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  1. Asawapaithulsert P, Flaherty GT, Piyaphanee W
    Am J Trop Med Hyg, 2022 Aug 17;107(2):492-494.
    PMID: 35895400 DOI: 10.4269/ajtmh.22-0177
    Prior to the COVID-19 pandemic, there was a rapid increase in international travel. Travel medicine is a branch of preventive medicine focusing on risk assessment pre-travel, during travel and post-travel with the aim of promoting health and preventing adverse health outcomes. Travel medicine specialists inform travelers about potential health risks and mitigate infectious disease risks such as travelers' diarrhea, yellow fever, and malaria. Travel medicine topics were popular in the American Society of Tropical Medicine and Hygiene conferences between 2016 and 2020, and now comprise approximately 2% of all presentations. Most topics related to the post-travel assessment (50%), followed by diseases contracted during travel (26%), and pre-travel assessment and consultation (24%). Our analysis of the 10 sub-domains of travel medicine issues found that malaria (26%) and immunization (12%) were represented to the greatest extent. We anticipate that both travel and tropical medicine fields will regain their popularity after recovery from the pandemic.
  2. Jongsoowiwatwong N, Flaherty GT, Pisutsan P, Matsee W, Kusolsuk T, Silachamroon U, et al.
    Travel Med Infect Dis, 2024;62:102780.
    PMID: 39447943 DOI: 10.1016/j.tmaid.2024.102780
    BACKGROUND: Last-minute travelers (LMTs) present significant challenges for travel health services and are considered vulnerable due to their lack of health preparation. However, there is a lack of data to support this assumption.

    METHODS: The proportion of LMTs was investigated through a cross-sectional study involving all Thai travelers who visited the Thai Travel Clinic before their departure abroad. A prospective study was conducted by enrolling the travelers after the consultation, utilizing two online questionnaires. The first aimed to gather demographic data and categorize participants as either LMTs (if their departure date was ≤14 days) or non-LMTs, while the second assessed travel-related illnesses either upon their return or at the one-month point if their trip exceeded a month.

    RESULTS: A quarter (25.5 %) of 310 Thai travelers abroad were classified as LMTs. Both LMTs and non-LMTs showed similar gender distributions with mean ages of 35.8 and 35.7 years old, respectively, but LMTs were more likely to travel for tourism, travel in groups, visit countries within Asia and plan shorter stays abroad. Follow-up studies were conducted from July 2023 to February 2024. 452 departed respondents consisted of 150 LMTs and 302 non-LMTs. Although overall health problems were insignificantly higher in LMTs (32.0 % vs 22.0 %, AOR = 1.469, p = 0.107), gastrointestinal and neurological symptoms (primarily headache and dizziness) were significantly more common among LMTs.

    CONCLUSIONS: LMTs represent a significant portion of Thai travelers, posing challenges for travel health specialists in Thailand. Intervention and education efforts may be necessary to address this issue.

  3. Piyaphanee W, Stoney RJ, Asgeirsson H, Appiah GD, Díaz-Menéndez M, Barnett ED, et al.
    J Travel Med, 2023 May 18;30(3).
    PMID: 36637429 DOI: 10.1093/jtm/taad002
    BACKGROUND: International travellers may seek care abroad to address health problems that arise during their trip or plan healthcare outside their country of residence as medical tourists.

    METHODS: Data were collected on travellers evaluated at GeoSentinel Network sites who reported healthcare during travel. Both unplanned and planned healthcare were analysed, including the reason and nature of healthcare sought, characteristics of the treatment provided and outcomes. Travellers that presented for rabies post-exposure prophylaxis were described elsewhere and were excluded from detailed analysis.

    RESULTS: From May 2017 through June 2020, after excluding travellers obtaining rabies post-exposure prophylaxis (n= 415), 1093 travellers reported care for a medical or dental issue that was an unanticipated part of the travellers' planned itinerary (unplanned healthcare). Travellers who sought unplanned healthcare abroad had frequent diagnoses of acute diarrhoea, dengue, falciparum malaria and unspecified viral syndrome, and obtained care in 131 countries. Thirty-four (3%) reported subsequent deterioration and 230 (21%) reported no change in condition; a third (n = 405; 37%) had a pre-travel health encounter. Forty-one travellers had sufficient data on planned healthcare abroad for analysis. The most common destinations were the US, France, Dominican Republic, Belgium and Mexico. The top reasons for their planned healthcare abroad were unavailability of procedure at home (n = 9; 19%), expertise abroad (n = 9; 19%), lower cost (n = 8; 17%) and convenience (n = 7; 15%); a third (n = 13; 32%) reported cosmetic or surgical procedures. Early and late complications occurred in 14 (33%) and 4 (10%) travellers, respectively. Four travellers (10%) had a pre-travel health encounter.

    CONCLUSIONS: International travellers encounter health problems during travel that often could be prevented by pre-travel consultation. Travellers obtaining planned healthcare abroad can experience negative health consequences associated with treatments abroad, for which pre-travel consultations could provide advice and potentially help to prevent complications.

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