Routine Vaccination for Travelers from Emerging Countries: Epidemiological Profile of a Public Travel Medicine Clinic in Sao Paulo/Brazil

Document Type : Original Article

Authors

1 Instituto Federal de Educação, Ciência e Tecnologia de São Paulo, São Paulo, Brazil

2 Instituto de Medicina Tropical de São Paulo – USP, São Paulo, Brazil

3 Ambulatório dos Viajantes e CRIE – Centro de referência para Imunobiológicos Especiais - FMUSP-HC System, São Paulo, Brazil

10.15171/ijtmgh.2019.04

Abstract

Introduction: Emerging countries have increased their presence in international travel (46.8% of travels). Pre- and post-travel consultations may provide insights about travelers’ health.
Methods: A retrospective descriptive analysis of the medical data of all travelers assisted at Ambulatório dos Viajantes, a free public health clinic for travelers in São Paulo, Brazil, from January to December 2016 was performed. The patients were profiled based on post-travel consultation data and screened by gender, age according to the United Nations working-age population distribution (0-14 years, children; 15-24 years, youths; 25-65 years, working age; over 65 years, older persons), travel destination, and diseases that affected travelers.
Results: In 2016 (n=280 appointments), 93.92% of clients received some type of vaccine (regular or booster dose). Post-travel consultations (n=27; 9.64%) were predominantly male (62.96% of appointments) and comprised cases of malaria (44.4%; 6 positive cases of Plasmodium falciparum, 4 positive cases of Plasmodium vivax, and 2 unclassified), fever (7.4%), AGE - acute gastroenteritis (7.4%), hepatitis A (3.7%), nausea (3.7%), insect bite (3.7%), abdominal pain (3.7%), arthralgia (3.7%), vaginal discharge (3.7%), and cases under investigation (18.5%). Brazilian travelers presented the same incidence of post-travel counseling as developed countries’ travel medicine clinics (~9%).
Conclusion: Immunization in pre-travel counseling may reduce the importation of preventable infectious diseases and increase Brazilians’ traveler vaccine coverage, a current concern in the country.

Keywords

References

  1. United Nations World Tourism Organization (UNWTO). Tourism Highlights - 2016. Geneva: UNWTO; 2016.
  2. Fujita DM, Nali LH, Urbano PR, Soeiro DM, Andrade HF Jr. The fast transmission of infectious diseases around the world - a new concern to the public health. Braz J Infect Dis. 2016;20(5):513- 515. doi:10.1016/j.bjid.2016.06.003.
  3. Igreja RP. [Travel Medicine: a new field of work for the specialist in Infectious and Parasitic Diseases]. Rev Soc Bras Med Trop. 2003;36(4):539-540. doi:10.1590/S0037-86822003000400020.
  4. Mun N, Lai S. Global Population Age Structures and Sustainable Development. New York: United Nations Population Division; 2016.
  5. Brazil. Dados do Anuário do Transporte Aéreo. Brasília; 2016.
  6. Chaves Tdo S, Alves JR, Lopes MH. Pre-travel counselling in Brazil. Travel Med Infect Dis. 2015;13(4):340-341. doi:10.1016/j.tmaid.2015.03.007.
  7. Horvath LL, Murray CK, Dooley DP. Effect of maximizing a travel medicine clinic’s prevention strategies. J Travel Med. 2005;12(6):332-337. doi:10.2310/7060.2005.12606.
  8. Brazil. Travel Medicine Clinics - Anvisa. Available at: http://portal.anvisa.gov.br/centros-de-orientacao-do-viajante. Accessed March 16, 2017.
  9. dos Santos RP, Konkewicz LR, Nagel FM, et al. Changes in hand hygiene compliance after a multimodal intervention and seasonality variation. Am J Infect Control. 2013;41(11):1012- 1016. doi: 10.1016/j.ajic.2013.05.020.
  10. Brazil. Saúde do Viajante. Brasília: ANVISA; 2012.
  11. Brazil. Viajante BR. Brazilian Ministry of Health. Available at: http://portalsaude.saude.gov.br/index.php/o-ministerio/principal/secretarias/svs/viajante. Accessed May 2, 2017.
  12. Vilkman K, Pakkanen SH, Laaveri T, Siikamaki H, Kantele A. Travelers’ health problems and behavior: prospective study with post-travel follow-up. BMC Infect Dis. 2016;16:328. doi:10.1186/s12879-016-1682-0.
  13. Dash AP, Bhatia R, Sunyoto T, Mourya DT. Emerging and re-emerging arboviral diseases in Southeast Asia. J Vector Borne Dis. 2013;50(2):77-84.
  14. Nali LH, Fujita DM, Salvador FS, et al. Potential measles transmission risk in mass gatherings: Are we safe for the Olympic games--Rio 2016? J Travel Med. 2016;23(4). doi:10.1093/jtm/taw026.
  15. Garcia M. Situação epidemiológica das arboviroses e malária Brasil, 2018. Brasília; 2018.
  16. Fujita DM, da Silva Nali LH, Salvador FS, de Andrade Junior HF. Recommendations for travellers during the yellow fever outbreaks in Brazil-2018. J Travel Med. 2018;25(1). doi:10.1093/jtm/tay016.
  17. Brazil. Situação dos Casos de Sarampo nos Estados de Roraima e Amazonas-2018 Monitoramento da situação epidemiológica de sarampo nos estados de Roraima e Amazonas. Brasilia; 2018.
  18. Aggleton P, Bell SA, Kelly-Hanku A. ‘Mobile men with money’: HIV prevention and the erasure of difference. Glob Public Health. 2014;9(3):257-270. doi:10.1080/17441692.2014.889736.
  19. Buhler S, Ruegg R, Steffen R, Hatz C, Jaeger VK. A profile of travelers--an analysis from a large swiss travel clinic. J Travel Med. 2014;21(5):324-331. doi:10.1111/jtm.12139.
  20. Marchand C, Merrina F, Gagnayre R, Bouchaud O. A descriptive study of advising practices during travel health consultations in France. J Travel Med. 2017;24(5). doi:10.1093/jtm/tax042.
  21. Rowe K, Chaves N, Leder K. Challenges to providing pre-travel care for travellers visiting friends and relatives: an audit of a specialist travel medicine clinic. J Travel Med. 2017;24(5). doi:10.1093/jtm/tax038.
  22. Rodrigo Saez L, Riestra Menendez S, Fernandez Rodriguez E, Fernandez Velazquez MR, Garcia Alonso S, Lauret Brana ME. Epidemiological study of the prevalence of Helicobacter pylori infection in the general population in Asturias, Spain. Rev Esp Enferm Dig. 1997;89(7):511-522.

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History

  • Receive Date: 09 October 2018
  • Revise Date: 20 December 2018
  • Accept Date: 10 February 2019

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