourist receiving country) framework to understand their causes and natures. Theoretically, this study served as a pioneering attempt to link the concept of travel constraints with VFR tourism and enriched our understanding of VFR travelers’ related decision making. Practically, destination management organizations and tourism businesses should find the study findings insightful because they demonstrate ways of promoting VFR travel to foster tourism rejuvenation in the post-pandemic. Limitations and future research directions were discussed at the end of this study.

VFR TURİZM MOTİVASYONU: GENÇ AKADEMİSYENLERE YÖNELİK BİR VAKA ÇALIŞMASI

Visiting Friends and Relatives (VFR) tourism takes great attention from scholars in recent years. Due to its consisting a large part of the tourism market, understanding the motivations of VFR travelers is essential. Several reasons determine the motivations of VFR travelers. The duration of the trip, the attractions of the destination, the frequency of visits are some of these reasons.&#x0D; In this study, the motivation of visiting friends or relatives was tried to be revealed by interviewing academicians with similar income and education levels. As a result of the interviews, it was revealed that traditions mostly affect VFR travels. In Turkish traditions, it is especially important to visit family elders and other relatives on holidays. Therefore, the duration of stay can take a few days. Another important factor is the budget. VFR travels are preferred to lodgings because they are more affordable. Participants stated that they preferred to stay with their friends rather than with their relatives.

Understanding students as hosts: moving beyond sightseeing

PurposeNeither visitors of visiting friends and relatives (VFR) travel nor hosts are homogeneous segments (Griffin & Guttenberg, 2020). For this reason, this study aims to address students as hosts of VFR travel and analyzes differences in the visitor and the host segment. As a result, marketing implications for destination marketing organizations that seek to realize the potential of the student VFR segment arise.Design/methodology/approachThis research project adopts a multi-method approach to derive a deeper empirical understanding of visitors’ behaviors and the role of students hosting friends and relatives (SHFR). The quantitative study aims to reveal the relevance and differences between visits to friends (VF) and visits to relatives (VR), whereas the qualitative study elaborates on the findings of the quantitative study and seeks to understand the role and experiences of students as hosts.FindingsThe findings reveal that VR and VF travelers vary in terms of their expenditure. Hosts’ spending depends on visitors’ budgets; in general, both their direct and indirect (when relatives pay) spending increases when they have visitors. Furthermore, the data identify two distinct hosting styles: functional hosting is concerned with providing outstanding hospitality based on a more traditional, guest-oriented understanding of the role, whereas integrative hosting blurs the lines between hospitality and lifestyle based on a more modern, host-oriented understanding of the role.Research limitations/implicationsRegarding limitations, this study did not differentiate between students who were simultaneously locals and students who resided in the city only for study purposes. In a similar vein, the cultural background of the students was not considered in the research. Finally, the differences between VF and VR could further be explored in a quantitative follow-up study and in testing for significant differences in SHFR spending behaviors. Further research could examine whether domestic travelers, travelers with cultural proximity and/or short-distance VFR travelers are more likely to visit after COVID-19 as suggested by Backer and Ritchie (2017) in the case of crises and disaster.Practical implicationsStudents as hosts differ from other hosts in VFR travel in their reluctance to embrace conventional tourism products. This study found that place attachment makes hosts of VFR travelers passionate ambassadors and advertisers for the destinations; destination marketing organizations (DMOs) could support this already positive image by providing and supporting students with more detailed information about their cities and the opportunities they offer. Results are of particular relevance because the COVID-19 pandemic is forcing DMOs to develop destination strategies that incorporate social-distancing and avoid crowded places.Social implicationsWhen students take their friends out to events and nightclubs, they contribute significantly to experiences that go beyond typical tourism activities such as sightseeing and shopping. By offering special discounts to visitors who come with their hosts, DMOs could help visitors delve more deeply into city life and thereby reduce the likeliness of crowded city centers. Considering the findings relating to the social and emotional qualities of VFR travel, DMO marketing to VFR travelers could benefit from promoting socio-cultural spaces and offerings that value groups’ social ties (e.g. family prices for families with adult children) or alumni status.Originality/valueAccording to the authors’ knowledge, this study is the first which analyzes both, visitors and hosts of VFR travel using a two methods approach. Very recently, Griffin and Guttenberg (2020) miss VFR research focusing on the heterogeneity of the segment, and Backer et al. (2020) claim for more VFR research on the role of hosts carried out outside of Australia, New Zealand, Canada, the UK and the USA. To the authors’ best knowledge, this study is the first which delivers empirical insights on SHFR in Central Europe.

