International Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201Lessons From Zika Policies to Improve Gender Equity1391407818910.15171/ijtmgh.2018.25ENEmmaRichardsonCentre for Ethical, Social and Cultural Risk, St. Michael’s Hospital, Toronto, CanadaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, CanadaElizabethAlvarezDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, CanadaCentre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada0000-0003-2333-0144TemitayoIfafore-CalfeeGlobal South Solutions, Arlington, USA0000-0003-1274-4325Journal Article20180621Gender equity is easily supported in theory but harder to pursue in practice. In this article, the case of Zika travel policies is used to illustrate some glaring gaps related to gender, for both men and women, at both international and national levels. Zika travel policies have not considered new evidence on biological or social determinants of health, putting babies at risk of exposure. The authors suggest best practices at the international level, such as developing pre-organized gender committees to provide actionable and swift advice for international infectious disease policies; at the national level, such as promoting holistic policies addressing mosquito control and sex and gender considerations, including access to reproductive health services; and at the local level, such as education on local infectious diseases. These deliberations are especially important with emerging infectious diseases (EIDs), as little may be known about them. New knowledge needs to be translated in a timely fashion in order to shape effective and equitable policies.https://www.ijtmgh.com/article_78189_4acd793a645f227d84ddb7c4c3f16603.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201Adolescents Traveling to High-Risk Destinations: Review and Considerations for Clinicians1411487362810.15171/ijtmgh.2018.26ENHelena C.MaltezouDepartment for Interventions in Health Care Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece0000-0003-0264-3547AndroulaPavliDepartment for Interventions in Health Care Facilities, Hellenic Centre for Disease Control and Prevention, Athens, GreeceJournal Article20180327<strong>Introduction:</strong> International travels have increased dramatically in recent years. Adolescents constitute a fast-growing group of travelers. Travels provide an opportunity for exposure to high-risk behavior. The current study reviewed the published data about travel-related morbidity among adolescents traveling to international destinations.<br /> <strong>Methods:</strong> PubMed was searched for articles published from 2000-2017. The websites of public health organizations were also searched.<br /> <strong>Results:</strong> In total, 21 articles presenting original data about adolescent international travelers were identified. The data indicated that adolescents frequently develop ailments during travel, including those attributable to age-related high-risk behavior. In addition, adolescents often manifest a travel-associated morbidity that differs in terms of proportion (e.g., higher rates of systemic febrile illness) from the travel-associated morbidity encountered in younger children and adults. Pre-travel counseling is sought by less than half of adolescents traveling to high-risk destinations. Gaps were found in travel vaccinations and antimalarial prophylaxis in adolescents traveling to endemic areas. Information about vaccinations, antimalarial prophylaxis, and pre-travel counseling for adolescent travelers should be improved.<br /> <strong>Conclusion:</strong> There is a need to improve pre-travel services for adolescents planning to travel to high-risk international destinations. Communication strategies to access adolescent travelers and their parents should be investigated.https://www.ijtmgh.com/article_73628_193e9e21d5dcd4624c111851c099e77b.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201Deaths of Irish Civilians Abroad: Analysis of National Mortality Data, 2016-20181491538059510.15171/ijtmgh.2018.27ENMiladDarratSchool of Medicine, National University of Ireland Galway, Ireland0000-0002-0617-0911Gerard T.FlahertySchool of Medicine, National University of Ireland Galway, IrelandSchool of Medicine, International Medical University, Kuala Lumpur, Malaysia0000-0002-5987-1658Journal Article20181009<strong>Introduction:</strong> International travel is increasing, yet few studies have reported on country-level death rates among international travelers. The data regarding the death profiles of overseas Irish travelers is insufficient. The current study examined data obtained from the Irish Department of Foreign Affairs and Trade to profile these deaths.