A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children

Flores, Michelle S.; Hickey, Patrick W.; Fields, Joshua H.; Ottolini, Martin G.

doi:10.1016/j.cppeds.2015.06.005

Cited by 5 publications

(4 citation statements)

References 46 publications

(82 reference statements)

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“…Nuestro caso ilustra la importancia del diagnóstico y el tratamiento temprano de la MMx. El enfoque sindromático de los síntomas inespecíficos en un paciente con antecedente epidemiológico debe ser la piedra angular del abordaje, como ha sido revisado en población pediátrica (18). Adicionalmente, se resalta la importancia de fortalecer el acercamiento a la medicina tropical en las escuelas de medicina en zonas no endémicas, particularmente en un país con alta prevalencia de enfermedades tropicales como Colombia.…”

Section: Conclusiónunclassified

Malaria mixta: a propósito del diagnóstico de un caso en zona no endémica

Barahona-Correa

Vigna

Hernández

et al. 2018

UNIVMED

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Las infecciones por malaria mixta (MMx) son frecuentemente subdiagnosticadas, a pesar de su alta morbimortalidad. La presencia de más de una especie de Plasmodium spp. y su asociación con síntomas palúdicos configura una MMx. El artículo presenta el caso de una paciente pediátrica diagnosticada con MMx en un hospital en una zona no endémica. Se hace una breve revisión del tema y su abordaje terapéutico para Colombia.

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Section: Conclusiónunclassified

Malaria mixta: a propósito del diagnóstico de un caso en zona no endémica

Barahona-Correa

Vigna

Hernández

et al. 2018

UNIVMED

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“…Typically, studies track specific spatio-temporal disease, illness and injury vectors that commonly affect tourist populations (e.g., Chen, Chang, & Chen, 2014; Leshem et al, 2016; Ratnam, Leder, Black, & Torresi, 2013), and discuss associated pathological concerns (e.g., Flores, Hickey, Fields, & Ottolini, 2015; Matteelli, Centis, Sulis, & Tadolini, 2016; Salazar-Austin et al, 2015). Comprehensive statistical data about tourists’ use of health care abroad and their health outcomes is, however, mostly sparse and dated (Angelo, Kozarsky, Ryan, Chen, & Sotir, 2017).…”

Section: Introductionmentioning

confidence: 99%

A challenging entanglement: health care providers’ perspectives on caring for ill and injured tourists on Cozumel Island, Mexico

Hoffman

Crooks

Snyder

2018

International Journal of Qualitative Studies on Health and Well

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Purpose: Despite established knowledge that tourists often fall ill or are injured abroad, little is known about their treatment. The intent of this study was to explore health care professionals’ treatment provision experiences on Cozumel Island, Mexico. Methods: 13 semi-structured interviews were undertaken with professionals across a number of health care vocations on Cozumel Island. Interviews were transcribed and thematically analysed to determine common challenges faced in the provision of treatment for transnational tourists. Results: Three thematic challenges emerged from the data: human and physical resource deficiencies, medical (mis)perceptions held by patients and complexities surrounding remuneration of care. Health care providers employ unique strategies to mitigate these challenges. Conclusion: Although many of these challenges exist within other touristic and peripheral spaces, we suggest that the challenges experienced by Cozumel Island’s health care professionals, and their mitigation strategies, exist as part of a complex entanglement between the island’s health care sector and its dominant tourism landscape. We call on tangential tourism services to take a larger role in ensuring the ease of access to, and provision of quality health care services for tourists on Cozumel Island.

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“…12 Eliciting a travel history is especially relevant in pediatric settings because children travel for shorter durations of time and are less likely to receive pretravel medical advice. 4,5,13 Prior research has commented on the frequency at which general practitioners record travel histories from patients who require acute medical care 1 ; however, few studies have focused on travel histories in pediatrics. Previously at our institution, a simulation study was conducted with first-year pediatric resident physicians and medical students to endorse the necessity of travel histories, which found that travel histories are not commonly asked for.…”

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confidence: 99%

“…One tertiary care center found that pediatric patients with malaria often are misdiagnosed as acute gastroenteritis, which can occur without knowledge of recent travel 12 . Eliciting a travel history is especially relevant in pediatric settings because children travel for shorter durations of time and are less likely to receive pretravel medical advice 4,5,13 …”

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confidence: 99%

Do We Know Where They Go? Obtaining Travel History in Pediatric Patients

Chilukuri¹,

Orr²,

Blakemore³

et al. 2021

Southern Medical Journal

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Objective: To determine how often travel histories are obtained in pediatric patients.Methods: A retrospective medical record review was performed at a single tertiary care children's hospital for patients aged 2 months to 18 years who were admitted October 2015-December 2017 with International Classification of Diseases, 10th Revision codes for potential travel-related illnesses. Demographic information and travel history documentation were obtained, along with travel-related testing. From May to June 2018, prospective, single-blinded, direct observation of a convenience sample of pediatric residents was performed during the initial patient encounter to determine the frequency and quality of travel histories obtained regardless of documentation.Results: Of 249 charts reviewed, 27 (10.8%) patients had a travel history query documented. Patients with complex chronic conditions were significantly less likely to have a travel history documented (37% vs 67%; P = 0.005). Age, sex, length of stay, race, payer status, and critical care admission did not significantly differ between groups. Those with a travel history documented were more likely to have a documented exposure history (100% vs 52%; P < 0.001) and additional testing performed (56% vs 13%, P < 0.001). During this time, a simulation course with residents featuring travel-related diagnoses led to a significant increase in documented travel histories (5% prior versus 21% after, P = 0.03). A total of 37 patient encounters were observed; travel history was asked for 4 times (4/37, 10.8%).Conclusions: Travel histories are rarely asked for in pediatric patients. Missed diagnoses may not only affect the patient but also have broader public health implications. Simulation is an effective tool to improve history-taking skills, yet more work is still needed.

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A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children

Cited by 5 publications

References 46 publications

Malaria mixta: a propósito del diagnóstico de un caso en zona no endémica

Malaria mixta: a propósito del diagnóstico de un caso en zona no endémica

A challenging entanglement: health care providers’ perspectives on caring for ill and injured tourists on Cozumel Island, Mexico

Do We Know Where They Go? Obtaining Travel History in Pediatric Patients

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