ORIGINAL_ARTICLE
Bone Marrow Transplantation and Medical Tourism at Erciyes University - A Single Center Experience
Medical tourism emerged when people were challenged with high costs and slow service in medical care. As a consequence of these issues, people started to look for medical treatment in other countries. Globalization accelerated the growth of medical tourism. Several “push” and “pull” factors play roles in the motivation of patients to become a medical tourist. This review addresses the different aspects of medical tourism in general, describes the development of medical tourism in Turkey, and describes experiences with medical tourism in the Bone Marrow Transplantation Center (BMTC) at Erciyes University, Kayseri, Turkey. Since January 2016, an international collaboration has existed between BMTC and the King Hamed University Hospital (KHUH) in Bahrain. Ten allogeneic stem cell transplantations (SCTs) have been performed on patients from Bahrain with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Hodgkin lymphoma, and myelofibrosis. Furthermore, ten autologous SCT have been conducted on patients from Bahrain with multiple myeloma (MM), Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL). In 2016, transplant-related mortality (TRM) at 100 days among Bahrain patients was 0% compared to 2.6% in all patients. Although these numbers are small, the first results show that the outcomes of international patients are similar to those of non-international patients. In our experience, the key to a successful collaboration between international hospitals is having close communication regarding the treatment of the international patient. The outcome of a large group of international compared with non-international patients should be further studied.
https://www.ijtmgh.com/article_55844_b335e552019a5b2732b9b963d19cec93.pdf
2018-02-01
1
6
10.15171/ijtmgh.2018.01
Medical tourism
Health tourism
Bone Marrow Transplantation
Nicolette
Tiren-Verbeet
nicoletteleonie@gmail.com
1
Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
AUTHOR
Mustafa
Cetin
mcetin2000@yahoo.com
2
Department of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
AUTHOR
Emine
Alp
ealp@erciyes.edu.tr
3
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
AUTHOR
Mehmet
Doganay
mdoganay@erciyes.edu.tr
4
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
LEAD_AUTHOR
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Passweg JR, Baldomero H, Bader P, et al. Use of haploidentical stem cell transplantation continues to increase: the 2015 European Society for Blood and Marrow Transplant activity survey report. Bone Marrow Transplant. 2017;52(6):811-817. doi:10.1038/bmt.2017.34.
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Sirinoglu Demiriz I, Tekgunduz E, Altuntas F. What is the most appropriate source for hematopoietic stem cell transplantation? Peripheral stem cell/bone marrow/cord blood. Bone Marrow Res. 2012;2012:834040. doi:10.1155/2012/834040.
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Mohty M, Harousseau JL. Treatment of autologous stem cell transplant-eligible multiple myeloma patients: ten questions and answers. Haematologica. 2014;99(3):408-416. doi:10.3324/haematol.2013.096149.
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Robinson SP, Boumendil A, Finel H, et al. Autologous stem cell transplantation for relapsed/refractory diffuse large B-cell lymphoma: efficacy in the rituximab era and comparison to first allogeneic transplants. A report from the EBMT Lymphoma Working Party. Bone Marrow Transplant. 2016;51(3):365-371. doi:10.1038/bmt.2015.286.
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Staton AD, Langston AA. Autologous stem cell transplant: still the standard for fit patients with mantle cell lymphoma. Clin Lymphoma Myeloma Leuk. 2017;17s:S96-s99. doi:10.1016/j.clml.2017.02.021.
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Myers RM, Hill BT, Shaw BE, et al. Long-term outcomes among 2-year survivors of autologous hematopoietic cell transplantation for Hodgkin and diffuse large b-cell lymphoma. Cancer. 2017. doi:10.1002/cncr.31114.
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Kassim AA, Sharma D. Hematopoietic stem cell transplantation for sickle cell disease: The changing landscape. Hematol Oncol Stem Cell Ther. 2017;10(4):259-266. doi:10.1016/j.hemonc.2017.05.008.
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Tekgunduz E, Kaynar L, Goker H, et al. Retrospective analysis of adult patients with acute lymphoblastic leukemia undergoing allogeneic hematopoietic cell transplantation: A multicenter experience of daily practice. Transfus Apher Sci. 2016;54(1):41- 47. doi:10.1016/j.transci.2016.01.010.
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Eroglu C, Pala C, Kaynar L, et al. Comparison of total body irradiation plus cyclophosphamide with busulfan plus cyclophosphamide as conditioning regimens in patients with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplant. Leuk Lymphoma. 2013;54(11):2474-2479. doi:10.3109/10428194.2013.779691.
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50
ORIGINAL_ARTICLE
Update on Epidemiology and Circulating Genotypes of Rotavirus in Iranian Children With Severe Diarrhea: 1986-2015
Rotaviruses are the most common cause of severe diarrhea in children under 5 years of age worldwide with a higher prevalence in developing countries. In accordance with the World Health Organization (WHO) recommendations for the global use of rotavirus vaccines, it is important to review trends of rotavirus epidemiology, distribution and diversity of rotavirus strains in the pre-vaccine period. In Iran, the average rotavirus positivity rate is 40.04% in all patients under 5 years of age hospitalized for acute gastroenteritis (AGE). Studies have shown a substantial increase in the rotavirus detection rate over time from 1986 to 2013. Moreover, there has been continued predominance of G (G1) and P (P[8]) genotypes, although the peak prevalence of G1 appeared to decline in 2007-2011 compared to 2001-2006. The data presented in this review, which suggests a change in the pattern of rotavirus genotypes in the Iranian population, further highlights the important role of continuous monitoring of rotavirus genotypes before starting any national rotavirus vaccination program.
