Search

Understand through the literature brings about the importance of nursing in health care for travelers. An integrative literature review was carried out in the PUBMED, Journal of Travel Medicine, MEDLINE, SciELO databases from 2012 to 2022 with the descriptors in Portuguese and English: Traveller's Health, Nursing Assistance, Tourism. A total of 22 articles were found according to inclusion and exclusion criteria, with only 03 Brazilian articles addressing the topic. More publications of Brazilian articles on the subject are needed and highlight the importance of nurses in this specialty. [ABSTRACT FROM AUTHOR]

Deletion of histidine-rich protein genes pfhrp2/3 in Plasmodium falciparum causes infections to go undetected by HRP2-based malaria rapid diagnostic tests. We analyzed P. falciparum malaria cases imported to Australia (n = 210, collected 2010–2018) for their pfhrp2/3 status. We detected gene deletions in patients from 12 of 25 countries. We found >10% pfhrp2-deletion levels in those from Nigeria (13.3%, n = 30), Sudan (11.2%, n = 39), and South Sudan (17.7%, n = 17) and low levels of pfhrp3 deletion from Sudan (3.6%) and South Sudan (5.9%). No parasites with pfhrp2/3 double deletions were detected. Microsatellite typing of parasites from Nigeria, Sudan, and South Sudan revealed low relatedness among gene-deleted parasites, indicating independent emergences. The gene deletion proportions signify a risk of false-negative HRP2-RDT results. This study’s findings warrant surveillance to determine whether the prevalence of gene-deleted parasites justifies switching malaria rapid diagnostic tests in Nigeria, Sudan, and South Sudan.

Background Typhoid fever in the United States is acquired primarily through international travel by unvaccinated travelers. There is currently no typhoid vaccine licensed in the United States for use in children <2 years. Methods We reviewed Salmonella enterica serotype Typhi infections reported to the Centers for Disease Control and Prevention (CDC) and antimicrobial-resistance data on Typhi isolates in CDC's National Antimicrobial Resistance Monitoring System from 1999 through 2015. Results 5131 cases of typhoid fever were diagnosed and 5004 Typhi isolates tested for antimicrobial susceptibility. Among 1992 pediatric typhoid fever patients, 1616 (81%) had traveled internationally within 30 days of illness onset, 1544 (81%) of 1906 were hospitalized (median duration, 6 days; range, 0–50), and none died. Forty percent (799) were <6 years old; 12% were <2 years old. Based on age and travel destination, 1435 (83%) of 1722 pediatric patients were vaccine-eligible; only 68 (5%) of 1361 were known to be vaccinated. Of 2003 isolates tested for antimicrobial susceptibility, 1216 (61%) were fluoroquinolone-nonsusceptible, of which 272 (22%) were also resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole (multidrug-resistant [MDR]). All were susceptible to ceftriaxone and azithromycin. MDR and fluoroquinolone-nonsusceptible isolates were more common in children than adults (16% vs 9%, P < .001, and 61% vs 54%, P < .001, respectively). Fluoroquinolone nonsusceptibility was more common among travel-associated than domestically acquired cases (70% vs 17%, P < .001). Conclusions Approximately 95% of currently vaccine-eligible pediatric travelers were unvaccinated, and antimicrobial-resistant infections were common. New public health strategies are needed to improve coverage with currently licensed vaccines. Introduction of an effective pretravel typhoid vaccine for children <2 years could reduce disease burden and prevent drug-resistant infections. [ABSTRACT FROM AUTHOR]

Introduction: Even though Istanbul is one of the centers of the world's fastest-growing tourism and travel sector, there are limited statistics on the knowledge, attitudes, and practices (KAP) of travelers from this region regarding travel-related infectious diseases. This study aimed to determine the passengers' KAP about contagious diseases and contribute to developing new solutions for the problems people face while traveling abroad. Methods: A questionnaire was administered to 182 Turkish travelers planning on traveling abroad and applied to the Istanbul Travel Health Center and the Istanbul Airport Health Control Center between January and March 2019. Results: The proportion of carrying a vaccination certificate was statistically higher in those who received healthcare services at international terminals (P = 0.002), especially those who had yellow fever (P < 0.001) and meningococcal vaccine (P = 0.011). More than half of the vaccinated passengers did not carry their vaccination certificates, while around half (53.8%) were traveling to Africa. When compared to travelers flying to Europe, vaccination checks were 6.7 times (95% CI: 2.5-17.9) higher in passengers traveling to Africa, 6.1 times (95% CI: 1.5-24.3) higher in passengers traveling to Asia, and 14.8 times (95% CI: 1.3-164.3) higher in passengers traveling to South America. In addition, the vaccination certificate carrying proportion was significantly higher in those with a travel duration of 15 days or more (P = 0.028), those who received health services at international terminals (P = 0.002), and those vaccinated (P < 0.001). Conclusion: Improved knowledge of travel-related infectious diseases and increased adoption of pre-travel health advice and vaccines are urgently needed among Turkish travelers. [ABSTRACT FROM AUTHOR]