<br /> <strong>Methods:</strong> Data on Irish civilian citizen deaths occurring abroad was obtained from the Consular Division of the Irish Department of Foreign Affairs and Trade and analyzed based on age, gender, time of death, travel destination, and recorded cause of death.<br /> <strong>Results:</strong> Between January 2016 and April 2018, the Consular Division received 654 reports of Irish civilians dying abroad, of which 72% (n=469) were males and 23% (n=149) were females; in 6% (n=36) the sex was not recorded. The mean age at death was 58±5 years old (range from 1 to 110, median 62 years). Recorded causes of death were illness (25%; n=162), traumatic deaths including homicides and suicides (24%; n=151), and natural (age-related) (3%; n=19); the rest were classified as unidentified cause (47%; n=309). The majority of deaths (63%; n=309) occurred in European destinations followed by Asia (16%; n=102) and the Americas (12%; n=75).<br /> <strong>Conclusion:</strong> At least 25% of Irish deaths abroad can be considered preventable. More tailored pre-travel medical interventions may prevent further deaths. In the collection of data, consular services miss the opportunity to acquire valuable information for both travelers and healthcare professionals. The authors recommend the creation of a comprehensive database of international traveler deaths.https://www.ijtmgh.com/article_80595_7c72b3b74029b369b7a04864b098456d.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201Perceived Training Needs of Maritime Doctors and General Practitioners1541608075610.15171/ijtmgh.2018.28ENOlaf C.JensenCentre of Maritime Health and Society, School of Health Sciences, University of Southern Denmark, Esbjerg, Denmark0000-0001-7672-9891GeorgeCharalambousHippokration Hospital Athens, Greece & Frederick University, Nicosia, Cyprus0000-0003-1731-7867DebbieAndriotiCentre of Maritime Health and Society, School of Health Sciences, University of Southern Denmark, Esbjerg, Denmark0000-0002-9355-3004Journal Article20181015<strong>Introduction:</strong> Medical practitioners provide pre-employment examinations and periodic health examinations to seafarers, fishermen, offshore employees, and maritime students to ensure that they are fit for work. So far, very little is known about doctors’ perceptions of their professional training needs and expectations. The objective of this study was to gain insight on (<em>a</em>) the breadth of services offered, (<em>b</em>) follow-up practices, and (<em>c</em>) perceived training needs on aspects of maritime medicine.<br /> <strong>Methods:</strong> All maritime doctors (110) recognized by the Danish Maritime Authority (DMA) and 100 general practitioners (GPs) were invited to participate. A questionnaire was sent out electronically to gather information on the demographics, breadth of services, follow-up practices, and perceived training needs of the participants. Descriptive statistics described the characteristics of the 2 groups.<br /> <strong>Results:</strong> The training priorities of maritime doctors were rules and regulations (68.7%) followed by working conditions and health risks aboard ship (62.8%). The self-rated training priorities of the GPs were working conditions and health risks aboard ship (44.1%), occupational disease diagnostics, prevention, and follow-up (41.1%), and health and safety at work (38.2%).<br /> <strong>Conclusion:</strong> Members of both medical disciplines were in favor of flexible and accredited training. More specifically, GPs considered a course in occupational risks, diseases, and follow up targeting high-risk professions very important. Maritime doctors suggested the establishment of a website as a one-stop shop for relevant guidelines and information. The small size of the GPs sample prevented a more in-depth gap analysis; however, the results could be used to help the respective authorities establish relevant training programs.https://www.ijtmgh.com/article_80756_0a459f133fe4e807c96992e5af0b1e00.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201Risk Assessment and Travelers Characteristics: 6-Month Travel Clinic Experience From Qatar1611678145410.15171/ijtmgh.2018.29ENMohammedAbukhattabDivision of Infectious Disease, Department of Medicine, Hamad General Hospital, Doha, Qatar0000-0002-3335-0563MunaAl-MaslamaniCommunicable Disease Center (CDC), Doha, QatarAbdul LatifAl-KhalDivision of Infectious Disease, Department of Medicine, Hamad General Hospital, Doha, QatarJournal Article20180924<strong>Introduction:</strong> The number of international travelers is increasing, yet currently, there is no data on risk assessment and travelers’ characteristics from Qatar. To identify and minimize the risks associated with travel, a detailed knowledge of travelers’ characteristics is needed.