接受旅行前健康建议对澳大利亚朝圣者预防朝觐相关疾病的影响：队列研究。
The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study.
机构信息
Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
School of Public Health, The University of Sydney, Sydney, Australia.
出版信息
JMIR Public Health Surveill. 2020 Jul 14;6(3):e10959. doi: 10.2196/10959.
BACKGROUND
Pretravel health advice can play a crucial role in improving both travelers' awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non-mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims' health behaviors.
OBJECTIVE
The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims' awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses.
METHODS
A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ≥18 years in 2015.
RESULTS
A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses.
CONCLUSIONS
Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors.
背景
旅行前健康建议对提高旅行者对疾病风险的认识和遵守预防措施至关重要。国际上报道全科医生（GP）和互联网是前往非集会（MG）目的地旅行者获取健康建议的主要来源。然而，很少有研究试图调查前往麦加朝圣（包括朝觐）的旅行者获取健康建议的来源，而且这些研究都没有进一步调查旅行前建议对朝圣者健康行为的影响。
目的
本研究旨在调查旅行前健康建议来源（来自 GP 和专业朝觐旅行代理商）对朝觐者对健康建议的认识和遵守情况以及与朝觐相关疾病发病率的影响。
方法
对 2015 年澳大利亚年龄≥18 岁的成年朝圣者进行了一项前瞻性队列研究（朝觐前和朝觐期间）。
结果
共有 421 名朝圣者在朝觐前参加了研究，其中 391 名（93%）在朝觐期间提供了随访数据。所有参与者均从一个或多个来源获得了旅行前健康建议，其中朝觐旅行代理商（46%）和全科医生（GP；40%）是最常报告的来源。共有 288 名（74%）参与者报告了与朝觐相关的症状，其中 86%（248/288）为呼吸道症状。从旅行代理商处获得旅行前健康建议的参与者更有可能了解沙特官方建议（调整后的优势比[OR]2.1，95%CI 1.2-3.8；P=.01），在旅行前接受推荐疫苗（调整后的 OR 2.4，95%CI 1.4-3.9；P=.01），使用包括肥皂在内的洗手液（调整后的 OR 2.5，95%CI 1.1-6.1；P=.03），并在朝觐期间接触患病者后洗手（调整后的 OR 2.9，95%CI 1.1-7.1；P=.01），而从 GP 处获得建议的参与者则不然。然而，旅行代理商或 GP 提供的建议均与较低的与朝觐相关疾病发病率无关。
结论
与从 GP 处获得的建议相比，来自旅行代理商的建议似乎更受旅行者欢迎，并且与更有可能采取积极的旅行健康行为相关。
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