Factors Affecting Pre-Travel Health Seeking Behaviour and Adherence to Pre-Travel Health Advice: A Systematic Review

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
Dylan Kain ◽  
Aidan Findlater ◽  
David Lightfoot ◽  
Timea Maxim ◽  
Moritz U G Kraemer ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Public Health Education ◽  
International Travel ◽  
Health Providers ◽  
Health Seeking ◽  
Factors Affecting ◽  
Travel Health ◽  
Health Advice ◽  
Full Text Review

Abstract Background Recent years have seen unprecedented growth in international travel. Travellers are at high risk for acquiring infections while abroad and potentially bringing these infections back to their home country. There are many ways to mitigate this risk by seeking pre-travel advice (PTA), including receiving recommended vaccinations and chemoprophylaxis, however many travellers do not seek or adhere to PTA. We conducted a systematic review to further understand PTA-seeking behaviour with an ultimate aim to implement interventions that improve adherence to PTA and reduce morbidity and mortality in travellers. Methods We conducted a systematic review of published medical literature selecting studies that examined reasons for not seeking PTA and non-adherence to PTA over the last ten years. 4484 articles were screened of which 56 studies met our search criteria after full text review. Results The major reason for not seeking or non-adherence to PTA was perceived low risk of infection while travelling. Side effects played a significant role for lack of adherence specific to malaria prophylaxis. Conclusions These data may help clinicians and public health providers to better understand reasons for non-adherence to PTA and target interventions to improve travellers understanding of potential and modifiable risks. Additionally, we discuss specific recommendations to increase public health education that may enable travellers to seek PTA.

Vaccine passports and health disparities: a perilous journey

2021 ◽  
pp. medethics-2021-107491
Author(s):  
Nancy S Jecker
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Current Practice ◽  
Racial Profiling ◽  
Public Health Education ◽  
International Travel ◽  
Individual Liberty ◽  
Ethical Guidelines ◽  
Travel Health ◽  
Domestic Use

This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vaccines are widely and equitably available. It raises health equity concerns related to racial profiling and fairness to people who are vaccine cautious. Part III sets forth a proposal for a flexible pass that certifies people who have been vaccinated, tested, previously infected or granted a conscientious objection. It sets ethical guidelines for the timing and use of flexible passes that promote equity, public health education, antidiscrimination, privacy and flexibility.

Geographical Pattern of Infectious Diseases and Infection Prevention for Travellers

2019 ◽  
Author(s):  
Desmond Hsu ◽  
Zahir Osman Eltahir Babiker
Keyword(s):  
Infectious Diseases ◽  
Migratory Birds ◽  
Sunshine Duration ◽  
The United States ◽  
International Travel ◽  
Travel Health ◽  
Health Advice ◽  
Visiting Friends And Relatives ◽  
Main Determinants ◽  
Key Aspects

Infectious diseases are transmitted either directly from person to person via direct contact or droplet exposure, or indirectly through a vector organism (mosquito or tick) or a non-biological physical vehicle (soil or water). Vector-borne infectious diseases are highly influenced by climate factors such as temperature, precipitation, altitude, sunshine duration, and wind. Therefore, climate change is a major threat for the emergence and re-emergence of infectious diseases, e.g. re-emergence of dengue fever in some parts of southern Europe. The natural reservoirs of infectious diseases are either humans (anthroponoses) or animals (zoonoses). Population movement due to travel or civil unrest risks introducing non-immune populations to regions that are endemic for certain infectious diseases. By contrast, global trade contributes to the movement of animals or arthropods across the world and this poses a major risk for introducing infectious diseases to previously non-endemic settings, e.g. rats on board commercial ships and the global spread of hantaviruses; international trade in used car tyres and the risk of introducing flavivirus-infected mosquitoes into non-endemic settings; and the contribution of migratory birds to the introduction and the spread of West Nile virus in the United States. The unprecedented growth of international travel facilitates the swift movement of pathogens by travellers from one region to another. The main determinants of travel-related infections are destination country, activities undertaken during travel, and pre-existing morbidities. Therefore, the pre-travel consultation aims to assess potential health hazards associated with the trip, give advice on appropriate preventative measures, and educate the traveller about their own health. Attitudes towards seeking pre-travel health advice vary by the type of traveller. For example, those visiting friends and relatives (VFRs) in their country of origin are less likely to seek pre-travel health advice compared to tourists and therefore stand a higher chance of presenting with preventable infections such as malaria. The key aspects of a pre-travel consultation include: ● comprehensive risk assessment based on the demographic and clinical background of the traveller as well as the region of travel and itinerary.