https://www.ijtmgh.com/article_57619_6fafcb3b3edca1c63924f5b31b934c59.pdf
2018-02-01
7
10
10.15171/ijtmgh.2018.02
Rotavirus Group A
Epidemiology
Genotype
Iran
Somayeh
Jalilvand
1
Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Farzin
Roohvand
2
Virology Department, Pasteur Institute of Iran, Tehran, Iran
AUTHOR
Arash
Arashkia
3
Virology Department, Pasteur Institute of Iran, Tehran, Iran
AUTHOR
Zabihollah
Shoja
z_shoja@pasteur.ac.ir
4
Virology Department, Pasteur Institute of Iran, Tehran, Iran
LEAD_AUTHOR
Xu C, Fu J, Zhu Y. A Narrative Review of Norovirus Gastroenteritis: More Global Attention Is Needed. Int J Travel Medicine Glob Health. 2016;4(4):101-106. doi:10.21859/ijtmgh-040402.
1
Jalilvand S, Marashi SM, Tafakhori A, Shoja Z. Extraintestinal Involvement of Rotavirus Infection in Children. Arch Iran Med. 2015;18(9):604-605. doi:0151809/AIM.0010.
2
Tan EM, Cawcutt KA, Zomok CD, Go RS, Sia IG. Activity of Nitazoxanide Against Viral Gastroenteritis: A Systematic Review. Int J Travel Medicine Glob Health. 2017;5(4):107-112. doi:10.15171/IJTMGH.2017.22.
3
Bishop RF, Davidson GP, Holmes IH, Ruck BJ. Virus particles in epithelial cells of duodenal mucosa from children with acute non-bacterial gastroenteritis. Lancet. 1973;2(7841):1281-1283. doi:10.1016/S0140-6736(73)92867-5.
4
Bishop RF, Davidson GP, Holmes IH, Ruck BJ. Detection of a new virus by electron microscopy of faecal extracts from children with acute gastroenteritis. Lancet. 1974;1(7849):149-151. doi:10.1016/S0140-6736(74)92440-4.
5
Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(2):136-141. doi:10.1016/S1473-3099(11)70253-5.
6
Rotavirus surveillance--worldwide, 2001-2008. MMWR Morb Mortal Wkly Rep. 2008;57(46):1255-1257.
7
Ruiz-Palacios GM, Perez-Schael I, Velazquez FR, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med. 2006;354(1):11-22. doi:10.1056/NEJMoa052434.
8
Vesikari T, Matson DO, Dennehy P, et al. Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med. 2006;354(1):23-33. doi:10.1056/NEJMoa052664.
9
Meeting of the immunization Strategic Advisory Group of Experts, April 2009--conclusions and recommendations. Wkly Epidemiol Rec. 2009;84(23):220-236.
10
Matthijnssens J, Otto PH, Ciarlet M, Desselberger U, Van Ranst M, Johne R. VP6-sequence-based cutoff values as a criterion for rotavirus species demarcation. Arch Virol. 2012;157(6):1177-1182. doi:10.1007/s00705-012-1273-3.
11
Tang B, Gilbert JM, Matsui SM, Greenberg HB. Comparison of the rotavirus gene 6 from different species by sequence analysis and localization of subgroup-specific epitopes using site-directed mutagenesis. Virology. 1997;237(1):89-96. doi:10.1006/viro.1997.8762.
12
Matthijnssens J, Ciarlet M, Heiman E, et al. Full genome-based classification of rotaviruses reveals a common origin between human Wa-Like and porcine rotavirus strains and human DS-1- like and bovine rotavirus strains. J Virol. 2008;82(7):3204-3219. doi:10.1128/JVI.02257-07.
13
Matthijnssens J, Ciarlet M, Rahman M, et al. Recommendations for the classification of group A rotaviruses using all 11 genomic RNA segments. Arch Virol. 2008;153(8):1621-1629. doi:10.1007/s00705-008-0155-1.
14
Banyai K, Laszlo B, Duque J, et al. Systematic review of regional and temporal trends in global rotavirus strain diversity in the pre rotavirus vaccine era: insights for understanding the impact of rotavirus vaccination programs. Vaccine. 2012;30 Suppl 1:A122- 130. doi:10.1016/j.vaccine.2011.09.111.
15
Santos N, Hoshino Y. Global distribution of rotavirus serotypes/ genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Rev Med Virol. 2005;15(1):29-56. doi:10.1002/rmv.448.
16
WHO. Global Rotavirus Information and Surveillance Bulletin. http://www.who.int/immunization/diseases/rotavirus/rota_info_surv_bulletin/en/. Published 2012.
17
WHO. Child cause of death: estimates 2000–2013. http://www.who.int/healthinfo/global_burden_disease/estimates_child_cod_2013/en/. Published 2015.
18
Mousavi Jarrahi Y, Zahraei SM, Sadigh N, et al. The cost effectiveness of rotavirus vaccination in Iran. Hum Vaccin Immunother. 2016;12(3):794-800. doi:10.1080/21645515.2015.1087626.
19
Javanbakht M, Moradi-Lakeh M, Yaghoubi M, et al. Cost-effectiveness analysis of the introduction of rotavirus vaccine in Iran. Vaccine. 2015;33 Suppl 1:A192-200. doi:10.1016/j.vaccine.2014.12.035.
20
Shakerian S, Moradi Lakeh M, Esteghamati A, Zahraei M, Yaghoubi M. Cost-Effectiveness of Rotavirus Vaccination for Under-Five Children in Iran. Iran J Pediatr. 2015;25(4):e2766. doi:10.5812/ijp.2766.
