International Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Unmasking the Myths Surrounding Use of Barrier Face Coverings During the COVID-19 Pandemic13413611922910.34172/ijtmgh.2020.23ENChee HwuiLiewSchool of Medicine, National University of Ireland Galway, Galway, IrelandSchool of Medicine, Trinity College Dublin, Dublin, IrelandGerard ThomasFlahertySchool of Medicine, National University of Ireland Galway, Galway, IrelandSchool of Medicine, International Medical University, Kuala Lumpur, Malaysia0000-0002-5987-1658Journal Article20200826Face masks have been worn by members of the public for source control during pandemics and major outbreaks of infectious disease across the centuries. As the current coronavirus disease 2019 pandemic evolves, reluctance towards the wearing of face masks and anti-mask sentiments by some people have been encountered, with strongly held personal views and misinformation being disseminated through social media. Some of this resistance may arise from personal beliefs about the limited effectiveness of masks. Negative perceptions towards use of face masks have also been voiced by patients with pre-existing medical conditions such as chronic obstructive pulmonary disease and asthma. There are concerns that face coverings may not be suitable for children or individuals with autism. Health care professionals have an obligation to be advocates for this public health intervention. Individual patients’ concerns about mask use should be sensitively addressed by countering misinformation with reliable evidence from the scientific literature.https://www.ijtmgh.com/article_119229_ee4f553c32227adf7971e33939ae5b1b.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Pathogenesis of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Respiratory Infection13714511097410.34172/ijtmgh.2020.24ENAbolaji SamsonOlagunjuDepartment of Biochemistry, University of Ibadan, Ibadan, Nigeria0000-0003-0868-2440Ifeoluwa PeaceOladapoDepartment of Zoology, University of Ibadan, Ibadan, Nigeria0000-0002-5595-6785Samson OluwapelumiKosemaniDepartment of Biochemistry, University of Ibadan, Ibadan, NigeriaFolashade GloriaOlorunfemiDepartment of Biochemistry, University of Lagos, Lagos, NigeriaAdesewa SukuratAdeyemoDepartment of Zoology, University of Ibadan, Ibadan, NigeriaJournal Article20200607With the occurrence of a mysterious pneumonia in the Hubei province (Wuhan) of China in December 2019, a different coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has commanded global awareness and has been named by the World Health Organization (WHO) as a public health emergency of international concern. Two other coronavirus infections (SARS and MERS) were also characterized by severe respiratory distress in 2002-2003. In addition to the new coronavirus, the emerging infectious diseases resulting in universal spread are caused by the β-coronavirus strains. Even though coronaviruses typically target the upper and/or lower respiratory tract, viral shedding into the plasma or serum is frequent, and the human coronavirus (CoV) represents 15%–30% of respiratory syndromes, including common colds. Based on a recent hypothesis, SARS-CoV-2 has been shown to induce lung injury by inhibiting the angiotensin converting enzyme-2 (ACE-2) and could possibly attack organs with high expression. With the lack of a vaccine or major treatment for the disease, palliative care is provided for individuals already infected with the virus. The aim of this review is to discuss the influence and relationship of the coronavirus, particularly SARS-CoV-2, on the respiratory system with a proposed mechanism of action in lung injury and pathogenesis.https://www.ijtmgh.com/article_110974_e0c9dce8822485eb28b8af705bca48c2.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Death at Sea: Passenger and Crew Mortality on Cruise Ships14615111959110.34172/ijtmgh.2020.25ENTravis W.HeggieBowling Green State University, School of Human Movement, Sport and Leisure Studies, Bowling Green, OH 43403, USATraceyBurton-HeggieBowling Green State University, School of Human Movement, Sport and Leisure Studies, Bowling Green, OH 43403, USAJournal Article20200909<strong>Introduction:</strong> This study reports the global occurrence of passenger and crew mortality on cruise ships. To date, no comprehensive study of passenger and crew mortality has been published.<br /> <strong>Methods:</strong> All data on passenger and crew mortality between 2000 and 2019 were obtained from 78 ocean and river cruise lines registered globally and analyzed by their age, gender, nationality, cruise line, and recorded cause of death.<br /> <strong>Results:</strong> There were 623 reported deaths. Out of all deaths, 89% were passenger deaths and 11% were crew deaths. United States residents accounted for 61% of passenger deaths and crew from India (18%) and the Philippines (17%) recorded the highest crew deaths. Falls overboard or onto lower decks (23%), suicide, murder, and a terror attack (19%), unspecified natural causes (18%), and cardiac incidents (16%) were the primary causes of passenger deaths. Suicide and murder (29%) and falls overboard or from height (24%) were the primary cause of crew member deaths. The most passenger deaths occurred on Carnival Cruise Lines (29%), Royal Caribbean Cruises (12%), and Norwegian Cruise Line (10%). The highest crew member deaths occurred on Carnival Cruise Line (19%) and Royal Caribbean Cruises (19%).