Surveying Health-Related Knowledge, Attitudes, and Behaviors of U.S.-Based Residents Traveling Internationally to Visit Friends and Relatives.

.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.

Travel health seeking behaviours, masks, vaccines and outbreak awareness of Australian Chinese travellers visiting friends and relatives - Implications for control of COVID-19.

BackgroundThe COVID-19 pandemic has highlighted the role of international travel in spreading infections. Travellers visiting friends and relatives (VFR) are at higher risk of acquiring infections than other travellers, therefore improving the travel health behaviour of these travellers is important. Ethnic Chinese are one of the largest migrant groups in many countries, yet there have been no published studies regarding this population as VFR travellers. We present findings of a study of Australian Chinese VFR travellers relevant to the pandemic response.MethodsIn 2013, five focus groups were conducted with Australian Chinese VFR travellers, exploring topics such as vaccines, face masks, outbreaks and travel health seeking behaviour. Participants were aged 18 years or older and had travelled to China for VFR purposes in the preceding 18 months. Sessions were recorded and transcribed, and thematic analysis was undertaken.ResultsParticipants viewed VFR travel as low risk, and underestimated the risks associated with travelling during an outbreak. However, they were generally willing to receive pre-travel vaccination specifically for an outbreak, but not otherwise. Attitudes towards face masks and other infection control measures were mixed. Multiple factors influenced their travel health behaviour, including low risk awareness, misconceptions, and cultural barriers to seeking health care.ConclusionOur research found that Chinese VFR travellers undertake suboptimal precautions related to VFR travel, associated with an underestimation of risks. While they share many characteristics with other VFR travellers, unique cultural health beliefs should be taken into account when developing risk communication and educational interventions as part of a pandemic response.

Ensuring the Safety of Yellow Fever Vaccination in Travelers-The Experience at a Large U.S. Academic Medical Center in Colorado.

Background: Yellow fever (YF) virus has the potential to cause fatal outcomes among at-risk individuals visiting endemic areas. Vaccinating travelers who are at risk is necessary to prevent virus-related life-threatening complications. We lack data on the clinical features of persons seeking YF vaccination. We aim to describe the characteristics of a cohort of persons receiving the YF vaccine before travel. Methods: A retrospective analysis of 964 travelers receiving the YF vaccine (Stamaril®) from Oct 2016 to Jul 2019 was performed at the University of Colorado Hospital, U.S. Percentages, means, and standard deviations were calculated. A multivariate logistic regression model was built to evaluate the association between receiving YF vaccination less than 10 days before departure and visiting friends and relatives (VFR). Results: The average age of the subjects was 39 ± 18 years with a range of nine months to 83 years. Persons who were 60 years of age and older represented 17%. Women consisted of 52%, and most of the travelers were Caucasians (64%). Travelers reported traveling to Africa (57%) or South America (40%). The primary destinations for travelers overall were Kenya (19%), Uganda (11%), and Tanzania (11%) in Africa; and Peru (14%) and Brazil (13%) in South America. The most common reasons for travel included leisure (44%), VFR (18%), and mission trips (10%). Comorbidities included a history of hematologic disorders (4%), HIV infection (2%), and diabetes mellitus (3%). The average duration between vaccine administration and travel was 43 days. Those VFR were two times more likely to receive the YF vaccination <10 days before departure. Conclusions: Identifying the type of travel, itinerary, and underlying medical conditions allows providers to administer the YF vaccine to travelers safely. There is a need to identify strategies to improve the timing of YF vaccination among VFR travelers.

