Knowledge, Attitude, and Practice among Egyptian Travelers: Pre-travel Vaccination and Malaria Prophylaxis

Document Type : Original Article

Authors

1 Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt

2 Health Education and Behavioral Science Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt

10.15171/ijtmgh.2018.23

Abstract

Introduction: More than one third of travelers to developing countries report health problems when traveling. The Egyptian Ministry of Health reports the occurrence of 400 cases of malarial infection yearly among Egyptian travelers. This article aimed to assess the knowledge, attitude, and practice (KAP) of Egyptian travelers towards infectious diseases, vaccination, and malaria chemoprophylaxis.
Methods: A survey was conducted at Cairo International Airport and included 1500 travelers. The questionnaire inquired about the travelers’ knowledge about infectious diseases at their destinations and their KAP regarding vaccination, malaria, and its prophylaxis.
Results: Most travelers (68%) had poor knowledge, specifically; 90.2%, 85.6%, 88.5% did not know the endemic diseases at their destinations, the modes of disease transmission, or the protective measures against disease, respectively. Knowledge about malaria prevalence, symptoms, modes of transmission, and prevention was good in only 18%, 29.8%, 6.7%, and 21.4% of travelers, respectively. Poor practice of malaria prophylactic measures was found in 66.3% of travelers. Although 91.3% did not receive any vaccination, the general attitude towards vaccination was good. The total travel health knowledge, practice, general attitude toward vaccination, and the perceived benefits of malarial prophylaxis scores were significantly correlated with older age and high socioeconomic level. Most of the studied travelers (90.4%) did not carry or use malaria chemoprophylaxis. Ignorance was the main barrier to receiving vaccines (65.3%) and to adherence to malaria chemoprophylaxis (88.3%).
Conclusion: Egyptian travelers have poor travel health knowledge and practices. Their knowledge and practice scores improve with older age, urban residence, and higher educational levels. They have a good attitude towards vaccination, and ignorance was the main barrier to sound practices.