21
Shoja Z, Jalilvand S, Mokhtari-Azad T, Nategh R. Epidemiology of cocirculating human rotaviruses in Iran. Pediatr Infect Dis J. 2013;32(4):e178-181. doi:10.1097/INF.0b013e31827ee392.
22
Matthijnssens J, Heylen E, Zeller M, Rahman M, Lemey P, Van Ranst M. Phylodynamic analyses of rotavirus genotypes G9 and G12 underscore their potential for swift global spread. Mol Biol Evol. 2010;27(10):2431-2436. doi:10.1093/molbev/msq137.
23
Doro R, Laszlo B, Martella V, et al. Review of global rotavirus strain prevalence data from six years post vaccine licensure surveillance: is there evidence of strain selection from vaccine pressure? Infect Genet Evol. 2014;28:446-461. doi:10.1016/j.meegid.2014.08.017.
24
ORIGINAL_ARTICLE
Brazilian Public Health Policy for Cruise Ships - A Review of Morbidity and Mortality Rates - 2009/2015
Introduction: For 10 years, Brazil has presented a significant flow in cruise ships with 597 011 travelers in 2015. Cruise ships represent a major mass gathering capacity, generating more risk of outbreaks and epidemics. Moreover, visiting several places presents travelers with the possibility of contact with some tropical diseases, which demands the development of specific policies for public health surveillance. Methods: In this study, case reports on transmissible diseases, accidents and deaths on board of cruise ships in the Brazilian coast during 2009 to 2015 were reviewed and correlated with the development of public health surveillance policies implemented by ANVISA, which established the mandatory communication of infectious diseases in 2009 and of deaths onboard in 2011. Results: Norovirus was the major etiologic agent of outbreaks, though the rate of outbreak has been declining in recent years. The lethality rate last season was 0.67:100 000, mostly because of preexisting conditions (75%); the remaining cases were caused by accidents. The mandatory reporting of outbreaks and deaths is an important tool in the planning of preventive actions for the safety and health of travelers in Brazil. The continuous evolution of hygiene surveillance may reduce outbreaks; the adoption of transparency policies and fast communication of deaths has contributed to the significant reduction in accidents. Conclusion: The effectiveness of specific public policies for the safety and security of travelers established for cruise ships in Brazil is indicated by the quantitative reduction in outbreaks and deaths. New destinations such as Cuba and China may adopt the same strategy of surveillance and protection against potential outbreaks of infectious diseases provided by cruise ships.
https://www.ijtmgh.com/article_51470_e63960bf28bfc3f96a4d8b57b51b31e3.pdf
2018-02-01
11
15
10.15171/ijtmgh.2018.03
Brazil
travelers
Outbreaks
Deaths
Cruises Ships
ANVISA
Dennis Minoru
Fujita
dmfujita@usp.br
1
Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
LEAD_AUTHOR
Luiz Henrique
da Silva Nali
luiz.nali@usp.br
2
Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
AUTHOR
Rita
de Cassia Giraldi
rgiraldi@usp.br
3
Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
AUTHOR
Gerusa Maria
Figueiredo
gfigueiredo@usp.br
4
Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
AUTHOR
Heitor Franco
de Andrade Júnior
hfandrad@usp.br
5
Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
AUTHOR
CLIA. 2017 Cruise Industry Outlook. https://www.cruising.org/docs/default-source/research/clia-2017-state-of-the-industry.pdf?sfvrsn=0.
1
Pavli A, Maltezou HC, Papadakis A, et al. Respiratory infections and gastrointestinal illness on a cruise ship: A three-year prospective study. Travel Med Infect Dis. 2016;14(4):389-397. doi:10.1016/j. tmaid.2016.05.019.
2
Rodriguez-Morales AJ, Schlagenhauf P. Zoonoses and travel medicine: “one world--one health”. Travel Med Infect Dis. 2014;12(6 Pt A):555-556. doi: 10.1016/j.tmaid.2014.11.003.
3
Kak V. Infections on Cruise Ships. Microbiol Spectr. 2015;3(4). doi: 10.1128/microbiolspec.IOL5-0007-2015.
4
ABREMAR. Temporada de Navios de Cruzeiros 2015. http://abremar.hospedagemtemporaria.com.br/temporadas-2/.%20Accessed%20August%208,%202016.
5
Brazil. Brazilian Health Legislation Data Bank 2015. ANVISA. http://portal2.saude.gov.br/saudelegis/LEG_NORMA_PESQ_CONSULTA.CFM. Accessed October 26, 2014.
6
ANVISA. Temporada de Navios de Cruzeiros. http://www.anvisa.gov.br/hotsite/cruzeiros/industria.html.
7
Fernandes EG, de Souza PB, de Oliveira ME, et al. Influenza B outbreak on a cruise ship off the Sao Paulo Coast, Brazil. J Travel Med. 2014;21(5):298-303. doi: 10.1111/jtm.12132.
8
Cruise Ships Season - Anvisa. http://www.anvisa.gov.br/hotsite/cruzeiros/industriaingles.html. Accessed July 24, 2017.
9
CDC. CDC - Vessel Sanitation Program. http://www.cdc.gov/nceh/vsp/. Accessed March 20, 2016.
10
Mouchtouri VA, Nichols G, Rachiotis G, et al. State of the art: public health and passenger ships. Int Marit Health. 2010;61(2):49-98.
11
Marchand C, Merrina F, Gagnayre R, Bouchaud O. A descriptive study of advising practices during travel health consultations in France. J Travel Med. 2017;25(5):582–602. doi:10.1093/jtm/ tax042.