VFR travel interactions through the lens of the host

Visiting friends and relatives (VFR) travel is a substantial segment of tourism globally. In many countries, VFR travel represents a large proportion of visitor movement. The size of the segment is often underestimated because official data only reveal VFR by purpose of visit or VFR by accommodation, contributing to the underestimation of the size of VFR travel. Similarly, there is a lack of research that considers the role of the VFR host in VFR travel which results in a lack of understanding. Clearly, the role of the host is critical in VFR travel and it is what centrally defines VFR. This study contributes to the research in VFR travel through providing research related to hosting VFRs. Of note, this study was undertaken in Turkey, which makes a significant contribution to scholarship given the lack of research that has been undertaken outside of Australia, New Zealand, Canada, the United Kingdom and the United States, which are the areas in which VFR travel research has dominated. This study determined the profiles and characteristics of 423 VFR travellers to Nevsehir, Turkey, and their hosts. Accordingly, this study provides a significant contribution to the scholarship of tourism by providing rich data on an area of tourism (hosting VFRs) that had to date, been overlooked.

Expanding the concept of the VFR market: Excavating ‘hidden VFR travellers’

Visiting friends and relatives (VFR) travellers have often been categorised based on their purpose of travel and their use of accommodations. This study focuses on the non-VFR category defined by these two factors and on the investigation of ‘hidden VFR travellers (HVFRs)’ in the non-VFR category. A total of 500 Japanese participants who met their friends or relatives in five major English-speaking destinations completed an online survey. Using the two criteria, 164 were categorised as VFRs, whereas the others were grouped into the non-VFR category. Among the non-VFR travellers, there was a group that shared similar characteristics with the VFR travellers. The result implies that there are HVFRs in the non-VFR category. To expand the current understanding and concept of VFR travellers, this study proposes an additional criterion for categorising VFR, namely, the influence of VFR hosts.

Pre-travel health care attendance among migrant travellers visiting friends and relatives (VFR): a 10-year retrospective analysis

BackgroundTravellers visiting friends and relatives (VFR) define a specific population of travellers exposed to higher risks for health and safety than tourists. The aim of this study was to assess differentials in pre-travel health care in VFR travellers compared to other travellers.MethodsA retrospective cohort study was performed including attendees of the Travel Medicine Clinic of the Hospital Universitari de Bellvitge, Barcelona, Spain, between January 2007 and December 2017.ResultsOver the 10-year period, 47,022 subjects presented to the travel clinic for pre-travel health care, 13.7% of whom were VFR travellers. These showed higher rates of vaccination against yellow fever and meningococcus, but lower rates for hepatitis A, hepatitis B, influenza, rabies, cholera, polio, typhoid IM vaccine and tetanus vaccine boosters. Regarding malaria prevention measures, results highlighted that VFR travellers, when compared with tourists, were more likely to be prescribed with chemoprophylaxis, particularly with mefloquine, than with atovaquone/proguanil.ConclusionsFindings from this large-scale study indicated differences in vaccination rates and completion, as well as in chemoprophylaxis for malaria, between VFR and non-VFR travellers, fostering specific interventions for promoting adherence to pre-travel health advice among migrant travellers.

Entertaining Visiting Friends and Relatives (VRF) in Destination Settings: a Cross-cultural Host Comparison

This study aims to examine whether there is a difference between two different host groups in terms of hosting styles in visiting friends and relatives (VFR) tourism. The study provides some insights into this issue by comparing hosting type, hosting length, expenditure type, etc. between Turkish and British hosts. A self-administered questionnaire was conducted among 238 Turkish and 224 British hosts who live in Didim, located in the Aegean Region of Turkey. Data were analyzed using descriptive statistics. The findings demonstrated that Turkish and British participants played an important role in hosting their friends and/or relatives. They also represented a large and underestimated part of VFR tourism with their expenditures and behaviors towards their guests. On the other hand, significant differences were found between Turkish and British hosts in which hosting their guests. Another finding of the study is that Turkish and British hosts and VFR travelers engage in activities in and around Didim. However, British hosts participated in activities more than Turkish hosts. In other words, this study found that British hosts contribute more to the local economy.

