[Usefulness of a physical examination upon return from the tropics]

This study was undertaken to determine the usefulness of medical check-ups after return from the tropics by retrospective analysis of the data of the outpatient clinic for tropical medicine and imported diseases of the University Hospital of Nijmegen. During the years 1986-1990, 379 persons who had returned from the tropics and who were asymptomatic were subjected to a medical check-up (this group comprised 32% of the total of 1190 patients seen in the clinic during this period). In 230 persons (61%) no abnormality was detected. In 101 persons (27%) one or more diagnoses were made which were related to their stay in the tropics. For three-quarters of them treatment was indicated (77 patients). In the remaining 48 persons (13%) diagnoses were made which were neither related to the tropics nor required treatment (e.g. mild varices or minor kyphoscoliosis). Such diagnoses did not contribute to the usefulness of a medical check-up. In 200 persons a chest X-ray was made, either because they had stayed in the tropics for more than 3 years, or had had close contacts with the local population or because abnormalities were suspected on the basis of history or physical examination. While four X-rays revealed significant pathology, in only one of these did the patient benefit from its detection (early pulmonary tuberculosis). We conclude from our study that a medical check-up after return from the tropics is justifiable. The duration of the stay in the tropics by itself is no indication for a chest X-ray.(ABSTRACT TRUNCATED AT 250 WORDS)