Displaying publications 41 - 60 of 77 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. 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.
  3. Barrett JP, Behrens RH
    J Travel Med, 1996 Mar 01;3(1):60-61.
    PMID: 9815425
    Chloroquine-resistant Plasmodium vivax was originally reported in Papua, New Guinea by Reickman in 1989.1 In the same year, in Colombia, South America, Arias and Corredor2 reported relapses of 11 patients suffering from vivax malaria, following a chloroquine-primaquine regimen. Garavelli and Corti3 suggested chloroquine-resistant Plasmodium vivax may be present in Brazil following these therapeutic relapses. Further therapeutic failures in returned travelers from South America were reported by Moore et al (1994).4 We report vivax malaria in a group of expeditioners visiting Guyana who, whereas compliant with antimalarial chemoprophylaxis, developed clinical malaria, adding evidence to the presence of chloroquine-resistant Plasmodium vivax in South America. Raleigh International is a youth development charity that undertakes environmental and community projects around the world. These are usually in remote locations. Nine expeditions in countries such as Chile, Belize, Zimbabwe, Uganda, and Malaysia are organized annually. A project manager and a medical officer are placed at each site, along with approximately 10 venturers (age 17-25.) Participants are of all nationalities, but, at present, they are predominantly British.
  4. Johnston N, Sandys N, Geoghegan R, O'Donovan D, Flaherty G
    J Travel Med, 2018 01 01;25(1).
    PMID: 29394388 DOI: 10.1093/jtm/tax092
    Background: Increasingly, medical students from developed countries are undertaking international medical electives in developing countries. Medical students understand the many benefits of these electives, such as the opportunity to develop clinical skills, to gain insight into global health issues and to travel to interesting regions of the world. However, they may be much less aware of the risk to their health and wellbeing while abroad. Compounding this problem, medical students may not seek advice from travel medicine practitioners and often receive inadequate or no information from their medical school prior to departure.

    Methods: The PubMed database was searched for relevant literature relating to the health of medical elective students. Combinations of the following key words were used as search terms: 'international health elective', 'medical student' and 'health risks'. Articles were restricted to those published in English from 1997 through June 2017. A secondary review of the reference lists of these articles was performed. The grey literature was also searched for relevant material.

    Results: This narrative literature review outlines the risks of clinical electives in resource-poor settings which include exposure to infectious illness, trauma, sexual health problems, excessive sun exposure, mental health issues and crime. Medical students may mitigate these health risks by being informed and well prepared for high-risk situations. The authors provide evidence-based travel advice which aims to improve pre-travel preparation and maximize student traveller safety. A safer and more enjoyable elective may be achieved if students follow road safety advice, take personal safety measures, demonstrate cultural awareness, attend to their psychological wellbeing and avoid risk-taking behaviours.

    Conclusion: This article may benefit global health educators, international elective coordinators and travel medicine practitioners. For students, a comprehensive elective checklist, an inventory of health kit items and useful web-based educational resources are provided to help prepare for electives abroad.

  5. 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.

  6. Connolly R, Prendiville R, Cusack D, Flaherty G
    J Travel Med, 2017 Mar 01;24(2).
    PMID: 28395093 DOI: 10.1093/jtm/taw082
    Background: Death during international travel and the repatriation of human remains to one's home country is a distressing and expensive process. Much organization is required involving close liaison between various agencies.

    Methods: A review of the literature was conducted using the PubMed database. Search terms included: 'repatriation of remains', 'death', 'abroad', 'tourism', 'travel', 'travellers', 'travelling' and 'repatriation'. Additional articles were obtained from grey literature sources and reference lists.

    Results: The local national embassy, travel insurance broker and tour operator are important sources of information to facilitate the repatriation of the deceased traveller. Formal identification of the deceased's remains is required and a funeral director must be appointed. Following this, the coroner in the country or jurisdiction receiving the repatriated remains will require a number of documents prior to providing clearance for burial. Costs involved in repatriating remains must be borne by the family of the deceased although travel insurance may help defray some of the costs. If the death is secondary to an infectious disease, cremation at the site of death is preferred. No standardized procedure is in place to deal with the remains of a migrant's body at present and these remains are often not repatriated to their country of origin.

    Conclusions: Repatriation of human remains is a difficult task which is emotionally challenging for the bereaving family and friends. As a travel medicine practitioner, it is prudent to discuss all eventualities, including the risk of death, during the pre-travel consultation. Awareness of the procedures involved in this process may ease the burden on the grieving family at a difficult time.

  7. Flaherty GT, Geoghegan R, Brown IG, Finucane FM
    J Travel Med, 2019 05 10;26(3).
    PMID: 30855079 DOI: 10.1093/jtm/taz018
    BACKGROUND: It is unknown whether obesity is a barrier to international travel. The purpose of this qualitative study was to describe the travel experiences of a cohort of severely obese individuals attending a hospital-based bariatric service, to identify their perceived barriers to travel and to generate recommendations that address the needs of severely obese individuals.

    METHODS: Semi-structured interviews were conducted with severely obese patients attending a regional, structured, multidisciplinary lifestyle modification programme. Coding and thematic analysis of the transcripts were completed by three independent researchers. A thematic analysis was performed based on examination of the transcribed interviews. Demographic and clinical data such as gender, age and body mass index were also recorded.

    RESULTS: Twelve patients (six males), with a mean age of 54 ± 5.98 years and a mean body mass index of 46.2 ± 8.2 kg/m2, agreed to semi-structured interviews (14-52-minute duration). The principal themes emerging from the interviews included obese air traveller embarrassment, physical discomfort on commercial flights, perceived weight bias, challenges in accessing hotel rooms, heat intolerance in warm climates, restricted leisure travel activities and medical co-morbidities. Most of the interviewees perceived a health benefit to travel but regarded obesity as a significant barrier to international travel.

    CONCLUSION: These findings highlight the limitations experienced by obese travellers when engaging in international travel. Our results may inform the pre-travel health advice given to obese travellers. They might also serve to raise awareness among operators within the travel industry of the difficulties travellers with severe obesity face.

  8. Flaherty GT, Khairy WMZBM, Holmes A
    J Travel Med, 2023 Jun 23;30(4).
    PMID: 36322169 DOI: 10.1093/jtm/taac131
  9. 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.
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