Background: International travelers from regions with high incidence rates of COVID-19 have a high probability of being infected and spreading the disease when in contact with other people, so it is necessary to investigate the influence of the entry of these travelers on the transmission of COVID-19 during the second wave of the epidemic. Objective: To determine the influence of the entry of international travelers and other indicators on the transmission of COVID-19 in Santiago de Cuba province. Methods: an ecological study of correlation of the incidence of COVID-19 with certain variables was developed considering as units of analysis the municipalities of Santiago de Cuba province. Spearman's correlation coefficient was used to determine the correlation. To determine the variables that most influenced the number of confirmed cases, multiple linear regression and partial least squares were applied. Cluster analysis was used to determine the most similar municipalities. Results: six models and the formation of several clusters were obtained. The municipality of Santiago de Cuba was atypical. The most influential variables were: travelers, travelers with COVID, number of outbreaks, number of asymptomatic, population density and collaborator. The regions and countries that determined the model were America, Europe, Spain, Mexico and Venezuela. Conclusions: the number of travelers with and without COVID-19 has been a trigger for the number of infected cases in the epidemic in Santiago de Cuba. [ABSTRACT FROM AUTHOR]

Severe imported malaria is a clinically significant problem in non-endemic areas. We report two cases of travelers with Plasmodium falciparum infection who traveled from Africa and came home to a Brazilian non-endemic region. The epidemiology and diagnostic aspects of severe imported malaria for travel medicine clinicians in non-endemic regions are reviewed.

Deletion of histidine-rich protein genes pfhrp2/3 in Plasmodium falciparum causes infections to go undetected by HRP2-based malaria rapid diagnostic tests. We analyzed P. falciparum malaria cases imported to Australia (n = 210, collected 2010-2018) for their pfhrp2/3 status. We detected gene deletions in patients from 12 of 25 countries. We found >10% pfhrp2-deletion levels in those from Nigeria (13.3%, n = 30), Sudan (11.2%, n = 39), and South Sudan (17.7%, n = 17) and low levels of pfhrp3 deletion from Sudan (3.6%) and South Sudan (5.9%). No parasites with pfhrp2/3 double deletions were detected. Microsatellite typing of parasites from Nigeria, Sudan, and South Sudan revealed low relatedness among gene-deleted parasites, indicating independent emergences. The gene deletion proportions signify a risk of false-negative HRP2-RDT results. This study's findings warrant surveillance to determine whether the prevalence of gene-deleted parasites justifies switching malaria rapid diagnostic tests in Nigeria, Sudan, and South Sudan. [ABSTRACT FROM AUTHOR]

Abstract: Gnathostomiasis is a parasitic infection caused by the third larval stage of nematodes of the genus Gnathostoma. The disease is endemic in some countries around the world. In the American continent, the majority of cases is concentrated in Mexico, Ecuador, and Peru. However, due to increasing traveling either at the intercontinental or intracontinental level, the disease is seen each time more frequently in tourists. Furthermore, countries, such as Brazil, that have never been considered endemic are reporting autochthonous cases. The disease usually presents as a deep-seated or slightly superficial migratory nodule in patients with history of eating raw fish, in the form of ceviche, sushi, or sashimi. Along with the clinical presentation, diagnostic criteria include either blood or tissue eosinophilia. In most instances, these criteria are enough for the attending physician to institute therapy. Chances of finding the parasite are low, unless the biopsy is taken from a very specific area that develops after antiparasitic treatment is started. The potential of other organ involvement with more serious consequences should always be kept in mind.