<br /> <strong>Conclusion:</strong> Falls overboard or onto lower decks, cardiac incidents, and suicides are the leading cause of passenger deaths. Suicide and murder and falls are the leading cause of death for crew members. Travel health advisories targeting US citizen passengers and crew members from India and the Philippines are warranted. The addition of mental health care to ship infirmaries is also suggested.https://www.ijtmgh.com/article_119591_26a6df187682ffb94693bbe5c5d0edc3.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Travel Health - Gaps in Awareness and Practices Among Medical Interns of a Tertiary Care Hospital in India15215611960410.34172/ijtmgh.2020.26ENJyoti A.LandgeDepartment of Community Medicine, Nootan Medical College and Research Centre, Visnagar, India0000-0002-3864-048XKajalShrivastavaDepartment of Community Medicine, Dr. D. Y. Patil Medical College, Pimpri, Pune, IndiaSwatiGhongeDepartment of Community Medicine, Dr. D. Y. Patil Medical College, Pimpri, Pune, IndiaJournal Article20200622<strong>Introduction:</strong> Pretravel health assessments aim to promote risk reduction through preventive measures and safe behaviour. It also ensures that travellers are up-to-date with travel vaccine uptake. However, studies assess pretravel health-seeking practices from a variety of medical and nonmedical sources and vaccine uptake prior to travel to both developing and developed countries. The present study was an effort to address the awareness and practice of pre-travel health care among medical interns of a tertiary care hospital.<br /> <strong>Methods:</strong> A cross-sectional study was carried out in medical interns of tertiary care hospital. Study participants were Bachelor of Medicine and Bachelor of Surgery (MBBS) interns posted in the preventive medicine departments during the internship program in the same hospital. Awareness and practice of pre-travel health were assessed with help of a preformed self-assessment questionnaire.<br /> <strong>Results:</strong> Study had 59 (53.6%) males and 51 (46.4%) female respondents. All were of Indian origin and 69 (62.7%) had travelled internationally in the last 5 years. The mean age of study participants was 23.3±1.3yrs with range of 23-30 years. The majority (69.6%) of them had travelled abroad for holiday purposes. Most (73.9%) of them had travelled with family members. Out of 69 who had travelled internationally, 47 (68.1%) had visited a doctor for travel health advice prior to the trip and 29 (42%) had taken the required vaccination for the destination countries in their last international travels. The age and sex of the respondents did not have any statistically significant influence on the uptake of the travel vaccine.<br /> <strong>Conclusion:</strong> Study findings revealed inadequate awareness and practice of travel medicine among medical interns.https://www.ijtmgh.com/article_119604_1f104e7daf14d39fb270b5b75766553d.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Household Income and Children’s Depressive Symptoms: Immigrants’ Diminished Returns15716411977010.34172/ijtmgh.2020.27ENShervinAssariDepartment of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USADepartment of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA0000-0002-5054-6250Journal Article20200715<strong>Introduction:</strong> Relative to socially privileged groups, socially marginalized people experience weaker health effects of household income and other economic resources, a pattern known as Minorities’ Diminished Returns (MDRs). These MDRs are frequently seen in racial and ethnic minorities, but less is known about the relevance of such MDRs in immigrant families. To investigate the MDRs of household income on children’s depression as a function of immigration, we compared non-immigrant and immigrant children for the effect of household income on children’s depressive symptoms.<br /> <strong>Methods:</strong> This cross-sectional study was conducted across multiple cities in the United States. Baseline data from the Adolescent Brain Cognitive Development (ABCD) study collected in 2018 was used. A total of 6,412 children between the ages of 9-10 years old were included. The predictor variable was household income. The primary outcome was children’s depression measured by the Child Behavior Checklist (CBCL). Race, ethnicity, age, sex, parental marital status, parental employment, and financial difficulties were the covariates. Immigration status was the effect modifier.<br /> <strong>Results:</strong> Overall, high household income was associated with lower children’s depressive symptoms. Immigration status showed a statistically significant interaction with household income on children’s depression. This interaction term suggested that high household income has a smaller protective effect against depression for immigrant children than non-immigrant children.