The tourist experience of domestic VFR travellers: the case of Hungary

Visiting friends and relatives (VFR) is the main driver of domestic travel in many countries. This study is one of the first to analyse VFR travel from a perspective of tourist experience. This study aims to investigate the complex dynamics behind VFR-related travel, especially in aspects of trip activities and tourist experience formation. Based on a survey (N = 879) examining domestic VFR travellers’ trip activities in Hungary, the paper discusses the formation of a tourist experience in context of short-haul domestic VFR travel, especially the role of influencing factors. The results reveal differences between the segments with trip motivation of visiting friends (VF) and visiting relatives (VR) – the two main types of VFR tourists. It was found that independent variables such as VF, staying for longer and participating in leisure and tourism-type activities have a positive effect on tourist experience evolvement; however, factors such as VR, being rather passive during such a visit and focusing on social acts and bonding negatively affect the formulation of a tourist experience. The paper’s novelty and uniqueness lies in applying a new perspective of analysing and discussing VFR travel: the theoretical concept of tourist experience formation.

Challenges to providing pre-travel care for travellers visiting friends and relatives: an audit of a specialist travel medicine clinic.

Travellers visiting friends and relatives (VFRs) often have complex pre-travel needs. We identified the characteristics, destinations, vaccinations and pre-travel advice provided to VFRs and compared these with non-VFR travellers. The significant differences we found suggest that future research should focus on improving the uptake of recommended interventions in VFR travellers.

Malaria Surveillance - United States, 2014.

Malaria Surveillance - United States, 2014.

Comparing imported malaria in adults and children presenting to an Italian teaching hospital: A 10-year retrospective study.

Malaria is not endemic in Italy, but it still represents an important threat to the travelers' health. With this study we wanted to compare the characteristics of imported malaria between adults and children. This retrospective observational study includes all patients admitted to the Infectious Diseases Unit and in the Pediatric Department of Padua (Italy), and discharged with a diagnosis of malaria from 2005 to 2015. The variables considered are epidemiological and clinical. 172 cases of imported malaria were studied (124 adults and 48 children), P.falciparum was responsible for 90,7% of the cases, and was contracted mostly in Africa (96,5%), especially by foreigners visiting friends and relatives (VFR). Chemoprophylaxis was adopted only by few patients. 93% of all the patients developed the uncomplicated malaria, but pediatric patients had severe malaria significantly more often than adults (OR=4,06, p=0,015). Children also had significantly lower hemoglobin levels and higher parasitemia. The drugs used to treat the two groups were substantially different, but both had a good overall outcome. In order to reduce the risk of imported malaria, educational actions should target potential VFR travelers, and they should underline the different risk of severe malaria in adults and children. A further implementation of the recommended therapies could improve the patients' outcome.

VFR Travel: A Viable Market for Tourism Crisis and Disaster Recovery?

AbstractRebuilding tourist arrivals after crises/disasters is important. However, tourism may have negative impacts in terms of interfering with the destination recovery efforts, and adding distress to local residents. Therefore, consideration should be placed on timing tourism marketing as well as the market segments most suitable to target. This paper integrates both medical literature and tourism literature to consider whether Visiting Friends and Relatives (VFR) travel may be viable for destinations to consider after crises/disasters. The authors conclude that VFR travel offers both benefits and risks and recommends that only domestic VFR travellers are targeted to aid destination recovery. Future research avenues are also outlined. Copyright © 2017 John Wiley &amp; Sons, Ltd.

Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers

BackgroundMalaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012.ResultsA modest increase in overall imported malaria notifications occurred in 2008–2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008–2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008–2012, incidence in tourists visiting Central and West Africa dropped markedly.ConclusionsImported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands.