Displaying publications 1 - 20 of 38 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.

    Matched MeSH terms: Travel Medicine
  2. Maher S, Hallahan B, Flaherty G
    Travel Med Infect Dis, 2017 05 31;18:70-72.
    PMID: 28576666 DOI: 10.1016/j.tmaid.2017.05.011
    Matched MeSH terms: Travel Medicine*
  3. Flaherty G, O'Connor R, Johnston N
    Travel Med Infect Dis, 2016 May-Jun;14(3):200-11.
    PMID: 27040934 DOI: 10.1016/j.tmaid.2016.03.015
    High altitude training is regarded as an integral component of modern athletic preparation, especially for endurance sports such as middle and long distance running. It has rapidly achieved popularity among elite endurance athletes and their coaches. Increased hypoxic stress at altitude facilitates key physiological adaptations within the athlete, which in turn may lead to improvements in sea-level athletic performance. Despite much research in this area to date, the exact mechanisms which underlie such improvements remain to be fully elucidated. This review describes the current understanding of physiological adaptation to high altitude training and its implications for athletic performance. It also discusses the rationale and main effects of different training models currently employed to maximise performance. Athletes who travel to altitude for training purposes are at risk of suffering the detrimental effects of altitude. Altitude illness, weight loss, immune suppression and sleep disturbance may serve to limit athletic performance. This review provides an overview of potential problems which an athlete may experience at altitude, and offers specific training recommendations so that these detrimental effects are minimised.
    Matched MeSH terms: Travel Medicine
  4. Gately R, Economos H, Fleming C, Flaherty G
    Travel Med Infect Dis, 2015 Jul-Aug;13(4):342-3.
    PMID: 26005161 DOI: 10.1016/j.tmaid.2015.05.003
    Matched MeSH terms: Travel Medicine/methods*
  5. Flaherty GT, Walden LM
    Travel Med Infect Dis, 2015 Mar-Apr;13(2):120-1.
    PMID: 25812774 DOI: 10.1016/j.tmaid.2015.03.005
    Matched MeSH terms: Travel Medicine*
  6. Chinikar S, Ghiasi SM, Shah-Hosseini N, Mostafavi E, Moradi M, Khakifirouz S, et al.
    Travel Med Infect Dis, 2013 May-Jun;11(3):166-9.
    PMID: 23194952 DOI: 10.1016/j.tmaid.2012.10.001
    Dengue fever is one of the most important arthropod-borne viral diseases of public health significance. It is endemic in most tropical and subtropical parts of the world, many of which are popular tourist destinations. The presence of dengue infection was examined in Iranian patients who were referred to the Arboviruses and Viral Haemorrhagic Fevers Laboratory of the Pasteur Institute of Iran and tested negative for Crimean-Congo Haemorrhagic Fever (CCHF) between 2000 and 2012. Serum samples from these patients were tested for the presence of specific IgG and IgM and viral nucleic acid in blood. Of the 300 sera tested, 15 (5%) were seropositive, and 3 (1%) were both serologically and PCR positive. Of the 15 seropositive cases, 8 (53.3%) had travelled to endemic areas including Malaysia (5, 62.5%), India (2, 25%) and Thailand (1, 12.5%). In contrast, 7 (46.7%) of the cases had not reported travelling abroad. Of these, six cases were from the Sistan and Baluchistan province in southeast Iran and neighbouring Pakistan. Travellers play a key role in the epidemiology of dengue infection in Iran and it is recommended that travellers to endemic areas take precautionary measures to avoid mosquito bites.
    Matched MeSH terms: Travel Medicine*
  7. Kc B, Khan TM, Xuan WY, Alrasheedy AA, Mohamed Ibrahim MI, Leggat PA
    Travel Med Infect Dis, 2019 07 31;33:101463.
    PMID: 31376464 DOI: 10.1016/j.tmaid.2019.07.019
    BACKGROUND: Millions of tourists visit Malaysia annually while a large number of Malaysians travel overseas. Taking care of travellers' healthcare needs is important aspect of the healthcare system. Community pharmacies are ideally positioned to provide travel health-related services. However, studies are lacking in this area. Therefore, this study aims to explore the nature and type of travel health-related services provided by Malaysian community pharmacies.

    METHODS: A survey was carried out at 135 community pharmacies in nine districts of Selangor, Malaysia, from November 2017 to February 2018, using a self-administered standardized questionnaire.

    RESULTS: The majority (n = 95, 85%) of community pharmacies reported to have provided services to both international travellers and outbound Malaysian travellers. The common healthcare services provided to international travellers were monitoring of chronic diseases including hypertension and diabetes, and advice on minor ailments, supplements and medical devices. The key health services provided to outbound Malaysian travellers were advice on vaccination requirements, better management of chronic diseases and necessary medications to manage illness during travel. Most of the respondents supported the provision of travel health-related services through the community pharmacies.

    CONCLUSION: The study findings showed that Malaysian community pharmacies provided several travel health-related services to both international and Malaysian outbound travellers. Pharmacists in Malaysia are ideally positioned to have an increased role in travel medicine. They have the training to advise on complex medication issues especially with regard to interactions and polypharmacy. However, further training and courses should be provided that are tailored specifically for the needs of this professional group.

    Matched MeSH terms: Travel Medicine/methods*; Travel Medicine/statistics & numerical data*
  8. Myrvang B
    Tidsskr. Nor. Laegeforen., 2010 Feb 11;130(3):282-3.
    PMID: 20160773 DOI: 10.4045/tidsskr.09.0554
    Since 2004, malaria with a "fifth" plasmodium, Plasmodium knowlesi (common in macaque monkeys), has been diagnosed in a number of people in Southeast Asia. This article gives a short overview of the epidemiology, clinical picture, diagnostics and treatment of P. knowlesi infection.
    Matched MeSH terms: Travel Medicine
  9. Taha NA, See YL
    Int J Pharm Pract, 2016 Oct;24(5):326-32.
    PMID: 26914019 DOI: 10.1111/ijpp.12256
    OBJECTIVES: The risk for travel-related illnesses has increased with significant growth in international travel, but very few travellers seek travel advice. Community pharmacists can play a vital role in the provision of travel medicine advice due to their accessibility. This study aimed to assess travel medicine knowledge, attitudes and practices (KAP) among community pharmacists in Kuala Lumpur, Malaysia.

    METHODS: A self-administered KAP questionnaire was distributed to a convenience sample of pharmacists in Kuala Lumpur identified from the list of licensed community pharmacists in Malaysia year 2014.

    KEY FINDINGS: Questionnaires were returned by 111 pharmacists of 143 distributed (response rate, 78%). Most of the respondents (82%) were not trained in travel medicine. Overall, mean knowledge score was 4.4 ( ± 1.7), indicating a moderate level of knowledge on a variety of travel-related health issues. Community pharmacists who graduated from foreign universities possessed significantly higher knowledge scores than did those who graduated locally (P < 0.05). The majority had a positive attitude towards travel medicine. A vast majority provided travel medicine advice mainly to adults who travel as tourists, and the primary travel advice given was on traveller's diarrhoea.

    CONCLUSION: There are gaps in the knowledge and practice of travel medicine among Malaysian pharmacists. Positive attitudes of pharmacists towards travel medicine and appropriate interventions, such as incorporation of travel medicine in local pharmacy curricula, continuous pharmacy education or certified training may improve the quality of travel advice given and allow pharmacists to be recognised as a credible source of information on travel medicine.

    Matched MeSH terms: Travel Medicine/education*
  10. 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.
    Matched MeSH terms: Travel Medicine
  11. 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.
    Matched MeSH terms: Travel Medicine
  12. Weibel Galluzzo C, Wagner N, Michel Y, Jackson Y, Chappuis F
    Rev Med Suisse, 2014 May 7;10(429):1008-13.
    PMID: 24908745
    Travels, migration and circulation of goods facilitate the emergence of new infectious diseases often unrecognized outside endemic areas. Most of emerging infections are of viral origin. Muscular Sarcocystis infection, an acute illness acquired during short trips to Malaysia, and Chagas disease, a chronic illness with long incubation period found among Latin American migrants, are two very different examples of emerging parasitic diseases. The former requires a preventive approach for travelers going to Malaysia and must be brought forth when they return with fever, myalgia and eosinophilia, while the latter requires a proactive attitude to screen Latin American migrant populations that may face difficulties in accessing care.
    Matched MeSH terms: Travel Medicine/organization & administration
  13. 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.
    Matched MeSH terms: Travel Medicine/statistics & numerical data*
  14. 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.
    Matched MeSH terms: Travel Medicine
  15. Hashim S, Ayub ZN, Mohamed Z, Hasan H, Harun A, Ismail N, et al.
    J Travel Med, 2016 Feb;23(2):tav019.
    PMID: 26858268 DOI: 10.1093/jtm/tav019
    BACKGROUND: Respiratory illness continues to exert a burden on hajj pilgrims in Makkah. The purpose of this study is to determine the prevalence of respiratory illness and its associated factors among Malaysian hajj pilgrims in 2013 and to describe its preventive measures.

