Displaying publications 1 - 20 of 75 in total

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  1. Kositprapa C, Wimalratna O, Chomchey P, Chareonwai S, Benjavongkulchai M, Khawplod P, et al.
    J Travel Med, 1998 Mar;5(1):30-2.
    PMID: 9772313
    Rabies is still a major public health problem in Asia. The incidence of known annual human cases in India alone has recently been revised from 20,000 to 30,000, and over 500,000 patients are given some form of postexposure rabies treatment. Only China, Peninsular Malaysia, Singapore, and Thailand are reporting a significant decrease in the prevalence of this disease in humans. Over 150,000 courses of postexposure treatment (PET) are given in Thailand every year. To determine remaining barriers to further reduction of the number of human rabies deaths, we carried out a questionnaire study of government hospitals throughout the Kingdom.
  2. 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.
  3. Flaherty GT, Rossanese A, Steffen R, Torresi J
    J Travel Med, 2018 01 01;25(1).
    PMID: 30239856 DOI: 10.1093/jtm/tay088
  4. Chang L, Lim BCW, Flaherty GT, Torresi J
    J Travel Med, 2019 Sep 02;26(6).
    PMID: 31066446 DOI: 10.1093/jtm/taz034
    BACKGROUND: With the advent of highly active antiretroviral drugs for the treatment of human immunodeficiency virus (HIV) it has become possible for people with HIV to travel to destinations that may place them at risk of a number of infectious diseases. Prevention of infections by vaccination is therefore of paramount importance for these travellers. However, vaccine responsiveness in HIV-positive individuals is not infrequently reduced compared to HIV-negative individuals. An understanding of the expected immune responses to vaccines in HIV-positive travellers is therefore important in planning the best approach to a pretravel consultation.

    METHODS: A PubMed search was performed on HIV or acquired immune deficiency syndrome together with a search for specific vaccines. Review of the literature was performed to develop recommendations on vaccinations for HIV-positive travellers to high-risk destinations.

    RESULTS: The immune responses to several vaccines are reduced in HIV-positive people. In the case of vaccines for hepatitis A, hepatitis B, influenza, pneumococcus, meningococcus and yellow fever there is a good body of data in the literature showing reduced immune responsiveness and also to help guide appropriate vaccination strategies. For other vaccines like Japanese encephalitis, rabies, typhoid fever, polio and cholera the data are not as robust; however, it is still possible to gain some understanding of the reduced responses seen with these vaccines.

    CONCLUSION: This review provides a summary of the immunological responses to commonly used vaccines for the HIV-positive travellers. This information will help guide travel medicine practitioners in making decisions about vaccination and boosting of travellers with HIV.

  5. Yusof NBM, Khor ZS, Bakar RSBA, Zaman KHBK, Chem YK, Fatini NA, et al.
    J Travel Med, 2023 Sep 05;30(5).
    PMID: 36795049 DOI: 10.1093/jtm/taad020
  6. Nakayama E, Tajima S, Kotaki A, Shibasaki KI, Itokawa K, Kato K, et al.
    J Travel Med, 2018 01 01;25(1).
    PMID: 29394382 DOI: 10.1093/jtm/tax072
    Background: Due to the huge 2-way human traffic between Japan and Chikungunya (CHIK) fever-endemic regions, 89 imported cases of CHIK fever were confirmed in Japan from January 2006 to June 2016. Fifty-four of 89 cases were confirmed virologically and serologically at the National Institute of Infectious Diseases, Japan and we present the demographic profiles of the patients and the phylogenetic features of 14 CHIK virus (CHIKV) isolates.

    Methods: Patients were diagnosed with CHIK fever by a combination of virus isolation, viral RNA amplification, IgM antibody-, IgG antibody-, and/or neutralizing antibody detection. The whole-genome sequences of the CHIKV isolates were determined by next-generation sequencing.

    Results: Prior to 2014, the source countries of the imported CHIK fever cases were limited to South and Southeast Asian countries. After 2014, when outbreaks occurred in the Pacific and Caribbean Islands and Latin American countries, there was an increase in the number of imported cases from these regions. A phylogenetic analysis of 14 isolates revealed that four isolates recovered from three patients who returned from Sri Lanka, Malaysia and Angola, belonged to the East/Central/South African genotype, while 10 isolates from 10 patients who returned from Indonesia, the Philippines, Tonga, the Commonwealth of Dominica, Colombia and Cuba, belonged to the Asian genotype.