<br /> <strong>Methods:</strong> This retrospective descriptive study was conducted in a travel clinic in the Communicable Disease Center, Qatar. All patients seen in the clinic from February 2017 to August 2017 were included. Data was analyzed using SPSS version 22 software.<br /> <strong>Results:</strong> A total of 279 travelers were included in this study. The top 2 most visited countries were Tanzania and Kenya. Tourism (57.3%) was the number one purpose for travel, while travelers visiting friends and relatives (VFRs) accounted for 10.7% of travel. Among the study population, 21% of participants had pre-existing medical conditions with hypertension and diabetes as the most common comorbidities. Mean travel duration was 46.5 days (range = 3 to 90 days). Vaccinations were required by 97% of the study population with the most commonly prescribed vaccines being the typhoid (69%), Tdap (62%), hepatitis A (55%), flu (49.3%), and yellow fever (39%) vaccines.<br /> <strong>Conclusion:</strong> Travelers from Qatar tend to visit high-risk destinations; the lack of proper travel medicine services and awareness among travelers may increase the risk of illness, especially in Qatar where a large number of expatriates reside and travel frequently to and from their home countries (VFRs).https://www.ijtmgh.com/article_81454_ca89b7b947afed6fd6ad6b5e9f205805.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201International Travelers’ Behaviors and Knowledge of Travel Health, Travel-Related Diseases, and Vaccinations: A Cross-Sectional Study1681738146310.15171/ijtmgh.2018.30ENBilgeKalanlarDepartment of Public Health Nursing, Nursing Faculty, Hacettepe University, Ankara, Turkey0000-0001-5475-6725MakbuleŞenelFaculty of Nursing, Istanbul University – Cerrahpasa Florence Nightingale, Istanbul, TurkeyEbru TemelGürselTravel Health Center, Ankara, TurkeyNüvitGönülTravel Health Center, Ankara, TurkeyBünyaminBilgiçDirectorate General of Health for Border and Coastal Areas, Istanbul, TurkeyFulya KahramanAydoğanDirectorate General of Health for Border and Coastal Areas, Istanbul, TurkeyOsmanKanDirectorate General of Health for Border and Coastal Areas, Istanbul, TurkeyJournal Article20181021<strong>Introduction:</strong> Travel health centers offer very important health services for individuals traveling abroad. Little is known about the health status and knowledge of travel health, travel-related diseases, and vaccinations of individuals who travel abroad and visit travel health centers. This research studied travelers who visited a travel health center in order to evaluate their behavior and knowledge of travel health, travel-related diseases, and vaccinations.<br /> <strong>Methods:</strong> This cross-sectional study was conducted with 407 participants between June and September 2018, the busiest time for international travel. It was administered at a travel health center attached to the Directorate General of Health for Border and Coastal Areas of Turkey.<br /> <strong>Results:</strong> The results indicated that 78.6% of participants did not obtain travel health insurance before their trip, and 63.6% did not prepare a travel health kit for their trip. Moreover, 61.4% reported that they did not know about the health conditions and practices of their destination country. Individuals traveling for business did more research on travel-related diseases compared to those traveling for other reasons. Additionally, 61.3% of individuals who rated themselves healthy sought information about the health conditions at their travel destinations.<br /> <strong>Conclusion:</strong> The current study showed that the knowledge and healthcare practices among international travelers are inadequate. Raising awareness is needed to create a positive behavioral change in people’s travel health practices.https://www.ijtmgh.com/article_81463_709b6839d764651ee36ecdefdb0c486e.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11006420181201Rabies Vaccination Among Foreigners in Thailand: A Summary From a Medical Center1741746962810.15171/ijtmgh.2018.31ENVirojWiwanitkitDr DY Patil University, IndiaMedical Academic Center, Bangkok, Thailand0000-0003-1039-3728BeuyJoobMedical Academic Center, Bangkok, ThailandJournal Article20171228https://www.ijtmgh.com/article_69628_73574de5c7623eda12217e468b7fac9f.pdf