12
Goeijenbier M, van Genderen P, Ward BJ, Wilder-Smith A, Steffen R, Osterhaus AD. Travellers and influenza: risks and prevention. J Travel Med. 2017;24(1):taw078. doi: 10.1093/jtm/taw078.
13
Oldenburg M, Herzog J, Püschel K, Harth V. Mortality of German travellers on passenger vessels. J Travel Med. 2016;23(1). doi: 10.1093/jtm/tav003.
14
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.
15
Mitruka K, Felsen CB, Tomianovic D, et al. Measles, rubella, and varicella among the crew of a cruise ship sailing from Florida, United States, 2006. J Travel Med. 2012;19(4):233-237. doi:10.1111/j.1708-8305.2012.00620.x.
16
ORIGINAL_ARTICLE
Travel Health Survey: Risk Perception, Health-Seeking Behavior, and Subjective Evaluation of Travel Health Services in Egypt
Introduction: Travel health practice and research in Egypt lag behind both needs and demands. This study was done in two parts to assess travel health knowledge, attitude, and practice (KAP) among Egyptian travelers. Methods: This survey was conducted at the departure halls of Cairo International Airport and included 1500 travelers to Africa (excluding North Africa), Southeast Asia, and Latin America. An interview questionnaire was used to measure the KAP of travelers inquiring about different aspects of pre-travel health. Subjective evaluations of travel health services and suggestions for improvement were also solicited. Results: Travelers in this study were mainly males (89.3%), less than 40 years of age (82%), living in urban residences (89.1%), married (65.9%), university educated (83.3%), traveling for work (69.1%) with destinations of Africa (61.3%), Asia (28.4%), and Latin America (10.3%). They had poor travel-associated risk perception, and only 13.4% had risk management plan. Less than half (42.4%) sought information about their destination, and 11.9% sought health information; their source of information was mainly the internet (98.7%). The majority had poor scores on various travel-related practices, including seeking pre-travel health services (87.9%), receiving pre-travel vaccines (91.3%), and using malaria chemoprophylaxis (90.6%). The travel health services were rated good by 0.5% of travelers and bad, very bad, or undetermined by 11.4%, 61.3%, and 26.9% respectively. Conclusion: Egyptian travelers, although mostly educated, had poor travel health perceptions and practices and are unsatisfied with the travel health services in Egypt.
https://www.ijtmgh.com/article_57734_6dafc51bc6b2d1f9e0031ecc99b35b8d.pdf
2018-02-01
16
24
10.15171/ijtmgh.2018.04
Travel Medicine
Egypt
Surveys and Questionnaires
Engy
El-Ghitany
ingy.elghitany@gmail.com
1
Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
LEAD_AUTHOR
Mohamed
Abdelmohsen
m_abdelsalam_79@yahoo.com
2
Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
AUTHOR
Azza
Farghaly
farghalyazza.20@gmail.com
3
Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
AUTHOR
Ensaf
Abd El-Gawwad
ensafabdel1@hotmail.com
4
Health Education and Behavioral Science Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
AUTHOR
Ekram
Abd El-Wahab
ekramwassim@gmail.com
5
Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
AUTHOR
World Tourism Organization (UNWTO). Global report on Aviation: Responding to the needs of new tourism markets and destinations. Madrid: World Tourism Organization; 2012:76.
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The World Bank Group. Indicators 2010. The World Bank; 2015. http://data.worldbank.org/indicator/. Accessed Sep 15, 2016.
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3
Hill DR, Ericsson CD, Pearson RD, et al. The practice of travel medicine: guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43(12):1499-1539. doi:10.1086/508782.
4
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.
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Van Herck K, Zuckerman J, Castelli F, Van Damme P, Walker E, Steffen R. Travelers’ knowledge, attitudes, and practices on prevention of infectious diseases: results from a pilot study. J Travel Med. 2003;10(2):75-78. doi:10.2310/7060.2003.31638.
6
van Genderen PJ, van Thiel PP, Mulder PG, Overbosch D. Trends in knowledge, attitudes, and practices of travel risk groups toward prevention of hepatitis A: results from the Dutch Schiphol Airport survey 2002 to 2009. J Travel Med. 2012;19(1):35-43. doi:10.1111/j.1708-8305.2011.00578.x.
7
Pistone T, Guibert P, Gay F, et al. Malaria risk perception, knowledge and prophylaxis practices among travellers of African ethnicity living in Paris and visiting their country of origin in sub-Saharan Africa. Trans R Soc Trop Med Hyg. 2007;101(10):990-995. doi:10.1016/j.trstmh.2007.05.009.
8
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.
9
Machin D, Campbell MJ, Tan SB, Tan SH. Sample size tables for clinical studies. 3rd ed. London, UK: Blackwell Scientific Publishing; 2009:253.
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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.
11
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.
12
Cabada MM, Maldonado F, Quispe W, et al. Pretravel health advice among international travelers visiting Cuzco, Peru. J Travel Med. 2005;12(2):61-65. doi:10.2310/7060.2005.12201.
13
Greenwood Z, Black J, Weld L, et al. Gastrointestinal infection among international travelers globally. J Travel Med. 2008;15(4):221- 228. doi:10.1111/j.1708-8305.2008.00203.x.
14
Centers for Disease Control and Prevention. Travelers’ diarrhea. CDC; 2016. https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/travelers-diarrhea. Accessed Feb 9, 2016.
15
Mizuno Y, Kudo K. Travel-related health problems in Japanese travelers. Travel Med Infect Dis. 2009;7(5):296-300. doi:10.1016/j.tmaid.2009.03.002.
