Displaying publications 1 - 20 of 67 in total

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  1. Darrat M, Flaherty GT
    PMID: 31548898 DOI: 10.1186/s40794-019-0094-8
    Background: Older people represent a significant proportion of overseas travellers. The epidemiology of older international travellers is not well described in the literature. This study aims to identify demographics, travel characteristics and the medical profile of older travellers seeking pre-travel health advice in a specialist travel medicine clinic.

    Methods: Records of travellers aged 60 years and older attending the Tropical Medical Bureau clinic in Galway, Ireland between 2014 and 2018 were examined. Descriptive and inferential.analysis of data was performed.

    Results: A total of 337 older travellers sought pre-travel health advice during the study period. The mean age of the cohort was 65.42 (±10) years. Most of the travellers (n = 267, 80%) had at least one travelling companion. Nearly half of older travellers (n = 155, 46.8%) were travelling with a single companion. Tourism was the main reason for travel for the majority (n = 260, 77.6%), followed by visiting friends and relatives (VFR) (n = 23, 6.9%) travellers. The mean interval remaining before the planned trip was 4.36 (±2) weeks, and the mean duration of travel was 3.16 (±1) weeks. The most popular single country of destination was India with 33 (9.8%) visitors, and South East Asia was the most popular region with 132 (39.2%) older travellers. The majority of travellers (n = 267, 79.2%) had a documented pre-existing medical condition. The most commonly reported medical conditions were hypertension (n = 26, 7.7%), dyslipidaemia (n = 18, 5.3%), diabetes mellitus (n = 12, 3.5%), insect bite sensitivity (n = 11, 3.3%), and hypothyroidism (n = 9, 2.6%). Antihypertensive agents (n = 32, 9.4%) and statins (n = 24, 7.1%) were the most frequently used medications. Typhoid (n = 112, 33.2%) and hepatitis A (n = 84, 24.9%) were the most common vaccinations administered to older travellers at the clinic.

    Conclusions: This study provides an insight into the demographics, travel characteristics, and medical profile of elderly travellers seeking advice at a large travel clinic in Ireland. A wide range of travel destinations, diseases and medication use was reported among this group of travellers, which may enable travel medicine physicians to provide more tailored advice and to more appropriately counsel older travellers.

  2. Lu TS, Holmes A, Noone C, Flaherty GT
    Trop Dis Travel Med Vaccines, 2020 Nov 27;6(1):24.
    PMID: 33292661 DOI: 10.1186/s40794-020-00124-0
    BACKGROUND: Sex tourism is defined as travel planned specifically for the purpose of sex, generally to a country where prostitution is legal. While much of the literature on sex tourism relates to the commercial sex worker industry, sex tourism also finds expression in non-transactional sexual encounters. This narrative review explores current concepts related to travel and sex, with a focus on trans-national sex tourism.

    METHODS: The PubMed database was accessed to source relevant literature, using combinations of pertinent search terms. Only articles published in the English language were selected. Reference lists of published articles were also examined for relevant articles.

    RESULTS: With regard to preferred destinations, South/Central America and the Caribbean were more likely to receive tourists looking for casual sex. Longer duration of travel, travelling alone or with friends, alcohol or drug use, being younger and being single were factors associated with higher levels of casual sex overseas. The majority of literature retrieved on sex workers focused on risk behaviours, sexually transmitted infections (STI), mobility of sex workers and how these factors affected their lives. Sex tourists require better access to effective methods of preventing HIV, such as pre-exposure prophylaxis, and better education on HIV prevention. Drugs and alcohol play a major role as risk factors for and cofactors in casual sexual behaviour while abroad.

    CONCLUSIONS: Travellers need to be informed of the increased risks of STI before travel. They should be aware of the local prevalence of STIs and the risks associated with their sexual practices when they travel, including engaging with commercial sex workers, having unprotected sexual intercourse and becoming victims of sexual violence.

  3. Flaherty GT, Hession P, Liew CH, Lim BCW, Leong TK, Lim V, et al.
    PMID: 32868984 DOI: 10.1186/s40794-020-00118-y
    Background: A high burden of severe disease and death from the coronavirus disease 2019 (COVID-19) has been consistently observed in older patients, especially those with pre-existing medical co-morbidities. The global pandemic lockdown has isolated many patients with chronic illnesses from their routine medical care. This narrative review article analyses the multitude of issues faced by individuals with underlying medical conditions during the COVID-19 pandemic.

    Methods: Sources for this publication were identified through searches of PubMed for articles published between 31st December 2019 and 4th June 2020, using combinations of search terms. Guidelines and updates from reputable agencies were also consulted. Only articles published in the English language were included.