    METHODS: A cross-sectional study was conducted in Makkah and Malaysia during the 2013 hajj season. A self-administered proforma on social demographics, previous experience of hajj or umrah, smoking habits, co-morbid illness and practices of preventive measures against respiratory illness were obtained.

    RESULTS: A total of 468 proforma were analysed. The prevalence of the respiratory illness was 93.4% with a subset of 78.2% fulfilled the criteria for influenza-like illness (ILI). Most of them (77.8%) had a respiratory illness of <2 weeks duration. Approximately 61.8% were administered antibiotics but only 2.1% of them had been hospitalized. Most of them acquired the infection after a brief stay at Arafat (81.2%). Vaccination coverages for influenza virus and pneumococcal disease were quite high, 65.2% and 59.4%, respectively. For other preventive measures practices, only 31.8% of them practiced good hand hygiene, ∼82.9% of pilgrims used surgical face masks, N95 face masks, dry towels, wet towels or veils as their face masks. Nearly one-half of the respondents (44.4%) took vitamins as their food supplement. Malaysian hajj pilgrims with previous experience of hajj (OR 0.24; 95% CI 0.10-0.56) or umrah (OR 0.19; 95% CI 0.07-0.52) and those who have practiced good hand hygiene (OR 0.35; 95% CI 0.16-0.79) were found to be significantly associated with lower risk of having respiratory illness. Otherwise, pilgrims who had contact with those with respiratory illness (OR 2.61; 95% CI 1.12-6.09) was associated with higher risk.

    CONCLUSIONS: The prevalence of respiratory illness remains high among Malaysian hajj pilgrims despite having some practices of preventive measures. All preventive measures which include hand hygiene, wearing face masks and influenza vaccination must be practiced together as bundle of care to reduce respiratory illness effectively.

    Matched MeSH terms: Travel Medicine
  16. 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.
    Matched MeSH terms: Travel Medicine
  17. Han CT, Flaherty G
    J Travel Med, 2015 Sep-Oct;22(5):312-7.
    PMID: 26095866 DOI: 10.1111/jtm.12221
    BACKGROUND: Patients with complex medical comorbidities travel for protracted periods to remote destinations, often with limited access to medical care. Few descriptions are available of their preexisting health burden. This study aimed to characterize preexisting medical conditions and medications of travelers seeking pre-travel health advice at a specialized travel medicine clinic.
    METHODS: Records of travelers attending the Galway Tropical Medical Bureau clinic between 2008 and 2014 were examined and information relating to past medical history was entered into a database. Data were recorded only where the traveler had a documented medical history and/or was taking medications.
    RESULTS: Of the 4,817 records available, 56% had a documented medical history and 24% listed medications. The majority of travelers with preexisting conditions were female. The mean age of the cohort was 31.68 years. The mean period remaining before the planned trip was 40 days. Southeast Asia was the most popular single destination, and 17% of travelers with medical conditions were traveling alone. The most frequently reported conditions were allergies (20%), insect bite sensitivity (15%), asthma (11%), psychiatric conditions (4%), and hypertension (3%). Of the 30 diabetic travelers, 14 required insulin; 4.5% of travelers were taking immunosuppressant drugs, including corticosteroids. Half of the female travelers were taking the oral contraceptive pill while 11 travelers were pregnant at the time of their pre-travel consultation.
    CONCLUSIONS: This study provides an insight into the medical profile of travelers attending a travel health clinic. The diverse range of diseases reported highlights the importance of educating physicians and nurses about the specific travel health risks associated with particular conditions. Knowledge of the effects of travel on underlying medical conditions will inform the pre-travel health consultation.
    Matched MeSH terms: Travel Medicine
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