SummaryTravelling to tropical and subtropical destinations is common among European citizens. Many of them consult their general practitioners (GPs) for pre-travel advice. Little is known about the knowledge, the sources of information and the needs of physicians. One hundred and fifty Swiss and 150 German GPs giving travel advice were interviewed using pretested telephone interviews and questionnaires to assess their knowledge about travel advice to be given for 2 frequent holiday destinations (Kenya and Thailand), and to ask which information sources were available to them. Ninety-six per cent and 89%, respectively, of GPs in 2 neighbouring areas of Switzerland and Germany gave travel advice to their clients. In telephone interviews, standard recommendations on malaria medication, as approved by the national travel advice committees, were stated by 45 and 25% of Swiss GPs, and 22 and 9% of German GPs for Kenya and Thailand. The figures for correct advice on vaccination requirements were 23 and 47% for the Swiss GPs, and 2 and 25% for the German GPs. Half of the GPs wanted to consult their documents before giving advice. The main source of information used by Swiss GPs was the monthly updated Bulletin of the Federal Office of Public Health (BFOPH). A variety of different sources was recorded among German practitioners. Regular, concise information on travel advice tops the list of requested information material in both countries. The extent of correct pre-travel advice is unsatisfactory in both study groups. Use of standardized, regularly updated and readily available sources of information on travel advice for the GP could avoid uncertainties of both the provider and the recipient of advice.keywords travel medicine, pre-travel advice, general practitioner
This case report describes an acute onset of non-length-dependent SFN potentially related to human papillomavirus vaccine administration. Literature review includes several similar case studies, and various pathological processes have been proposed for vaccine-associated polyneuropathies. Some theories describe immune-mediated hypersensitivity to the solvents/adjuvants and/or invasion of nervous system through a prolonged, less virulent infection. However, the lack requires that evidence must be carefully reviewed.
The risk of rabies in travelers to tropical countries appears to be neglected in pretravel advice provided by Swiss and German GPs. The recommendations on travel advice published in the Swiss Bulletin of the Federal Office of Public Health (BFOPH) and in the "Deutsches Arzteblatt" should be extended to "other specific health risks." In Switzerland this has now been done.
One hundred and sixty eight febrile adult outpatients were investigated at St Francis Designated District Hospital in fakara, a holoendemic area in Tanzania. We wanted to assess the potential anamnestic and clinical risk indicators for malaria and to establish a rational strategy for malaria management. Blood slide investigations showed that 14% of all patients were positive for P. falciparum. All the positive cases were found during the rainy season. No reliable criteria for malaria were found in the history taking and physical examinations. Signs and symptoms of respiratory tract infection such as difficulties during breathing, sore throat, chest pain, cough, pathological findings in lung auscultation and combinations of these were negatively associated with malaria parasitaemia. The same was true for lymph node swelling and a clinical diagnosis other than malaria. Quality control of blood slide results from the hospital revealed a sensitivity of 55%, a specificity of 72%, and positive and negative predictive values of 24% and 91%. The main recommendations for malaria management in adults were to improve the quality of blood slide examinations and to use a different diagnostic strategy during the dry and rainy seasons. During the dry season blood slides of febrile adult patients should only be performed if there is a suspicion of malaria and antimalarial drugs should only be administered if blood slide results are positive. During the rainy season all febrile adults without obvious cause of fever other than malaria should be treated with antimalarials without previous blood slide examination.
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