16
American Academy of Otolaryngology. Ears and altitude. Entnet 2013. http://www.entnet.org/HealthInformation/earsAltitude.cfm. Accessed Dec 16, 2016.
17
Shaw MT, Leggat PA. Life and death on the Amazon: illness and injury to travelers on a South American expedition. J Travel Med. 2003;10(5):268-271. doi:10.2310/7060.2003.2694.
18
Camps M, Vilella A, Marcos MA, et al. Incidence of respiratory viruses among travelers with a febrile syndrome returning from tropical and subtropical areas. J Med Virol. 2008;80(4):711-715. doi:10.1002/jmv.21086.
19
Leder K, Sundararajan V, Weld L, Pandey P, Brown G, Torresi J. Respiratory tract infections in travelers: a review of the GeoSentinel surveillance network. Clin Infect Dis. 2003;36(4):399-406. doi:10.1086/346155.
20
Antinori S, Galimberti L, Gianelli E, et al. Prospective observational study of fever in hospitalized returning travelers and migrants from tropical areas, 1997-2001. J Travel Med. 2004;11(3):135-142. doi:10.2310/7060.2004.18557.
21
Herbinger KH, Alberer M, Berens-Riha N, et al. Spectrum of Imported Infectious Diseases: A Comparative Prevalence Study of 16,817 German Travelers and 977 Immigrants from the Tropics and Subtropics. Am J Trop Med Hyg. 2016;94(4):757-766. doi:10.4269/ajtmh.15-0731.
22
Leder K, Torresi J, Libman MD, et al. GeoSentinel surveillance of illness in returned travelers, 2007-2011. Ann Intern Med. 2013;158(6):456-468. doi:10.7326/0003-4819-158-6-201303190-00005.
23
Hill DR. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med. 2000;7(5):259-266. doi:10.2310/7060.2000.00075.
24
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.
25
Chen CM, Tsai JS, Chen SH, Lee HT. Knowledge, attitudes, and practices concerning infection control among travelers between Taiwan and mainland China. Asia Pac J Public Health. 2011;23(5):712-720. doi:10.1177/1010539511419118.
26
Yoo YJ, Bae GO, Choi JH, et al. Korean travelers’ knowledge, attitudes, and practices regarding the prevention of malaria: measures taken by travelers departing for India from Incheon International Airport. J Travel Med. 2007;14(6):381-385. doi:10.1111/j.1708-8305.2007.00157.x.
27
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.
28
Alghamdi A, Ibrahim A, S Al-Ghamdi M, T Ryan E, 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.
29
Al-Hajri MM. Traveler’s preventive health measures against infectious diseases and physicians’ awareness toward travel medicine in Qatar 2007 [dissertation]. Qatar: Arab Board in Community; 2008.
30
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.
31
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.
32
Omer F, Hassan N, Hussain H, Mana S, Awad O. Travel health, gaps in knowledge, attitudes, and practices among Dubai travellers, Dubai UAE. Int J Prev Med Res. 2015;1(3):126-131.
33
LaRocque RC, Rao SR, Tsibris A, et al. Travel health knowledge, attitudes and practices among Australian travelers. J Travel Med. 2010;17(6):386-390.
34
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.
35
ORIGINAL_ARTICLE
Outbreak of Wilderness/Backcountry/Travelers’ Diarrhea at a Himalayan Base Camp at 4000 m/13,125 ft
Introduction: Wilderness or backcountry diarrhea is a type of travelers’ diarrhea commonly caused by Cryptosporidium and Giardia, which can survive freezing temperatures. Campsites pose additional risks worldwide, irrespective of developing or developed regions, due to inadequate hygiene. Methods: In a first of its kind, an outbreak of wilderness diarrhea at a semi-permanent Himalayan Base Camp at 4000 m/13,125 ft in Uttarkashi, India, was investigated and managed by empirical antimicrobials. Return of normal bowel function was considered as primary outcome, and return to routine training at Base Camp was considered secondary outcome. Results: Sixty-two personnel presented with wilderness diarrhea of 5.58 days mean duration with onset after mean stay of 10.26 days, despite provisions for adequate camp hygiene and sanitation. Both primary and secondary outcomes were reached by all except three students who were evacuated on foot to the district referral hospital 56 km downhill from Base Camp. Hygiene was compromised due to cold weather/water. Epidemiological surveillance was not contributory. Conclusion: Wilderness diarrhea can present in outbreak proportions from formerly safe water sources due to variable microbial contamination. On-site diagnostics and management are required to control outbreaks of wilderness diarrhea. Traveler risk management strategies and traveler awareness/education can be a targeted mandatory intervention to enhance preparedness and resilience capital in outdoor and mountain environments.