    Results: The volume of literature on COVID-19 continues to expand, with 17,845 articles indexed on PubMed by 4th June 2020, 130 of which were deemed particularly relevant to the subject matter of this review. Older patients are more likely to progress to severe COVID-19 disease requiring intensive care unit (ICU) admission. Patients with pre-existing cardiovascular disease, especially hypertension and coronary heart disease, are at greatly increased risk of developing severe and fatal COVID-19 disease. A controversial aspect of the management of COVID-19 disease has been the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Obese COVID-19 patients are more likely to require complex ICU management. Putative mechanisms of increased COVID-19 disease severity in diabetes include hyperglycaemia, altered immune function, sub-optimal glycaemic control during hospitalisation, a pro-thrombotic and pro-inflammatory state. Patients with mental health disorders are particularly vulnerable to social isolation, and this has been compounded by the suspension of non-emergency care in hospitals around the world, making it difficult for patients with chronic mental illness to attend outpatient appointments.

    Conclusions: The global pandemic of COVID-19 disease has had a disproportionately negative impact on patients living with chronic medical illness. Future research should be directed at efforts to protect vulnerable patients from possible further waves of COVID-19 and minimising the negative impact of pandemic mitigation strategies on these individuals.

  4. Liew CH, Flaherty GT
    Am J Trop Med Hyg, 2020 03;102(3):689-697.
    PMID: 31933464 DOI: 10.4269/ajtmh.19-0793
    Cardiovascular disease (CVD) is the leading cause of death among international travelers. It is unknown whether CVD is a barrier to international travel. The purpose of this study was to describe the travel experiences of a cohort of individuals with CVD, to identify their perceived barriers to travel, and to generate recommendations for CVD travelers, medical practitioners, and the travel industry. Semi-structured interviews were conducted with CVD patients who had attended either a regional, structured, multidisciplinary CVD prevention program or a cardiac rehabilitation program. Coding and thematic analysis of the transcripts were supported by NVivo® computer software. Peer debriefing with an independent researcher was undertaken. Demographic and clinical data such as gender, age, and types of cardiovascular condition were also recorded. Twelve patients (eight males), with a mean age of 68 ± 7.58 years, agreed to semi-structured interviews (26-78 minutes duration). The key themes emerging from the interviews included altered travel perception, accessing medical care overseas, issues with medications, medical device concerns at airports, restricted leisure travel activities, and optimal self-care. All interviewees perceived a health benefit to travel and did not regard CVD as a significant barrier to international travel. Certain cardiovascular conditions precipitated more travel anxiety. These findings highlight the unique experiences of CVD patients when engaging in international travel. Cardiovascular disease optimization and responsible travel health behaviors would facilitate medically uneventful overseas travel. The results may inform pretravel health advice given to CVD travelers. Further studies on issues relating to air travel in CVD are warranted.
  5. 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.
  6. Flaherty GT, Walden LM, Townend M
    J Travel Med, 2016 May;23(5).
    PMID: 27279126 DOI: 10.1093/jtm/taw036
    Few studies have examined emergency self treatment (EST) antimalarial prescribing patterns. 110 physician-members of the Travel Medicine Society of Ireland and British Global and Travel Health Association participated in this study. There was a trend towards the prescription of EST for travel to remote low-risk malaria areas; for long-term residents living in low-risk areas; and for frequent travellers to low-risk areas. This study provides insights into the use of EST in travellers' malaria.
  7. Flaherty GT, Choi J
    J Travel Med, 2016 Feb;23(2):tav026.
    PMID: 26858274 DOI: 10.1093/jtm/tav026
    Photography is an integral component of the international travel experience. Self-photography is becoming a mainstream behaviour in society and it has implications for the practice of travel medicine. Travellers who take selfies, including with the use of selfie sticks, may be subject to traumatic injuries associated with this activity. This review article is the first in the medical literature to address this emerging phenomenon.
  8. Flaherty GT, Leong SW, Finn Y, Sulaiman LH, Noone C
    J Travel Med, 2020 Sep 26;27(6).
    PMID: 32634210 DOI: 10.1093/jtm/taaa110
    BACKGROUND: Little is known about the awareness of travellers with diabetes about the health effects of international travel. This study aimed to design and validate a questionnaire to examine the travel health knowledge, attitudes and practices of people living with type 1 diabetes.

    METHODS: A set of 74 items based on a conceptual framework analysis underwent revision and its content validity was established. Items were grouped into three domains. A development study was conducted to establish evidence regarding their factorial structure. A construct validation study was then conducted in which the retained items were tested in an independent sample using confirmatory factor analysis (CFA).

    RESULTS: Four factors emerged from our development study and were labelled as pre-travel preparation-insect bites, pre-travel preparation-consultation, insulin and glycaemic control and travel risk behaviour. A CFA confirmed the factorial structure identified in the development study in an independent sample. Each factor loading had a significant (P 

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