Scientometric Evaluation of Published Articles in Travel Medicine and Global Health

Despite having to adapt to the disruptive effects of the coronavirus disease 2019 (COVID-19) pandemic, published travel medicine research continues unabated and reflects the rapid evolution of this dynamic specialism. From its origins some four decades ago, travel medicine has firmly established itself as a medical discipline in most developed countries, while being formally recognised as a postgraduate specialty in a minority of jurisdictions. Travel medicine is to some extent necessitated by inequalities and inconsistencies in global health, and travel medicine practitioners are obliged to be familiar with the sociocultural aspects of global health and the burden of disease in host countries. Deterioration and improvements in global health can have a direct influence on the health outcomes of international travellers. Scientometrics is a field of study related to data science, which concerns itself with the measurement and analysis of published scholarly literature.1 Scientometric and citation analyses have been published in relation to the most cited articles in travel medicine and articles published by leading journals in the field.2-5 The International Journal of Travel Medicine and Global Health (IJTMGH) is the only peerreviewed specialised travel medicine journal currently published in the Middle East, Africa or Asia. Published quarterly as an online, open access journal by the International Travel Medicine Center of Iran, it has been in existence since 2013. It uniquely addresses both travel medicine and global health issues and its editorial board comprises members drawn from 15 countries around the world. We aimed to conduct the first scientometric evaluation of articles published in IJTMGH, in order to gain insights into the development of travel medicine as a scholarship domain and to characterise the linkages between global health and travel medicine. http://ijtmgh.com Int J Travel Med Glob Health. 2021 June;9(2):73-77 doi 10.34172/ijtmgh.2021.12 TMGH IInternational Journal of Travel Medicine and Global Health J


Introduction
Despite having to adapt to the disruptive effects of the coronavirus disease 2019 (COVID-19) pandemic, published travel medicine research continues unabated and reflects the rapid evolution of this dynamic specialism. From its origins some four decades ago, travel medicine has firmly established itself as a medical discipline in most developed countries, while being formally recognised as a postgraduate specialty in a minority of jurisdictions. Travel medicine is to some extent necessitated by inequalities and inconsistencies in global health, and travel medicine practitioners are obliged to be familiar with the sociocultural aspects of global health and the burden of disease in host countries. Deterioration and improvements in global health can have a direct influence on the health outcomes of international travellers.
Scientometrics is a field of study related to data science, which concerns itself with the measurement and analysis of published scholarly literature. 1 Scientometric and citation analyses have been published in relation to the most cited articles in travel medicine and articles published by leading journals in the field. [2][3][4][5] The International Journal of Travel Medicine and Global Health (IJTMGH) is the only peerreviewed specialised travel medicine journal currently published in the Middle East, Africa or Asia. Published quarterly as an online, open access journal by the International Travel Medicine Center of Iran, it has been in existence since 2013. It uniquely addresses both travel medicine and global health issues and its editorial board comprises members drawn from 15 countries around the world. We aimed to conduct the first scientometric evaluation of articles published in IJTMGH, in order to gain insights into the development of travel medicine as a scholarship domain and to characterise the linkages between global health and travel medicine.

Methods
All articles published in IJTMGH were accessed via the journal website at http://www.ijtmgh.com over a twomonth period in January-February 2021. Articles were deemed eligible for inclusion if they had been published in IJTMGH from its inception to the most recently published volume 9, issue 1 (winter 2021). Data relating to individual articles were extracted from the PDF file of the article and its accompanying metadata, and entered into a Microsoft Excel 2016 database. The principal discipline area of each article was categorised as either travel medicine or global health. The subject theme(s) which most closely reflected the content of each article was also recorded. Additionally, the content of travel medicine articles was mapped to one or more of the seven subject domains of the Body of Knowledge syllabus of the International Society of Travel Medicine (2017 version). 6 The article category was indicated for each article from a list of 14 available options in the instructions for authors section of the journal website.
Details of the geographical origin of articles were documented, to include country or countries associated with the authors' institution(s) and the institutional affiliation of authors. The number of authors and institutions per article was determined in each case as an index of academic collaboration. The total article output from individual authors who published in IJTMGH was obtained from the journal website. The presence of funding for each study was established by consulting the obligatory funding statement at the end of each article. The level of attention given to each article was derived from the number of views and downloads received by each published article. Citation counts for each article were obtained by cross-referencing with Google Scholar. Data were independently verified for accuracy by two researchers (WWO and GTF). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational cohort studies were applied where applicable to our study. 7