    Conclusion: Through the phylogenetic analysis of the isolates, we could predict the situations of the CHIK fever epidemics in Indonesia, Angola and Cuba. Although Japan has not yet experienced an autochthonous outbreak of CHIK fever, the possibility of the future introduction of CHIKV through an imported case and subsequent local transmission should be considered, especially during the mosquito-active season. The monitoring and reporting of imported cases will be useful to understand the situation of the global epidemic, to increase awareness of and facilitate the diagnosis of CHIK fever, and to identify a future CHIK fever outbreak in Japan.

  7. Sapkota B, Saud B, Shrestha R, Al-Fahad D, Sah R, Shrestha S, et al.
    J Travel Med, 2022 May 31;29(3).
    PMID: 34918097 DOI: 10.1093/jtm/taab191
    BACKGROUND/OBJECTIVE: Heterologous prime-boost doses of COVID-19 vaccines ('mix-and-match' approach) are being studied to test for the effectiveness of Oxford (AZD1222), Pfizer (BNT162b2), Moderna (mRNA-1273) and Novavax (NVX-CoV2373) vaccines for COVID in 'Com-Cov2 trial' in UK, and that of Oxford and Pfizer vaccines in 'CombivacS trial' in Spain. Later, other heterologous combinations of CoronaVac (DB15806), Janssen (JNJ-78436735), CanSino (AD5-nCOV) and other were also being trialled to explore their effectiveness. Previously, such a strategy was deployed for HIV, Ebola virus, malaria, tuberculosis, influenza and hepatitis B to develop the artificial acquired active immunity. The present review explores the science behind such an approach for candidate COVID-19 vaccines developed using 11 different platforms approved by the World Health Organization.

    METHODS: The candidate vaccines' pharmaceutical parameters (e.g. platforms, number needed to vaccinate and intervals, adjuvanted status, excipients and preservatives added, efficacy and effectiveness, vaccine adverse events, and boosters), and clinical aspects must be analysed for the mix-and-match approach. Results prime-boost trials showed safety, effectiveness, higher systemic reactogenicity, well tolerability with improved immunogenicity, and flexibility profiles for future vaccinations, especially during acute and global shortages, compared to the homologous counterparts.

    CONCLUSION: Still, large controlled trials are warranted to address challenging variants of concerns including Omicron and other, and to generalize the effectiveness of the approach in regular as well as emergency use during vaccine scarcity.

  8. Alshahrani NZ, Alshahrani SM, Alshahrani AM, Leggat PA, Rashid H
    J Travel Med, 2021 02 23;28(2).
    PMID: 33146380 DOI: 10.1093/jtm/taaa205
  9. Deris ZZ, Hasan H, Sulaiman SA, Wahab MS, Naing NN, Othman NH
    J Travel Med, 2010 Mar-Apr;17(2):82-8.
    PMID: 20412173 DOI: 10.1111/j.1708-8305.2009.00384.x
    BACKGROUND: Respiratory symptoms including cough, runny nose, sore throat, and fever are the most common clinical manifestations faced by hajj pilgrims in Mecca. The aim of the study was to determine the prevalence of respiratory symptoms among Malaysian hajj pilgrims and the effect of a few protective measures taken by hajj pilgrims to reduce respiratory symptoms.
    METHODS: A cross-sectional study was conducted by distributing survey forms to Malaysian hajj pilgrims at transit center before flying back to Malaysia. The recruitment of respondents to the survey was on a voluntary basis.
    RESULTS: A total of 387 survey forms were available for analysis. The mean age was 50.4 +/- 11.0 years. The common respiratory symptoms among Malaysian hajj pilgrims were: cough 91.5%, runny nose 79.3%, fever 59.2%, and sore throat 57.1%. The prevalence of hajj pilgrims with triad of cough, subjective fever, and sore throat were 40.1%. The symptoms lasted less than 2 weeks in the majority of cases. Only 3.6% did not suffer from any of these symptoms. Seventy-two percent of hajj pilgrims received influenza vaccination before departure and 72.9% wore facemasks. Influenza vaccination was not associated with any of respiratory symptoms but it was significantly associated with longer duration of sore throat. Wearing masks was significantly associated with sore throat and longer duration of sore throat and fever.
    CONCLUSIONS: The prevalence of respiratory symptoms was high among Malaysian hajj pilgrims and the current protective measures seemed inadequate to reduce it. Beside standardization of the term used in hajj studies, more collaborative effort should be taken to reduce respiratory symptoms. The hajj authority should prepare for the challenge of pandemic influenza by providing more healthcare facilities and implementation of more strict measures to reduce the transmission of pandemic influenza strain among hajj pilgrims.
  10. Lim PL, Oh HM, Ooi EE
    J Travel Med, 2009 Jul-Aug;16(4):289-91.
    PMID: 19674272 DOI: 10.1111/j.1708-8305.2009.00313.x
    Chikungunya infections were detected in Singapore among returning travelers who had visited friends and relatives (VFR) in India and Malaysia. These sporadic imported cases occurred over a year before the 2008 chikungunya outbreaks in Singapore, demonstrating the potential for introducing this emerging viral infection into new areas via VFR travel.
  11. 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 