https://www.ijtmgh.com/article_57189_c8fffe80f6f21634241527e2dd4acf81.pdf
2018-02-01
25
29
10.15171/ijtmgh.2018.05
Diarrhea
Travelers’ Diarrhea
Wilderness Diarrhea
Outbreak
Himalayas
High Altitude
Inam Danish
Khan
titan_afmc@yahoo.com
1
Clinical Microbiology and Infectious Diseases, Army College of Medical Sciences and Base Hospital, New Delhi, India
LEAD_AUTHOR
VK
Sashindran
drvksashindran768@hotmail.com
2
Armed Forces Medical College, Pune, India
AUTHOR
Gurpreet Singh
Sandhu
drgurpeeetsandhu222@gmail.com
3
Armed Forces Medical College, Pune, India
AUTHOR
Shazia
Khan
drshaz001@yahoo.com
4
INHS Kalyani, Vishakhapatnam, India
AUTHOR
KS
Rajmohan
drksrajmohan0001@yahoo.com
5
Army College of Medical Sciences and Base Hospital, New Delhi, India
AUTHOR
Ashwani Kumar
Pandey
drashwanipandey60123@yahoo.com
6
Army College of Medical Sciences and Base Hospital, New Delhi, India
AUTHOR
Rahul
Pandey
drrahulpandey550@yahoo.com
7
Armed Forces Clinic, New Delhi, India
AUTHOR
Rajvinder
Singh
drrajvinder777@yahoo.com
8
Pension Paying Office, Dharan, Nepal
AUTHOR
Ajay Kumar
Sahni
drajaysahni0007@yahoo.com
9
Armed Forces Medical College, Pune, India
AUTHOR
Rajiv Mohan
Gupta
drrajivgupta6121@yahoo.com
10
Army Hospital Research and Referral, New Delhi, India
AUTHOR
Manish
Ranjan
drmanish1189@gmail.com
11
ESI Hospital Basaidarapur, New Delhi, India
AUTHOR
Johnson C, Winsor S. Oxford handbook of Expedition and Wilderness Medicine. Oxford University Press; 2015:822. doi:10.1093/med/9780199688418.001.0001.
1
Feng Y, Xiao L. Zoonotic potential and molecular epidemiology of Giardia species and giardiasis. Clin Microbiol Rev. 2011;24(1):110- 140. doi:10.1128/CMR.00033-10.
2
Auerbach PS. Wilderness Medicine E-Book: Expert Consult Premium Edition - Enhanced Online Features. 6th ed. Elsevier Health Sciences; 2011:2304.
3
Boulware DR. Influence of hygiene on gastrointestinal illness among wilderness backpackers. J Travel Med. 2004;11(1):27-33. doi:10.2310/7060.2004.13621.
4
Zell SC. Epidemiology of wilderness-acquired diarrhea: implications for prevention and treatment. J Wilderness Med. 1992;3(3):241-249. doi:10.1580/0953-9859-3.3.241.
5
Boulware DR, Forgey WW, Martin WJ 2nd. Medical risks of wilderness hiking. Am J Med. 2003;114(4):288-293.
6
McIntosh SE, Leemon D, Visitacion J, Schimelpfenig T, Fosnocht D. Medical incidents and evacuations on wilderness expeditions. Wilderness Environ Med. 2007;18(4):298-304. doi:10.1580/07-WEME-OR-093R1.1.
7
Meyer DJ, Costantino A, Spano S. An assessment of diarrhea among long-distance backpackers in the Sierra Nevada. Wilderness Environ Med. 2017;28(1):4-9. doi:10.1016/j.wem.2016.12.002.
8
Welch TR. Evidence-based medicine in the wilderness: the safety of backcountry water. Wilderness Environ Med. 2004;15(4):235- 237. doi:10.1580/1080-6032(2004)015[0235:EMITWT]2.0.CO;2.
9
Khan ID, Khan SA, Asima B, Hussaini SB, Zakiuddin M, Faisal FA. Morbidity and mortality amongst Indian Hajj pilgrims: a 3-year experience of Indian Hajj medical mission in mass-gathering medicine. J Infect Public Health. 2017. doi:10.1016/j.jiph.2017.06.004.
10
Shlim DR. Looking for evidence that personal hygiene precautions prevent traveler’s diarrhea. Clin Infect Dis. 2005;41 Suppl 8:S531-S535. doi:10.1086/432947.
11
Leder K. Advising travellers about management of travellers’ diarrhoea. Aust Fam Physician. 2015;44(1-2):34-37.
12
DuPont HL. Therapy for and prevention of traveler’s diarrhea. Clin Infect Dis. 2007;45 Suppl 1:S78-84. doi:10.1086/518155.
13
Khan ID. Extreme altitude pulmonary oedema (EAPO) in acclimatized soldiers. Med J Armed Forces India. 2012;68(4):339- 345. doi:10.1016/j.mjafi.2012.04.018.
14
Khan ID. Comorbid cerebral and pulmonary edema at 7010 M/23000 Ft: An Extreme Altitude Perspective. J Med. 2013;14(2):153-155. doi:10.3329/jom.v14i2.19668.
15
Khan ID. Cerebral venous sinus thrombosis masquerading as high altitude cerebral edema at extreme altitude. Int J Travel Med Glob Health. 2016;4(3):96-98. doi:10.21859/ijtmgh-040306.
16
Khan ID. On-site management of frostbite in the Himalayas. Int J Travel Med Glob Health. 2017;5(1):28-32. doi:10.15171/IJTMGH.2017.05.
17
Khan ID, Sahni AK. Possession syndrome at high altitude (4575 m/15000 ft). Kathmandu Univ Med J. 2013;11(43):253-255.
18
De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers’ diarrhoea. Cochrane Database Syst Rev. 2000(3):Cd002242. doi:10.1002/14651858.CD002242.
19
DuPont HL, Ericsson CD, Farthing MJ, et al. Expert review of the evidence base for prevention of travelers’ diarrhea. J Travel Med. 2009;16(3):149-160. doi:10.1111/j.1708-8305.2008.00299.x.
20
The Lancet Infectious D. Cholera in Yemen: war, hunger, disease... and heroics. Lancet Infect Dis. 2017;17(8):781. doi:10.1016/S1473-3099(17)30406-1.