We performed prospective screening of stool for multidrug-resistant organisms from 608 US international travelers and identified an acquisition rate of 38% following travel. Carriage rates remained significantly elevated for at least 6 months post-travel. Travel-related diarrhea was a risk factor for acquisition, as well as for long-term carriage upon return. [ABSTRACT FROM AUTHOR]

A survey in Sao Paulo, Brazil, assessed travel agents' knowledge on travelers' health. Data were collected using an online questionnaire. From 200 agencies, 32 answered (34 agents). Most consultants reported discussing personal safety, health insurance and vaccination. Few provided information on water and food diseases or sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Estudo qualitativo, exploratório-descritivo, com objetivo de investigar as práticas de enfermagem para a orientação à saúde dos viajantes, tendo-se coletado dados junto a profissionais de enfermagem que atuam no setor de imunização de três Unidades Básicas de Saúde em Porto Alegre, Rio Grande do Sul, utilizando-se a técnica de entrevista semi-estruturada. Da análise de conteúdo emergiram cinco categorias: perfil de atendimento, orientação à saúde, encaminhamentos para troca do Cartão Nacional de Vacinação pelo Certificado Internacional de Vacinação, fonte de informações e material informativo. Os resultados sinalizam o início de uma organização das práticas de enfermagem voltadas para a saúde dos viajantes, indo além do enfoque na febre amarela. Falhas nas orientações para aquisição do Certificado Internacional de Vacinação ainda ocorrem e faltam materiais informativos. Aponta-se a necessidade de ampliar as discussões sobre a saúde dos viajantes para uma revisão das estratégias de organização desse cuidado e encaminhamentos para a construção de uma política específica.Estudio cualitativo, exploratorio-descriptivo, con objetivo de investigar las prácticas de enfermería para la orientación a la salud de los viajantes, tras la recolección de datos junto a profesionales de enfermería que actúan en el sector de inmunización de tres Unidades Básicas de Salud en Porto Alegre, Rio Grande do Sul, Brasil, utilizando la técnica de entrevista semiestructurada. A partir del análisis de contenido emergieron cinco categorías: perfil de atendimiento, orientación a la salud, encaminamientos para cambio de Tarjeta Nacional de Vacunas por el Certificado Internacional de Vacunas, fuente de informaciones y material informativo. Los resultados señalan el principio de una organización de las prácticas de enfermería volcadas hacia la salud de los viajantes, yendo más allá del enfoque en la fiebre amarilla. Fallas en las orientaciones para la adquisición del Certificado Internacional de Vacunas aún ocurren y faltan materiales informativos. Se apunta la necesidad de ampliar las discusiones sobre la salud de los viajantes para una revisión de las estrategias de organización de ese cuidado y encaminamientos para la construcción de una política específica.Qualitative study, exploratory and descriptive, in order to investigate the nursing practices on travelers' health orientation, having been collected data from nursing professionals who work in the immunization sector of three Basic Health Units in Porto Alegre, Rio Grande do Sul, Brazil, using the technique of semi-structured interview. From content analysis five categories emerged: care profile, health orientation, referrals to exchange the National Immunization Card for the International Certificate of Vaccination, information source and information material. The results signal the beginning of an organization of nursing practices focused on the travelers' health, going beyond the focus on yellow fever. Failures in the guidelines for acquisition of International Certificate of Vaccination still occur and information materials are missing. It points out the need to broaden the discussion on travelers' health for a review of strategies for care organization and referrals for the construction of a specific policy.

Background. Enteric fever in the United States has been primarily associated with travel and with worrisome changes in global patterns of antimicrobial resistance. We present the first comprehensive report of National Typhoid and Paratyphoid Fever Surveillance System (NTPFS) data for a 5-year period (2008-2012). Methods. We reviewed data on laboratory-confirmed cases reported to NTPFS, and related antimicrobial susceptibility results of Salmonella Typhi and Paratyphi A isolates sent for testing by participating public health laboratories to the Centers for Disease Control and Prevention's National Antimicrobial Resistance Monitoring System laboratory. Results. During 2008-2012, 2341 enteric fever cases were reported, 80% typhoid and 20% paratyphoid A. The proportion caused by paratyphoid A increased from 16% (2008) to 22% (2012). Foreign travel within 30 days preceding illness onset was reported by 1961 (86%) patients (86% typhoid and 92% paratyphoid A). Travel to southern Asia was common (82% for typhoid, 97% for paratyphoid A). Among 1091 (58%) typhoid and 262 (56%) paratyphoid A isolates tested for antimicrobial susceptibility, the proportion resistant to nalidixic acid (NAL-R) increased from 2008 to 2012 (Typhi, 60% to 68%; Paratyphi A, 91% to 94%). Almost all NAL-R isolates were resistant or showed decreased susceptibility to ciprofloxacin. Resistance to at least ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole (multidrug resistant [MDR]) was limited to Typhi isolates, primarily acquired in southern Asia (13%). Most MDR isolates were also NAL-R. Conclusions. Enteric fever in the United States is primarily associated with travel to southern Asia, and increasing resistance is adding to treatment challenges. A bivalent typhoid and paratyphoid vaccine is needed. [ABSTRACT FROM AUTHOR]

