Patterns of diseases in health students abroad: A systematic review.

BACKGROUND

Different health risks are associated with international electives among medical students, including the transmission of infectious diseases and non-communicable diseases. This review aims to summarise the evidence for illnesses associated with travel in medical students taking part in electives abroad.

METHODS

Articles were identified through a literature search in two databases (until 30 July 2020) - PubMed and Web of Science.

RESULTS

Sixteen articles were included in the systematic review. The results were classified into two broad categories: communicable diseases and non-communicable diseases. Gastrointestinal infections including travellers' diarrhoea were the most common infectious diseases reported by medical students abroad, followed by respiratory tract infections and skin infections. Blood-borne and sexually transmitted infection and systemic febrile infections due to vector-borne pathogens were rarely reported. Only six of the 16 studies addressed microbial carriage. The acquisition of resistant bacteria appeared to be frequent. Traffic accidents and mental health problems were also reported.

CONCLUSIONS

One of the lessons learned from this review is the requirement for large-scale epidemiological studies to evaluate the burden of infectious diseases such as gastrointestinal, respiratory and blood-borne infections with microbiological documentation. In particular, the emergence of the acquisition of resistant bacteria may lead to a theoretical risk of spread to the community and hospitals. Studies addressing mental health issues in the context of medical electives abroad are also needed.