<br /> <strong>Conclusion:</strong> The protective effect of household income against children’s depression is diminished for immigrant than non-immigrant children.https://www.ijtmgh.com/article_119770_30056fb90b891f3fcdb85b5b44b24d06.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Capacity Development Analysis of Medical Tourism in Hospitals of Tehran, Iran16516911928510.34172/ijtmgh.2020.28ENMoslemGhasemiDepartment of Geography and Tourism Planning, Kharazmi University, Tehran, IranAliMovahedDepartment of Geography and Tourism Planning, Kharazmi University, Tehran, IranSamiraMotaghiDepartment of Economics, Payam-e-Noor University, Tehran, IranSamanehKadkhodaeiDepartment of Geography and Tourism Planning, Kharazmi University, Tehran, IranJournal Article20200624<strong>Introduction:</strong> One of the new tourism capacities of Iran in recent years is medical tourism, which has grown significantly. Tehran is one of the most important cities in the Middle East in the field of medical tourism. This study intends to analyse medical tourism capacity development in Tehran hospitals from international tourists’ perspective to identify the most efficient factors in medical tourism capacity development in Tehran hospitals.<br /> <strong>Methods:</strong> The research type is applied and the research method is descriptive-analytical. The research sample is the international medical tourists entering five major Tehran hospitals having the International Patient Department license (IPD), in which 154 samples were selected randomly from a total sample society of 258 using Cochran formula.<br /> <strong>Results:</strong> The results show that the priority areas of medical tourism capacity development in Tehran are low medical costs, optimal quality of services, easy access to medical services and physicians’ knowledge, respectively.<br /> <strong>Conclusion:</strong> In general, regarding the studied variables, it can be concluded that there is a good opportunity for medical tourism capacity development in Tehran from the international tourists’ viewpoint.https://www.ijtmgh.com/article_119285_406389571bf56b0f3762ff23f74dfaba.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101Human Ocular Onchocerca lupi Infection Diagnosed in Norway17017311935910.34172/ijtmgh.2020.29ENTirilSandellDepartment of Ophthalmology, Oslo University Hospital, Oslo, NorwayDepartment of Ophtalmology, Drammen Sykehus, Vestre Viken HF, Drammen, NorwayAnne RegineSkogenDepartment of Ophthalmology, Oslo University Hospital, Oslo, NorwayToreLierDepartment of Infectious Diseases, University Hospital of North Norway, Tromsø, NorwayRegional Advisory Unit for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevål, Oslo University Hospital, Oslo, NorwayFrank OlavPettersenRegional Advisory Unit for Imported and Tropical Diseases, Department of Infectious Diseases, Ullevål, Oslo University Hospital, Oslo, NorwayJournal Article20200531<strong>Introduction: </strong>Zoonotic <em>Onchocerca lupi </em>infection is a rare but emerging zoonotic disease affecting the eye, subcutaneous tissue and subdural cervical spine. Endemic areas of <em>O. lupi </em>are East and Central Europe, Turkey, Iran and the Northwest of the USA. Thirteen confirmed cases have been published in the world literature.<br /> <strong>Case Presentation: </strong>We present a case of subconjunctival <em>O. lupi </em>infection in the left eye of a Norwegian male. The infection was most likely imported from Turkey. The diagnosis was verified by direct microscopy and molecular analyses with polymerase chain reaction (PCR) with subsequent sequencing. The worm did not contain microfilaria and was surgically removed. The patient was treated with tapering doses of topical steroids. At 6 months follow-up, he was asymptomatic.<br /> <strong>Conclusion: </strong>Increasing numbers of <em>O. lupi </em>infections are reported and it is not clear whether the increasing number of infections is true or due to availability of novel diagnostic tools that correctly identify the cases. Humans cannot eliminate their exposure to vector-borne zoonotic diseases and increasing globalization increases the risk of infection. Both physicians and laboratory staff should be aware of the existence of zoonotic onchocerciasis in their countries.https://www.ijtmgh.com/article_119359_a16bd5312ee6827435cee0fc6d7164b3.pdfInternational Travel Medicine Center of IranInternational Journal of Travel Medicine and Global Health2322-11008420201101COVID-19 in Nepal: Diagnostic and Management Dilemma17417511947910.34172/ijtmgh.2020.30ENPramodSubediDepartment of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, Australia0000-0002-3390-9830RajivKhadgeDepartment of Pathology, Medicare National Hospital and Research Center, Kathmandu, NepalSanjogTimilsinaBeni Hospital, Myagdi, NepalCOVID-19 PCR Lab, Pokhara (PPHL), Pokhara, NepalKritikaPoudelFaculty of Health Sciences, Hokkaido University, Sapporo, Japan0000-0003-4509-5499Journal Article20201004https://www.ijtmgh.com/article_119479_bb3935a1d2ab0bc875006ca200da6eb1.pdf