14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 32.012 Session: Travel Medicine and Travel Health Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Medical tourism research: A systematic review V. Balaban 1 , C. Marano 2 1 Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA, 2 CDC, Atlanta, GA, USA Background: Medical tourism, foreign travel for the purpose of seeking medical treatment, is an important new development in healthcare. Medical tourism is a world-wide, multibillion dollar phenomenon that is expected to grow substantially in the next 5-10 years. To provide a foundation for future investigations, a systematic review was conducted to identify and evaluate current data on medical tourism and associated health impacts. Methods: PubMed, EMBASE and Medline databases and the World Wide Web were searched to identify studies of medical tourism from 1990-2009 containing data. Results: 44 studies were identified. 75% (n=33) were reports oncomplications associated with medical tourism for: commercial organ transplantation (n=30), cosmetic surgery (n=1), dental care (n=1), and fertility treatments (n=-1). There were 9 (20%) surveys of travelers and/or medical tourism providers, and 2 (4%) business studies. Methodologies used were primarily retrospective record reviews (75%) and interview surveys (23%). Studies of commercial organ transplantation reviewed 2506 cases, primarily kidney (92%) and liver (8%) transplants. China and India were the most frequent transplant destinations. Studies' results suggest an apparent increase in "transplant tourism" from 1990-2009, and higher incidence of post-operative tissue rejection and severe infectious complications among transplant tourists compared to other transplant patients. These studies are limited by lack of denominator data for transplant tourism, exclusive focus on complications, survivorship bias, and the possibility that transplant touristsmay not be representative of all medical tourists. Business studies calculate widely varying estimates of the frequency of medical tourism, ranging from 60,000-750,000 medical travelers annually. These studies are limited by variability in the definitions and methodologies used to study medical tourism. Survey studies are limited by little or no data on treatment(s) received, reasons for seeking foreign healthcare, or treatment outcomes. Conclusion: Current epidemiological data on medical tourism are limited. Basic questions such as the prevalence of medical tourism and associated complication rates have not been established. Important directions for future research include: developing consistent definitions, and conducting prospective studies of demographics, motivations, treatment outcomes, and cost benefits to better understand the healthcare implications of medical tourism.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 32.013 Session: Travel Medicine and Travel Health Date: Wednesday, March 10, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Preventing enteric fevers in London VFR travellers Y. Knight, E. Dapaah, B. Walsh South West London Health Protection Unit, London, United Kingdom Background: Enteric fevers have recently increased in the UK; 40% of the 288 cases in 2007 were in London. South West London Health Protection Unit saw a doubling of enteric fever cases from 2007 (n=16) to 2008 (n=32). An initiative has been launched in south west London to provide pre-travel health promotion, particularly for travellers visiting friends and relatives (VFR) and of Indian, Pakistani or Bangladeshi ethnicity in whom the majority of UK enteric fever cases occur. An enhanced surveillance questionnaire revealed many VFRs do not seek pre-travel health advice, particularly not from expected sources such as general practitioners or travel clinics. Enteric fever health promotion needs to be targeted at London's VFR travellers and Asian communities. Methods: We present 4 approaches to improving enteric fever health promotion. Using feedback from an enhanced surveillance questionnaire we have developed a travel health information leaflet containing typhoid/paratyphoid prevention advice aimed at VFRs. The leaflet is the first of its kind in the UK, giving food, water, hygiene and immunization advice. We performed two qualitative surveys: i) a targeted reader’s group (n=15) to ascertain the accessibility and appropriateness of the leaflet to our target population; ii) in a sample of VFR and Asian Londoners we conducted a focus group (n=8) to identify the perceived barriers to accessing travel health information, and more suitable settings for travel health promotion in this population. All work was performed in collaboration with Leicester NHS, and the Health Protection Agency’s Communications and Travel & Migrant Health Sections. Results: Of 30 cases of enteric fever in south west London in 2008, 53% were typhoid, 70% were VFR travellers, and 67% were of Asian ethnicity. Content and style of the typhoid travel health promotion leaflet was found to be accessible to our target audience; concern was raised over potentially inaccessible use of language specific to typhoid and faeces. Perceived barriers included cultural views and notions of the purpose of travel. More appropriate settings for dissemination would include community pharmacies, school nurses and community centres. Conclusion: We have developed an appropriate, innovative travel health promotion leaflet aimed at preventing typhoid/paratyphoid in London VFR travellers which is additionally tailored toward the Asian community.
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