  12. Flaherty G, Md Nor MN
    J Travel Med, 2016 Jan;23(1).
    PMID: 26782127 DOI: 10.1093/jtm/tav010
    Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation.
  13. Charoensakulchai S, Onwan M, Kanchanasurakit S, Flaherty G, Matsee W
    J Travel Med, 2024 Jan 17.
    PMID: 38236178 DOI: 10.1093/jtm/taae012
    BACKGROUND: Drug tourism reflects the expanding illicit drug market, posing health risks in unfamiliar travel settings. Existing knowledge specifically addressing substance use among international travellers is sparse and has not been reviewed to date. This review aimed to describe the recreational substance abuse in international travellers.

    METHODS: A literature search was conducted on PubMed, Google Scholar, and Scopus using keywords related to recreational substances and international travellers. A total of 11 021 articles were reviewed, charted and summarized for the evidence on prevalence, patterns and characteristics of substance abuse and their health- and non-health-related problems on international travellers.

    RESULTS: Fifty-eight articles were included. Most were cross-sectional studies and review articles. Twenty articles addressed the prevalence of substance abuse in travellers, 33 looked at characteristics and patterns of substance abuse in travellers and 39 investigated the health- and non-health-related problems from substance abuse. Estimated prevalence of recreational substances abuse varied from 0.7% to 55.0%. Rates of substances abuse were 9.45% to 34.5% for cannabis, 20.4% to 35.9% for alcohol intoxication, 2.82% to 40.5% for MDMA, 2% to 22.2% for cocaine, 2% to 15% for psychedelic agents and 2% for methamphetamine. The prevalence varied according to travellers' characteristics and travel destinations. Direct health problems included neuropsychiatric problems. Indirect problems included accident and unintentional injuries, crime and violence, risky sexual behaviours and sexual violence and blood-borne infections. Non-health-related problems included air rage, deportation and violation of local laws.

    CONCLUSION: Substance abuse among international travellers is an underestimated problem that requires intervention. These findings emphasize the importance of addressing this issue to mitigate both health and well-being problems among travellers while promoting safer and more responsible travel experiences. In the context of travel health practices, practitioners should counsel travellers whose itineraries may include substance abuse, informing them about associated risks and consequences.

  14. Townsend CJ, Loughlin JM
    J Travel Med, 1998 Dec;5(4):226-7.
    PMID: 9876202
    Missionaries are well known to suffer the effects of stress. Patricia Miersma relates missionary stress to combat related stress. 1 Development workers too are known to be at increased risk of death whilst overseas-mostly due to traumatic incidents. Relief workers voluntarily enter high stress situations. These overseas workers are at real risk of Post Traumatic Stress Disorder (PTSD). The issue of Critical Incident Stress Debriefing (CISD, or Psychological Debriefing) has been critically examined in an editorial in the British Medical Journal.3 The first randomized, controlled study of CISD that we are aware of (for motor vehicle accident survivors) was published in 1996.4 With 54 intervention subjects, it did not demonstrate effectiveness.
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