前往印度支那的高级老年人旅行团中旅行者的疾病和伤害。
Illness and injury to travellers on a premium seniors' tour to Indochina.
机构信息
Worldwise Travellers Health Centres of New Zealand, Auckland, New Zealand.
出版信息
Travel Med Infect Dis. 2009 Nov;7(6):367-70. doi: 10.1016/j.tmaid.2009.04.003. Epub 2009 May 31.
BACKGROUND
Commercial expeditions and upmarket tours provide an opportunity for travellers to undertake various specialised travel to more adventurous and extreme destinations often in the relative security of accompanying medical cover provided by an expedition physician. There is limited knowledge of the nature of illnesses and injuries occurring on premium seniors' tours to Asia. This present study was designed to investigate the prevalence of injury and illness suffered by travellers on a premium tour to Indochina.
METHODS
In 2004, the tour expedition physician (MTMS) diagnosed and recorded all illnesses and injuries amongst 23 travellers on a premium seniors' tour to Viet Nam and Cambodia. Information recorded included age, sex, number of days into the tour, the nature of the presenting illness, the assessment of the condition and the treatment employed during the field phase of 14 days. Travel was by air, train and coach, for a total period of 18 days.
RESULTS
Nineteen (82%) travellers sought medical advice at least once for a total of 35 consultations. Females presented on 66% of occasions. The mean age of the travellers was 62 years (SD=13) with males being significantly older (p=0.002). Primary illnesses diagnosed related to the following systems: gastrointestinal 29%, respiratory 14%, dermatological 14%, cardiovascular 14%, musculoskeletal 9%, central nervous system 6%, ear/nose/throat 6%, dental 6%, and other problems on 3% of occasions. Of the gastrointestinal problems, diarrhoea was the commonest complaint on 17% of occasions, occurring at any stage throughout the journey. There was a mean of 2.5 presentations per day of the field phase of the tour. Presentations were highest on day 12. More than one third of presentations (37%) were handled conservatively without any further need for therapy, 17% requiring dressings, and 46% requiring specific medications. The commonest medications used were: lozenges/gargles (31%), antiemetic (25%), anti-diarrhoeal or other medications (13%). There were six accidents during the journey resulting in minor soft tissue injuries. There were no deaths or other major accidents requiring emergency evacuation or hospitalisation.
CONCLUSIONS
On this premium seniors' tour, the health problems encountered were largely similar to those reported for other specialised tours, including premium expeditions. The most common medical problems included gastrointestinal, respiratory, dermatological, cardiovascular and musculoskeletal conditions in descending order. One aspect requiring further study is the psychological adjustments made by travellers on group tours and expeditions. As well as being part of the service provided to travellers, the inclusion of an expedition physician on this premium seniors' tour increased the independence of the travel group on this journey.
背景
商业探险和高端旅游为旅行者提供了机会，让他们能够前往各种更具冒险性和极限性的目的地进行专业旅行，通常在探险医生提供的随行医疗保险的相对安全保障下进行。对于亚洲高端老年旅游团中发生的疾病和伤害的性质，我们知之甚少。本研究旨在调查前往印度支那的高端旅游团中旅行者受伤和患病的情况。
方法
2004 年，旅行探险医生（MTMS）诊断并记录了 23 名前往越南和柬埔寨的高端老年旅游团中所有旅行者的疾病和伤害。记录的信息包括年龄、性别、旅行天数、就诊时疾病的性质、病情评估以及在为期 14 天的实地阶段所采用的治疗方法。旅行方式为飞机、火车和长途客车，总时长为 18 天。
结果
19 名（82%）旅行者至少接受过一次医疗咨询，共进行了 35 次咨询。女性就诊比例占 66%。旅行者的平均年龄为 62 岁（标准差=13），男性明显更年长（p=0.002）。诊断出的主要疾病与以下系统有关：胃肠道 29%、呼吸系统 14%、皮肤科 14%、心血管系统 14%、肌肉骨骼系统 9%、中枢神经系统 6%、耳鼻喉 6%、牙科 6%，以及其他问题占 3%。胃肠道问题中，腹泻最常见，占 17%，在整个旅行过程中的任何阶段都有发生。实地阶段的每日就诊次数平均为 2.5 次。第 12 天就诊率最高。超过三分之一（37%）的就诊病例采用保守治疗，无需进一步治疗，17%需要包扎，46%需要特定药物。最常用的药物包括：润喉糖/漱口剂（31%）、止吐药（25%）、止泻药或其他药物（13%）。旅行途中发生了 6 起事故，导致轻微软组织损伤。没有死亡或其他需要紧急疏散或住院治疗的重大事故。
结论
在这次高端老年旅游团中，遇到的健康问题与其他专业旅游团，包括高端探险团，报告的问题大致相似。最常见的医疗问题包括胃肠道、呼吸系统、皮肤科、心血管系统和肌肉骨骼系统疾病，按降序排列。旅行者在团体旅行和探险中进行的心理调整是需要进一步研究的一个方面。作为为旅行者提供的服务的一部分，在这次高端老年旅游团中增加一名探险医生增加了旅行团在这次旅行中的独立性。
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