Morbidity and determinants of health on youth expeditions

To document the prevalence of illness and injury on youth expeditions and analyze specific determinants of health.

Two thousand nine hundred fifteen people, aged 15 to 18 years, traveled with a commercial company, World Challenge Expeditions Ltd, between June and September 2001. Adult team leaders were required to keep medical cards for each person. This study is a retrospective analysis of these medical cards.

Completed medical cards were available for 2402 people (82%). There were no medical problems in 36% of people. Illness or injury was reported by 64% (mean, 2.0 medical problems per person). Of the medical problems, 6% were defined as serious, and 1% were admitted to the hospital. One fatality occurred. The five most prevalent medical problems were diarrhea (22%), nausea and vomiting (20%), cold or sore throat (11%), headache (11%), and trauma (10%). Girls reported 19% more medical problems than the boys reported. Gastrointestinal illness was significantly increased at high altitude. Illness and injury were most prevalent in South America and least prevalent in Australasia.

Our results demonstrate that in young people traveling to remote parts of the world, illness and injury are common. Serious incidents are rare; however, the death of one person does highlight the dangers present. This study may help risk assessment for young people considering taking part in an expedition.