Background: The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice.Methods: Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects' health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling.Results: The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration.Conclusions: Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or after travel. As the symptoms mostly remained mild, health care services were seldom needed. Typical traveler profiles were identified, thereby providing a tool for pre-travel advice. The finding that one third reported new-onset illness during follow-up attests to the importance of advising clients on potential post-travel health problems already during pre-travel visits. [ABSTRACT FROM AUTHOR]

Background Children frequently travel internationally. Health-related data on such children are limited. We sought to investigate the demographics, health characteristics, and preventive interventions of outbound US international pediatric travelers. Methods We analyzed data from 32 099 travelers presenting for pre-travel healthcare at the Global TravEpiNet (GTEN), a national consortium of 19 travel clinics, from January 1, 2009 to June 6, 2012. Results A total of 3332 (10%) of all GTEN travelers were children (<18 years of age). These children traveled mostly for leisure (36%) or to visit friends or relatives (VFR) (36%). Most popular destination regions were Africa (41%), Southeast Asia (16%), Central America (16%), and the Caribbean (16%). Compared with children traveling for leisure, VFR children were more likely to present <14 days before departure for pre-travel consultation (44% vs 28%), intended to travel for 28 days or longer (70% vs 22%), and to travel to Africa (62% vs 32%). Nearly half of the pediatric travelers (46%) received at least 1 routine vaccine, and most (83%) received at least 1 travel-related vaccine. Parents or guardians of one third of the children (30%) refused at least 1 recommended travel-related vaccine. Most pediatric travelers visiting a malaria-endemic country (72%) received a prescription for malaria chemoprophylaxis. Conclusions Ten percent of travelers seeking pre-travel healthcare at GTEN sites are children. VFR-travel, pre-travel consultation close to time of departure, and refusal of recommended vaccines may place children at risk for travel-associated illness. Strategies to engage pediatric travelers in timely, pre-travel care and improve acceptance of pre-travel healthcare interventions are needed. [ABSTRACT FROM PUBLISHER]

Objective. To identify relationships between tourism and health as well as the methods employed in studies about this topic. Method. The PubMed and SciELO databases were searched in March of 2008 using the following strategy: traveler or traveller or tourism or tourist AND risk or hazard or vulnerability AND health or surveillance. The following were excluded: articles on animal health, conceptual and review articles, articles about non-tourist travel, and articles written in languages other than Portuguese, English, Italian, and Spanish. Of 153 articles identified, 112 were excluded, and 41 articles were examined. Results. The number of articles on tourism and health increased from one in the 1970s to 34 in the 2000s. Most studies were carried out in Europe, followed by the Americas, and most covered insect-borne diseases, respiratory diseases transmitted from person to person, and gastrointestinal diseases. Mail, telephone, or face-to-face questionnaires were generally used for data collection. In terms of location, 21 studies were performed at the place of departure, 17 at the destination, and in 3 this information was not specified. Four studies were carried out before the trip, 9 during the trip, 24 after the trip, and 3 did not specify this information. Most studies focus on the tourist as a likely victim of health problems, unprepared to face situations of exposure during the trip. Conclusions. The need to implement health care policies aimed at the tourist population is evident, with emphasis on infectious diseases and emergency actions to detect outbreaks involving tourists. A tourist-specific surveillance and notification system is also necessary, together with measures to prepare health care institutions to meet the individual demands of this population. [ABSTRACT FROM AUTHOR]

Summary: Tunga penetrans are ectoparasites distributed widely. The infestations are endemic in some areas. People both from and visiting this region are susceptible to these infestations. [Copyright &y& Elsevier]