Pre-travel health advice guidelines for humanitarian workers: A systematic review

2015 ◽  
Vol 13 (6) ◽  
pp. 449-465 ◽  
Author(s):  
Marco Costa ◽  
Martin Oberholzer-Riss ◽  
Christoph Hatz ◽  
Robert Steffen ◽  
Milo Puhan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Travel Health ◽  
Health Advice

scholarly journals Acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage after exposure to systemic antimicrobials during travel: systematic review and meta-analysis

2019 ◽  
Author(s):  
Terence C. Wuerz ◽  
Sameer S. Kassim ◽  
Katherine E. Atkins
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Odds Ratio ◽  
Meta Analysis ◽  
International Travel ◽  
Health Concern ◽  
Antimicrobial Use ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

ABSTRACTBackgroundInternational travel is an important risk factor for colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Antimicrobial use during travel likely amplifies this risk, yet to what extent, and whether it varies by antimicrobial class, has not been established.MethodsWe conducted a systematic review that included prospective cohorts reporting both receipt of systemic antimicrobials and acquired ESBL-PE isolated from stool or rectum during international travel. We performed a random effects meta-analysis to estimate odds of acquiring ESBL-PE due to antimicrobials during travel, overall and by antimicrobial class.ResultsFifteen studies were included. The study population was mainly female travellers from high income countries recruited primarily from travel clinics. Participants travelled most frequently to Asia and Africa with 10% reporting antimicrobial use during travel. The combined odds ratio (OR) for ESBL-PE acquisition during travel was 2.37 for antimicrobial use overall (95% confidence interval [CI], 1.69 to 3.33), but there was substantial heterogeneity between studies. Fluoroquinolones were the antibiotic class associated with the highest combined OR of ESBL-PE acquisition, compared to no antimicrobial use (OR 4.68, 95% CI, 2.34 to 9.37).ConclusionsThe risk of ESBL-PE colonization during travel is increased substantially with exposure to antimicrobials, especially fluoroquinolones. While a small proportion of colonized individuals will develop a resistant infection, there remains the potential for onward spread among returning travellers. Public health efforts to decrease inappropriate antimicrobial usage during travel are warranted.Research in contextEvidence before this studyAntimicrobial resistance (AMR) among bacteria that commonly cause human infection is of increasing public health concern. International travel has recently been associated with colonization with Extended-Spectrum Beta-Lactamase Producing-Enterobacteriaceae (ESBL-PE), increasing the spread of drug resistance among these important pathogens. We searched Pubmed, Embase, MEDLINE, Web of Science, SCOPUS, and the Cochrane Library for prospective cohort studies published between January 2000 and June 2018, reporting on acquisition of ESBL-PE among travellers, which reported on antimicrobial use during travel. 15 studies were included, which were at moderate risk of bias. The pooled odds ratio for acquisition of ESBL-PE during travel was 2.37 among antimicrobial users, compared to non-users (95% CI, 1.69 to 3.33). The magnitude of this association was stronger among travellers reporting fluoroquinolone use (OR 4.68, 95% CI 2.34 to 9.37).Added value of this studyThis is the first study to quantify the association between antimicrobial use during travel, overall and by specific antimicrobial class, with ESBL-PE acquisition across broad populations of travellers and destination countries.Implications of all the available evidenceFurther study into the mechanisms by which antimicrobials, such as fluoroquinolones, contribute to AMR may identify protective measures. Meanwhile, antimicrobial use during travel for prevention or treatment of mild-to-moderate traveller’s diarrhea should not be recommended routinely. Where indicated, alternatives to fluoroquinolone antimicrobials should be considered.