Keywords

References

  1. World Tourism Organization (UNWTO). Yearbook of tourism statistics data 2010-2014, compendium of tourism statistics and data files. Madrid: World Tourism Organization; 2014:906.
  2. Steffen R, deBernardis C, Banos A. Travel epidemiology--a global perspective. Int J Antimicrob Agents. 2003;21(2):89-95. doi:10.1016/S0924-8579(02)00293-5.
  3. Lawson CJ, Dykewicz CA, Molinari NA, Lipman H, Alvarado- Ramy F. Deaths in international travelers arriving in the United States, July 1, 2005 to June 30, 2008. J Travel Med. 2012;19(2):96- 103. doi:10.1111/j.1708-8305.2011.00586.x.
  4. Schreiber W, Mathys FK. Infections diseases in the history of medicine. Basle, Switzerland: Editiones Roche; 1987:232.
  5. Centers for Disease Control and Prevention (CDC). Measles cases and outbreaks. http://www.cdc.gov/measles/cases-outbreaks.html. Accessed Jan 2, 2016. Published 2015.
  6. Halstead SB. Dengue. Lancet. 2007;370(9599):1644-1652. doi:10.1016/S0140-6736(07)61687-0.
  7. Odolini S, Gautret P, Parola P. Epidemiology of imported malaria in the mediterranean region. Mediterr J Hematol Infect Dis. 2012;4(1):e2012031. doi:10.4084/mjhid.2012.031.
  8. Sapa. “Malaria Hits SA Team after All Africa Games. IOL News. November 7, 2003. www.iol.co.za/news/south-africa/malaria-hits-sa-team-after-all-africa-games-116477. Accessed November 10, 2016.
  9. Egyptian Ministry of Health and Population. MOHP Egypt website. https://www.elwatannews.com/news/details/1983558.
  10. El Sherbiny NA, Wafik GM. A study of travel medicine among National and International travellers in Egypt. J Public Health Epidemiol. 2011;3(7):324-328.
  11. El-Ghitany EM, Abdelmohsen MAM, Farghaly AG, Abd El-Gawwad E, Abd El-Wahab EW. Travel health survey: risk perception, health-seeking behavior, and subjective evaluation of travel health services in Egypt. Int J Travel Med Glob Health. 2018;6(1):16-24. doi:10.15171/ijtmgh.2018.04.
  12. Zuckerman J. Shaping travel health and medicine for the future. Lancet Infect Dis. 2001;1(5):296-297. doi:10.1016/S1473-3099(01)00142-6.
  13. Watanabe N, Kaneko A, Yamar S, et al. Determinants of the use of insecticide-treated bed nets on islands of pre- and post-malaria elimination: an application of the health belief model in Vanuatu. Malar J. 2014;13:441. doi:10.1186/1475-2875-13-441.
  14. Altmann M, Parola P, Delmont J, Brouqui P, Gautret P. Knowledge, attitudes, and practices of French travelers from Marseille regarding rabies risk and prevention. J Travel Med. 2009;16(2):107-111. doi:10.1111/j.1708-8305.2008.00283.x.
  15. Guerrero-Lillo L, Medrano-Diaz J, Perez C, Chacon R, Silva-Urra J, Rodriguez-Morales AJ. Knowledge, attitudes, and practices evaluation about travel medicine in international travelers and medical students in Chile. J Travel Med. 2009;16(1):60-63. doi:10.1111/j.1708-8305.2008.00263.x.
  16. Lopez-Velez R, Bayas JM. Spanish travelers to high-risk areas in the tropics: airport survey of travel health knowledge, attitudes, and practices in vaccination and malaria prevention. J Travel Med. 2007;14(5):297-305. doi:10.1111/j.1708-8305.2007.00142.x.
  17. Wilder-Smith A, Khairullah NS, Song JH, Chen CY, Torresi J. Travel health knowledge, attitudes and practices among Australasian travelers. J Travel Med. 2004;11(1):9-15. doi:10.2310/7060.2004.13600.
  18. Hamer DH, Connor BA. Travel health knowledge, attitudes and practices among United States travelers. J Travel Med. 2004;11(1):23-26. doi:10.2310/7060.2004.13577.
  19. Toovey S, Jamieson A, Holloway M. Travelers’ knowledge, attitudes and practices on the prevention of infectious diseases: results from a study at Johannesburg International Airport. J Travel Med. 2004;11(1):16-22. doi:10.2310/7060.2004.13587.
  20. Van Herck K, Van Damme P, Castelli F, et al. Knowledge, attitudes and practices in travel-related infectious diseases: the European airport survey. J Travel Med. 2004;11(1):3-8. doi:10.2310/7060.2004.13609.
  21. Namikawa K, Iida T, Ouchi K, Kimura M. Knowledge, attitudes, and practices of Japanese travelers on infectious disease risks and immunization uptake. J Travel Med. 2010;17(3):171-175. doi:10.1111/j.1708-8305.2010.00405.x.
  22. Zhang M, Zhang J, Hao Y et al. Vaccination knowledge, attitude and practice among Chinese travelers who visit travel clinics in Preparation for international travel. J Travel Med. 2016; 23(6). doi:10.1093/jtm/taw051.
  23. Zhang M, Liu Z, He H, et al. Knowledge, attitudes, and practices on malaria prevention among Chinese international travelers. J Travel Med. 2011;18(3):173-177. doi:10.1111/j.1708-8305.2011.00512.x.
  24. Weber R, Schlagenhauf P, Amsler L, Steffen R. Knowledge, attitudes and practices of business travelers regarding malaria risk and prevention. J Travel Med. 2003;10(4):219-224. doi:10.2310/7060.2003.40574.
  25. Teodosio R, Goncalves L, Atouguia J, Imperatori E. Quality assessment in a travel clinic: a study of travelers’ knowledge about malaria. J Travel Med. 2006;13(5):288-293. doi:10.1111/j.1708-8305.2006.00060.x.
  26. Laver SM, Wetzels J, Behrens RH. Knowledge of malaria, risk perception, and compliance with prophylaxis and personal and environmental preventive measures in travelers exiting Zimbabwe from Harare and Victoria Falls International airport. J Travel Med. 2001;8(6):298-303. doi:10.2310/7060.2001.23975.
  27. Piyaphanee W, Wattanagoon Y, Silachamroon U, Mansanguan C, Wichianprasat P, Walker E. Knowledge, attitudes, and practices among foreign backpackers toward malaria risk in southeast Asia. J Travel Med. 2009;16(2):101-106. doi:10.1111/j.1708-8305.2008.00282.x.
  28. Yimer F, Animut A, Erko B, Mamo H. Past five-year trend, current prevalence and household knowledge, attitude and practice of malaria in Abeshge, south-central Ethiopia. Malar J. 2015;14:230. doi:10.1186/s12936-015-0749-5.
  29. van Genderen PJ, van Thiel PP, Mulder PG, Overbosch D. Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: results from the Dutch Schiphol Airport Survey 2002 to 2009. Malar J. 2012;11:179. doi:10.1186/1475-2875-11-179.
  30. Stoney RJ, Chen LH, Jentes ES, et al. Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries. Am J Trop Med Hyg. 2016;94(1):136-142. doi:10.4269/ajtmh.15-0565.
  31. Heywood AE, Zhang M, MacIntyre CR, Seale H. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia. BMC Infect Dis. 2012;12:43. doi:10.1186/1471-2334-12-43.
  32. Al-Abri SS, Abdel-Hady DM, Al-Abaidani IS. Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges. J Epidemiol Glob Health. 2016;6(2):67- 75. doi:10.1016/j.jegh.2016.02.003.
  33. Abate A, Degarege A, Erko B. Community knowledge, attitude and practice about malaria in a low endemic setting of Shewa Robit Town, northeastern Ethiopia. BMC Public Health. 2013;13:312. doi:10.1186/1471-2458-13-312.
  34. Ouattara AF, Raso G, Edi CV, et al. Malaria knowledge and long-lasting insecticidal net use in rural communities of central Cote d’Ivoire. Malar J. 2011;10:288. doi:10.1186/1475-2875-10-288.
  35. Tyagi P, Roy A, Malhotra MS. Knowledge, awareness and practices towards malaria in communities of rural, semi-rural and bordering areas of east Delhi (India). J Vector Borne Dis. 2005;42(1):30-35.
  36. Zimmermann R, Hattendorf J, Blum J, Nuesch R, Hatz C. Risk perception of travelers to tropical and subtropical countries visiting a swiss travel health center. J Travel Med. 2013;20(1):3-10. doi:10.1111/j.1708-8305.2012.00671.x.
  37. Alghamdi AH, Ibrahim AM, Al-Ghamdi MS, Ryan ET, Al-Raddadi R. Travel health in the Kingdom of Saudi Arabia: Perception and practice of Saudi travelers. Int J Health Res Innov. 2014;2(2):25-39.
  38. Shady I, Gaafer M, Bassiony L. Travel risk behaviors as a determinants of receiving pre-travel health consultation and prevention. Trop Dis Travel Med Vaccines. 2015;1:3. doi:10.1186/s40794-015-0003-8.
International Journal of Travel Medicine and Global Health
Volume 6, Issue 3 - Serial Number 22
September 2018
Pages 125-136

Files

History

  • Receive Date: 28 July 2018
  • Revise Date: 12 August 2018
  • Accept Date: 13 August 2018

Share

How to cite

Statistics