21
Qadri F, Islam T, Clemens JD. Cholera in Yemen - an old foe rearing its ugly head. N Engl J Med. 2017;377(21):2005-2007. doi:10.1056/NEJMp1712099.
22
The L. Yemen and cholera: a modern humanity test. Lancet. 2017;390(10095):626. doi:10.1016/S0140-6736(17)32210-9.
23
Khan ID, Asima B, Khan SA. Operations throughput as a determinant of golden-hour in mass-gathering medicine. Int J Med Med Res. 2017;3(1):53-59. doi:10.11603/ijmmr.2413-6077.2017.1.7804.
24
Khan ID, Sahni AK, Sen S, Gupta RM, Basu A. Outbreak of Prototheca wickerhamii algaemia and sepsis in a tertiary care chemotherapy oncology unit. Med J Armed Forces India. 2017. doi:10.1016/j.mjafi.2017.07.012.
25
Khan ID, Sahni AK, Bharadwaj R, Lall M, Jindal AK, Sashindran VK. Emerging organisms in a tertiary healthcare set up. Med J Armed Forces India. 2014;70(2):120-128. doi:10.1016/j.mjafi.2013.09.005.
26
Khan ID. The world in 21st century: a sea of challenges and a mountain of opportunities Up. http://www.globalethicsnetwork.org/profiles/blogs/the-world-in-21st-century-a-sea-of-challenges-and-a-mountain-of. Published December 30, 2014.
27
Khan ID, Khan S, Khan MA, et al. Indian medical mission at Hajj- 2016: mass-gathering medicine perspectives, challenges, and opportunities in a mission posture. Int J Travel Med Glob Health. 2017;5(3):94-101. doi:10.15171/ijtmgh.2017.20.
28
Khan ID. Extreme Altitude Chronic Mountain Sickness Misdiagnosed As High Altitude Cerebral Edema. Int J Travel Med Glob Health. 2016;4(4):132-134. doi:10.21859/ijtmgh-040408.
29
Khan ID, Hussaini SB, Khan S, et al. Emergency response of Indian Hajj medical mission to heat illness among Indian pilgrims in Tent- Clinics at Mina and Arafat during Hajj, 2016. Int J Travel Med Glob Health. 2017;5(4):135-139. doi:10.15171/ijtmgh.2017.26.
30
Khan ID, Sahni AK. Rapid diagnosis of dengue outbreaks in resource limited facilities. West Indian Med J. 2017;66(1):4-9. doi:10.7727/wimj.2016.095.
31
Khan ID, Gupta N, Rangan NM, Singh R, Sharma AK, Khurana A, et al. Evaluation of pre and post analytical variables in clinical microbiology services in multidisciplinary ICU of a medical college and tertiary care hospital. J Basic Clin Med. 2016;5(1):2-4.
32
ORIGINAL_ARTICLE
Attempts to Achieve Millennium Development Goals in a Rural Area of Rio de Janeiro: Deworming and Control of Schistosomiasis
Introduction: According to the World Health Organization (WHO), helminth control could contribute to achieving 7 Millennium Development Goals (MDGs). The present study evaluated the impact of deworming on the infection rate of schistosomiasis in Sumidouro, Brazil and the consequences for the MDGs. Methods: The whole population of this area was invited to participate in the 2 stages of the study, the baseline from 2002 to 2003 and the follow-up from 2005 to 2006. Within this interval, no improvements to sanitation or access to safe water were undertaken. The statistical investigation was confined to the 164 people who were tested in both surveys. The diagnosis of parasitosis was based on coproscopy by Kato-Katz smears. Infected people were treated with a single oral dose of praziquantel. Results: The infection rate of schistosomiasis dropped from 28.7% (n=47) to 6.7% (n=11). Among women of childbearing age, this rate decreased was from 27.8% (n=10) to 5.6% (n=2), and among children, it dropped from 14.6% (n=6) to 3.3% (n=1). Conclusion: As there was no improvement in sanitation, deworming might have led to the reduced transmission of schistosomiasis. The drop in infection rate of schistosomiasis in children and women of childbearing age supports the argument that deworming would allow for the reduction of child mortality and the promotion of gender equality. A better future can also be foreseen, as no girl under 15 years of age was infected.
https://www.ijtmgh.com/article_57190_fd2d37f010ad47539403df0c5847d2ab.pdf
2018-02-01
30
33
10.15171/ijtmgh.2018.06
Schistosomiasis
Praziquantel
Rio de Janeiro
Brazil
Ricardo
Igreja
rpigreja@cives.ufrj.br
1
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
LEAD_AUTHOR
Magali
Barreto
mbarreto@ioc.fiocruz.br
2
Lab. de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
AUTHOR
Marisa
Soares
mssoares@ioc.fiocruz.br
3
Lab. de Avaliação e Promoção da Saúde Ambiental, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
AUTHOR
Cumming O. The sanitation imperative: A strategic response to a development crisis. Desalination. 2009;248(1):8-13. doi:10.1016/j.desal.2008.05.031.
1
Barreto ML, Genser B, Strina A, et al. Effect of city-wide sanitation programme on reduction in rate of childhood diarrhoea in northeast Brazil: assessment by two cohort studies. Lancet. 2007;370(9599):1622-1628. doi:10.1016/s0140-6736(07)61638- 9.
2
World Health Organization. Prevention and control of schistosomiasis and soil-transmitted helminthiasis: report of a WHO expert committee. WHO Technical Report Series 912. Geneva, Switzerland: WHO; 2002.
