Adherence to recommendations at a Canadian tertiary care Family Travel Clinic - A single centre analysis
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Published on: March 30, 2014
Emily K K Fong1, Lisa G Pell2, Ahmed Faress3
1Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada; Faculty of Medicine, University of Alberta, Edmonton, Canada.
Insights
Adherence to travel medicine advice, except for vaccines, was low, especially for those visiting friends and relatives (VFRs). This highlights a need to address barriers to following pre-travel health recommendations for safer international journeys.
Area of Science:
- Travel Medicine
- Public Health
- Infectious Disease Prevention
Background:
- International travel presents infectious and non-infectious health risks.
- Pre-travel advice from travel medicine practitioners can mitigate these risks.
Purpose of the Study:
- To assess adherence to pre-travel recommendations among international travelers, including children and those visiting friends and relatives (VFRs).
- To identify adherence levels for malaria chemoprophylaxis, safe food/water, insect bite protection, motor vehicle safety, and travel vaccines.
Main Methods:
- A prospective cohort study was conducted at a tertiary care children's hospital.
- Structured questionnaires assessed adherence in 290 participants (133 children, 157 adults).
- High-risk groups, including child travelers and VFRs, were specifically evaluated.
Main Results:
- Adherence to most travel recommendations was sub-optimal, excluding vaccines.
- Adherence to malaria chemoprophylaxis was lower in VFRs (children: 47%, adults: 33%) compared to non-VFRs.
- Adherence to safe food (18% children, 6% adults) and insect bite avoidance (21% children, 12% adults) was particularly low among VFRs.
Conclusions:
- Sub-optimal adherence to travel health recommendations, particularly among VFRs, was observed for all measures except vaccines.
- There is a clear need for proactive strategies to discuss and overcome barriers to adherence for international travelers.
Background:
Infectious and non-infectious risks associated with international travel can be reduced with adherence to pre-travel advice from practitioners trained in travel medicine.
Methods:
A prospective cohort study was conducted in a tertiary care children's hospital to assess adherence to malaria chemoprophylaxis, safe water and food consumption, mosquito bite protection, motor vehicle safety and travel vaccines using structured questionnaires. High risk groups assessed included child travelers and those visiting friends and relatives (VFRs).
Results:
In total, 290 participants (133 children and 157 adults) were enrolled and completed at least one study questionnaire. In general, with the exception of vaccines, adherence to recommendations was sub-optimal. Among children and adults, adherence to malaria prophylaxis recommendations was lower in VFRs than in non-VFRs. The proportion of children VFRs (cVFRs) and adult VFRs (aVFRs) who adhered to the following recommendations were malaria chemoprophylaxis (47%, 33%), safe water (71%, 74%) and food recommendations (18%, 6%), insect bite avoidance (21%, 12%), and motor vehicle safety (13%, 11%) respectively. Adherence to recommended vaccines uptake was greater than 90% in all groups.
Conclusion:
With the exception of vaccine uptake, sub-optimal adherence levels to travel recommendations was identified in all groups, and in particular VFRs, highlighting the need for proactive discussions around barriers to adherence.
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