Results
The IJTMGH is currently publishing articles in its ninth volume. At the time of writing, 240 articles have been published in the journal, the majority of which were original research articles (53.8%, n=129), followed in frequency by review articles (15.4%, n=37), and letters to the editor (11.3%, n=27). There were no missing data in our database. Less than a quarter (22.5%, n=54) of published articles reported a funding source. The mean number of authors per published article was 3.8. Articles with three authors were the most frequently published (21.7%, n=52). The total number of institutions involved in this set of publications was 189, with the leading institutions listed in Table 1. Baqiyatallah University of Medical Sciences in Iran was the source of the largest number of articles in this journal (25.4%, n=61). The mean number of institutional affiliations per journal article was 1.9. The majority of articles had a single institutional affiliation (44.4%, n=106) or arose from two institutions (31%, n=74). There were 39 countries of origin of the articles published in IJTMGH, with the leading sources of articles being Iran (48.8%, n=117), United States of America (13.8%, n=33), and Republic of Ireland (8.8%, n=21).
The majority of IJTMGH articles have been cited (65%, n=165) at least once. The mean number of cumulative citations per journal article was 3.5, with the most cited article by Nehrir et al, a systematic review of competency in nursing students, having received 37 citations at the time of writing. Of the 10 most cited articles (Table 2), five related to medical or health tourism. The majority of articles belonged to the general category of travel medicine (62%, n=149), with 38% of articles (n=91) being focused on global health and non-travel related infectious diseases. The 149 travel medicine-related articles mapped onto the ISTM Body of Knowledge syllabus ( Figure 1), with the majority of articles addressing the domain of pre-travel assessment of travellers (49.7%, n=74), including the sub-domains of patient evaluation, special populations of travellers, special itineraries, prevention and self-treatment, and communication of risks to travellers.
The most common thematic designations of IJTMGH articles were medical and health tourism (12.1%, n=29) and travel health (12.1%, n=29), followed by COVID-19 (6.7%, n=16). The mean number of article views and downloads from the journal website were 898 and 889, respectively. The most viewed and downloaded articles are listed in Table 3.

Discussion
The IJTMGH is now firmly established as one of the leading journals in its field. To date, there have been only four academic journals of travel medicine, but travel medicine research is often published in non-specialist journals, especially in the spheres of general internal medicine, infectious diseases, and public health. The diversity of its editorial board reflects the inclusivity of IJTMGH and its commitment to representing the full range of knowledge encompassed by travel medicine. Our scientometric analysis points to a broad coverage of topics within travel medicine and global health and it is consistent with the stated aims and scope of the journal. The emphasis on pre-travel assessment and consultation reflects trends observed in other leading travel medicine journals. 3,4 Given the expertise of its host institution in medical and health tourism, it is not surprising that almost one in eight articles published in the journal related to these subject areas. Medical tourism is a burgeoning global industry involving the annual movement of an estimated 50 million travellers around the world, mostly from developed to developing countries with well established medical tourism services. 24 The traditional dominance of dental, ophthalmologic and orthopaedic tourism is being challenged by the growing global demand for fertility, stem cell and bariatric surgery tourism. 25,26 Significant gaps remain in our understanding of the true scope of medical tourism, as well as the experiences of  The free open access nature of the journal greatly facilitates its accessibility and promotes early and unhindered citation of its articles. Although a detailed correlational analysis was beyond the scope of the current study, there was a high level of congruity between the lists of most cited and most accessed articles, reflecting the value of open access in dissolving barriers to the viewing and citing of journal output. The most cited and visited articles reflect the broad coverage of topics in this journal and the tendency for review articles in particular to attract larger numbers of citations from other authors. While the high visibility of the journal in the Middle East may account for the high proportion of accepted articles received from academics in Iran, our analysis revealed significant geographic diversity in the authorship and institutional affiliation of IJTMGH articles, with a growing trend for multiauthor and multi-institutional collaborations in evidence in more recent years.
Our study was limited by its lack of a comprehensive citation analysis, which would have included an examination of the source of citations, both self-citations and those received from other journals. This would provide further insights into the reach and influence of the journal and we recommend it be performed in the future as the journal's output continues to expand. A detailed mapping exercise at the level of individual topics would have yielded additional perspectives on the content of the journal. Many leading academic journals have established formal relationships with professional societies, which serve to extend the influence of their journals and increase their recognition among prospective authors. We recommend that the editorial team of IJTMGH give consideration to developing such partnerships, not least because to do so may assist in the development of travel medicine as a scholarly discipline throughout Western Asia. Citation metrics are dynamic and the data presented in our study are accurate only at the time of writing. Future periodic citation and bibliometric analyses will further illuminate the characteristics and performance of this reputable academic publication.

Conclusion
Our scientometric evaluation of all articles published in International Journal of Travel Medicine and Global Health provides useful insights into the content and geographic diversity of this journal and adds to our understanding of the development of travel medicine as a fertile academic entity with a rapidly growing evidence base.