Evidence-based decision-making: practical issues in the appraisal of evidence to inform policy and practice

2010 ◽  
Vol 34 (4) ◽  
pp. 435 ◽  
Author(s):  
Bronwyn J. Carter
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Decision Making ◽  
Critical Appraisal ◽  
Public Health Education ◽  
Evidence Based ◽  
National Guidelines ◽  
Policy And Practice ◽  
Public Health Decision ◽  
Evidence Based Decision Making

Objective. To highlight the differences between a systematic review of the literature and a systematic review of the best available evidence; to discuss practical issues in the appraisal of evidence to inform public health policy and practice; and to make recommendations for next steps in the development of evidence-based decision making in public health. Data sources and selection. Literature and other sources were reviewed including the subject reading list, recommended texts and websites for the La Trobe University postgraduate subject Evidence Based Public Health Practice 2007 and other relevant sources identified. Data extraction and synthesis. Relevant opinions were extracted to summarise debate in relation to definitions of evidence, usefulness of systematic reviews, tools for critical appraisal and other practical issues in the translation of evidence into practice. Conclusions. Evidence relevant to decisions regarding public health policy and practice may include evidence from the literature including experimental and observational studies as well as other sources, including policies and opinions of stakeholders. Further development of skills and approaches to the critical appraisal of evidence are required. Recommendations include: mapping of Australian competencies to public health education; development of national guidelines to inform the appraisal of evidence for public health decision making; and promotion of leadership and education in evidence-based approaches, discussion and debate in relation to definitions of evidence, and public health research that generates the best possible evidence. What is known about the topic? Systematic reviews are a well recognised tool for the critical appraisal of evidence to inform decision making. There is a lack of agreement about what constitutes valid evidence for inclusion in such reviews and many policy makers have no training or qualifications in the use of systematised approaches to the critical appraisal of evidence from a range of sources to inform decisions. Approaches to critical appraisal of evidence and skills in appraisal of evidence and evidence-based decision making require further development. What does this paper add? This paper reviews current opinions on what constitutes valid evidence and discusses important differences between a systematic review of the literature as distinct from a systematic review of available evidence. The desirable approach is recognised as the utilisation of the best available evidence from a range of sources to inform decision making, including evidence from observational studies including qualitative data, as well as contextual and colloquial evidence. This paper calls for: mapping of Australian competencies to public health education; development of national guidelines to inform the appraisal of evidence for public health decision making; and the promotion of leadership and education in evidence-based approaches, discussion and debate in relation to definitions of evidence and the promotion of public health research that generates the best possible evidence. What are the implications for practitioners? This paper calls upon practitioners to further develop skills in critical appraisal of evidence from a range of sources to inform policy and practice, and to foster collaborative partnerships between researchers, policy makers, educators, managers and clinicians.

Building Capacity of the Public Health Education Workforce Through Partnerships

2003 ◽  
Vol 1 (1) ◽  
pp. 49-59
Author(s):  
Mark Tomita
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
Health Education ◽  
Public Health Education ◽  
Professional Associations ◽  
State University ◽  
Cd Rom ◽  
The Public ◽  
Prevention Services ◽  
The Usa

The Global Health Disparities CD-ROM Project reaffirmed the value of professional associations partnering with academic institutions to build capacity of the USA public health education workforce to meet the challenges of primary prevention services. The Society for Public Health Education (SOPHE) partnered with the California State University, Chico to produce a CD-ROM that would advocate for global populations that are affected by health disparities while providing primary resources for public health educators to use in programming and professional development. The CD-ROM development process is discussed

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