3
Igreja RP, Gusmao MF, Barreto MG, et al. A 15-year follow-up study on schistosomiasis in a low-endemic area in Rio de Janeiro State, Brazil. J Helminthol. 2010;84(3):229-233. doi:10.1017/S0022149X09990575.
4
World Health Organization. The Millenium Development Goals. The evidence is in: deworming helps meet the Millenium Development Goals. http://whqlibdoc.who.int/hq/2005/WHO_ CDS_CPE_PVC_2005.12.pdf. Published 2005.
5
Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo. 1972;14(6):397-400.
6
Siegel S. Estatística Não-paramétrica para as Ciências do Comportamento. 1st ed. São Paulo: McGraw–Hill; 1975.
7
Ross AG, Bartley PB, Sleigh AC, et al. Schistosomiasis. N Engl J Med. 2002;346(16):1212-1220. doi:10.1056/NEJMra012396.
8
Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521-1532. doi:10.1016/S0140-6736(07)61638-9.
9
Thinking beyond deworming. Lancet. 2004;364(9450):1993- 1994. doi:10.1016/S0140-6736(04)17521-1.
10
Davis A. Schistosomiasis. In: Cook GC, ed. Manson’s Tropical Diseases. 20th ed. London: W B Saunders; 1996:1413-1456.
11
Raso G, N’Goran EK, Toty A, et al. Efficacy and side effects of praziquantel against Schistosoma mansoni in a community of western Cote d’Ivoire. Trans R Soc Trop Med Hyg. 2004;98(1):18- 27. doi:10.1016/S0035-9203(03)00003-8.
12
Igreja RP, Matos JA, Goncalves MM, Barreto MM, Peralta JM. Schistosoma mansoni-related morbidity in a low-prevalence area of Brazil: a comparison between egg excretors and seropositive non-excretors. Ann Trop Med Parasitol. 2007;101(7):575-584. doi:10.1179/136485907X229086.
13
King CH. Toward the elimination of schistosomiasis. N Engl J Med. 2009;360(2):106-109. doi:10.1056/NEJMp0808041
14
ORIGINAL_ARTICLE
Informal International Border Crossing, Refugee and Illegal Migrant Workers: Issue in Travel Medicine
https://www.ijtmgh.com/article_51830_2b144d3149a117685d49c2712862476b.pdf
2018-02-01
34
34
10.15171/ijtmgh.2018.07
Refugee
Migrant
Travel
Viroj
Wiwanitkit
wviroj@yahoo.com
1
Hainan Medical University, Hainan, China
LEAD_AUTHOR
Castaneda H, Holmes SM, Madrigal DS, Young ME, Beyeler N, Quesada J. Immigration as a social determinant of health. Annu Rev Public Health. 2015;36:375-392. doi: 10.1146/annurev-publhealth-032013-182419.
1
Ditton MJ, Lehane L. Towards realizing the health-related millennium development goals for migrants from Burma in Thailand. J Empir Res Hum Res Ethics. 2009;4(3):37-48. doi: 10.1525/jer.2009.4.3.37.
2
Tschirhart N, Sein T, Nosten F, Foster AM. Migrant and Refugee Patient Perspectives on Travel and Tuberculosis along the Thailand-Myanmar Border: A Qualitative Study. PLoS One. 2016;11(8):e0160222. doi: 10.1371/journal.pone.0160222.
3
Srikanok S, Parker DM, Parker AL, et al. Empirical lessons regarding contraception in a protracted refugee setting: A descriptive study from Maela camp on the Thai-Myanmar border 1996-2015. PLoS One. 2017;12(2):e0172007. doi: 10.1371/journal.pone.0172007.
4
McMichael C, Healy J. Health equity and migrants in the Greater Mekong Subregion. Glob Health Action. 2017;10(1):1271594. doi: 10.1080/16549716.2017.1271594.
5
ORIGINAL_ARTICLE
Travel Medicine in the Gulf Cooperation Council Countries
https://www.ijtmgh.com/article_57102_64b96ce2a159965b61677b361c702c2b.pdf
2018-02-01
35
35
10.15171/ijtmgh.2018.08
Travel Medicine
traveler
Health
Ayman
Al-Dahshan
aaldahshan@hamad.qa
1
Community Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar
AUTHOR
Mohamad
Chehab
mohamadchehab1989@gmail.com
2
Community Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar
LEAD_AUTHOR
Mohamed
Bala
mbala@hamad.qa
3
Community Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar
AUTHOR
Committee to Advise on Tropical Medicine and Travel (CATMAT). An Advisory Committee Statement (ACS): Guidelines for The Practice of Travel Medicine. Ottawa: Public Health Agency of Canada; 2009. https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/publicat/ccdr-rmtc/09pdf/acs-dcc-08.pdf.
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Zuckerman JN. Recent developments: Travel medicine. BMJ. 2002;325(7358):260-264. doi:10.1136/bmj.325.7358.260.
2
Kozarsky PE, Keystone JS. Body of knowledge for the practice of travel medicine. J Travel Med. 2002;9(2):112-115. doi:10.2310/7060.2002.21983.
3
The Middle East Outbound Travel Market with Special Insight into the Image of Europe as a Destination. Madrid: World Tourism Organization European Travel Commission; 2012.
4
Incoming-Tourism Germany Facts and Figures 2014. Frankfurt: German National Tourist Board (GNTB); 2015. https://www.germany.travel/media/pdf/dzt_marktforschung/GNTB_IncomingTourism-Germany-2015.pdf.
5
Manoochehry S, Rasouli HR. Recurrent human tragedy during Hajj. Int J Travel Med Glob Health. 2017;5(1):36-37. doi:10.15171/IJTMGH.2017.07.
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