影响标准旅行前健康建议的因素——比利时的一项研究

Van De Winkel Kristina, Van den Daele Alex, Van Gompel Alfons, Van den Ende Jef

Department of Clinical Sciences, Institute of Tropical Medicine Antwerp (ITMA), Travel Clinic, and Tropical Medicine Hospitalization Unit, University Hospital, Antwerp, Belgium.

J Travel Med. 2007 Sep-Oct;14(5):288-96. doi: 10.1111/j.1708-8305.2007.00141.x.

BACKGROUND

Travelers with risk factors, medical conditions such as immunosuppression, medication intake, pregnancy, or elderly age, need adaptation or reinforcement of pretravel health advice. The literature provides little data on the frequency of these risk groups in the travel population. This study intended to investigate whether risk factors influencing standard travel advice are common in the population attending our travel clinic.

METHODS

A prospective survey was carried out over a 2-month period in 2004 at the travel clinic of the Institute for Tropical Medicine in Antwerp, Belgium. A list of risk factors focused on the following three important advice categories: malaria prophylaxis, yellow fever vaccination, and travelers' diarrhea or other enteric infections. We counted how frequently a risk factor was observed for each advice category (potential influence) and, after considering the travel characteristics, how often a real adaptation of advice was necessary (actual influence).

RESULTS

Of 2,227 travelers, 276 were found to have a possible influencing factor (12.4%). The potential influence was 10.9% (243/2,227) for malaria prophylaxis advice, 6.1% (136/2,227) for yellow fever vaccination, and 1.9% (43/2,227) for travelers' diarrhea advice. The actual influence was lower 8% (184/2,227), 5% (109/2,227), and 1.2% (27/2,227), respectively. The main interfering factors were as follows: for influence on malaria advice, age>or=60 years (44%) and neuropsychiatric disorders (15.6%); for yellow fever vaccination, age>or=60 years (63.2%) and immunosuppression (10.3%); and for influence on travelers' diarrhea advice, decreased gastric acidity (44.2%) and immunosuppression (32.6%).

CONCLUSION

Travelers with risk factors are not infrequently seen at our travel clinic. Some groups are more prominently present and could be the focus of travel group-specific instructions. The study suggests that being informed about risk groups is essential for advising travelers.

背景

有风险因素的旅行者，如存在免疫抑制、正在服药、怀孕或年龄较大等医疗状况，需要调整或加强旅行前的健康建议。文献中关于这些风险群体在旅行者人群中的频率数据很少。本研究旨在调查影响标准旅行建议的风险因素在我们旅行诊所的就诊人群中是否常见。

方法

2004年在比利时安特卫普热带医学研究所的旅行诊所进行了为期2个月的前瞻性调查。一份风险因素清单聚焦于以下三个重要的建议类别：疟疾预防、黄热病疫苗接种以及旅行者腹泻或其他肠道感染。我们统计了每个建议类别中观察到风险因素的频率（潜在影响），并在考虑旅行特征后，统计了实际需要调整建议的频率（实际影响）。

结果

在2227名旅行者中，发现276人有可能的影响因素（12.4%）。疟疾预防建议的潜在影响为10.9%（243/2227），黄热病疫苗接种的潜在影响为6.1%（136/2227），旅行者腹泻建议的潜在影响为1.9%（43/2227）。实际影响分别较低，为8%（184/2227）、5%（109/2227）和1.2%（27/2227）。主要干扰因素如下：对疟疾建议的影响方面，年龄≥60岁（44%）和神经精神疾病（15.6%）；对黄热病疫苗接种的影响方面，年龄≥60岁（63.2%）和免疫抑制（10.3%）；对旅行者腹泻建议的影响方面，胃酸分泌减少（44.2%）和免疫抑制（32.6%）。