Farnham Andrea, Hatz Christoph, Fehr Jan, Baroutsou Vasiliki, Puhan Milo A, Veit Olivia, Bühler Silja
Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
Center for Tropical and Travel Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
J Travel Med. 2025 Mar 30;32(3). doi: 10.1093/jtm/taae141.
Travellers frequently visit popular destinations like Brazil, India, Peru, Thailand and Tanzania, each presenting varying malaria risks. The extent to which travellers enter high-risk malaria-endemic areas in destinations with heterogeneous malaria risk remains unclear. We used geo-location via a smartphone application to (i) describe where travellers go within countries with heterogeneous malaria risk (Brazil, India, Peru, Thailand) and (ii) compare mosquito bite prevention behaviours between these destinations and Tanzania, considered entirely high risk for malaria.
This analysis is a sub-study of the Tracking of Urgent Risks in Swiss Travellers (TOURIST2) cohort, which prospectively recruited 1000 travellers (≥18 years, travelling ≤4 weeks) from Swiss travel clinics (Zurich and Basel) between September 2017 and April 2019. We included 734 travellers to Brazil, India, Peru, Thailand and Tanzania who provided geo-location data. Daily health and geo-location data were collected using a smartphone application. Malaria risk was categorized using 2022 malaria maps from the Swiss Expert Committee for Travel Medicine.
Of the 734 travellers, 525 travelled to Brazil, India, Peru and Thailand and 225 to Tanzania. In Brazil, India, Peru and Thailand, only 2% (n = 13) visited high-risk malaria areas. In Peru, 4% (n = 4) visited a high-risk area; in Brazil, 3% (n = 6); in Thailand, 2% when crossing the border into Myanmar (n = 3); and in India, 0%. Travellers to high-risk areas were more often male (62%), slightly older (median age 42.0) and planned longer trips (median 23.0 days) than other travellers. No participants were diagnosed with malaria. Travellers to Brazil, India, Peru and Thailand used mosquito bite prevention measures less frequently than travellers to Tanzania. Those in Tanzania had higher, but still suboptimal, use of insect spray (65% of travel days).
Travellers to Brazil, India, Peru and Thailand rarely visited high-risk malaria areas, and their adherence to mosquito bite prevention measures was generally low. In Tanzania, adherence was higher but still suboptimal.
旅行者经常前往巴西、印度、秘鲁、泰国和坦桑尼亚等热门目的地，每个目的地的疟疾风险各不相同。旅行者进入疟疾风险各异的目的地中高风险疟疾流行地区的程度尚不清楚。我们通过一款智能手机应用程序利用地理位置信息来（i）描述旅行者在疟疾风险各异的国家（巴西、印度、秘鲁、泰国）内的行程，以及（ii）比较这些目的地与被认为疟疾风险完全高的坦桑尼亚之间预防蚊虫叮咬的行为。
本分析是瑞士旅行者紧急风险追踪（TOURIST2）队列研究的一项子研究，该队列在2017年9月至2019年4月期间从瑞士旅行诊所（苏黎世和巴塞尔）前瞻性招募了1000名旅行者（≥18岁，旅行时间≤4周）。我们纳入了734名前往巴西、印度、秘鲁、泰国和坦桑尼亚并提供了地理位置数据的旅行者。使用一款智能手机应用程序收集每日健康和地理位置数据。根据瑞士旅行医学专家委员会2022年的疟疾地图对疟疾风险进行分类。
在734名旅行者中，525人前往巴西、印度、秘鲁和泰国，225人前往坦桑尼亚。在巴西、印度、秘鲁和泰国，只有2%（n = 13）的人访问了高风险疟疾地区。在秘鲁，4%（n = 4）的人访问了高风险地区；在巴西，3%（n = 6）；在泰国，2%的人在穿越边境进入缅甸时（n = 3）；在印度，这一比例为0%。前往高风险地区的旅行者男性比例更高（62%），年龄稍大（中位年龄42.0岁），旅行计划时间更长（中位23.0天）。没有参与者被诊断出感染疟疾。前往巴西、印度、秘鲁和泰国的旅行者比前往坦桑尼亚的旅行者更少使用预防蚊虫叮咬的措施。坦桑尼亚的旅行者使用驱虫喷雾的比例更高，但仍未达到最佳水平（旅行天数的65%）。
前往巴西、印度、秘鲁和泰国的旅行者很少访问高风险疟疾地区，他们对预防蚊虫叮咬措施的依从性普遍较低。在坦桑尼亚，依从性较高但仍未达到最佳水平。
