Predicting morbidity in older travellers during a short-term stay in the tropics: the ELDEST study

Abstract

Background: Older persons may suffer more from travel-related health problems because of aging and underlying chronic disorders. Knowledge on who is more likely to have these health problems helps to tailor travel health advice more specifically. This study aimed to determine predictors of travel-related morbidity in older travelers by assessing their pre-travel characteristics and performance using physical and cognitive functioning tests. Methods: Multicenter prospective cohort study among older travelers (≥60 years) who consulted one of the participating Dutch travel clinics. Handgrip strength and cognitive performance were measured pre-travel. Participants completed questionnaires before departure and one and four weeks after return. A diary recorded health complaints during travel until two weeks post-travel. Results: 477 travelers completed the study (follow-up rate of 97%). Participants’ median age was 66 years. The most visited regions were South-East Asia (34%) and South Asia (14%). Median travel duration was 19 days. Polypharmacy (≥5 medications per day) was not uncommon (16%). The median Charlson Comorbidity Index (CCI) score was 0. Self-reported travel-related infectious diseases concerned primarily respiratory tract infections (21%) and gastroenteritis (10%), while non-infectious complaints were injuries (13%), peripheral edema (12%), and dehydration (3%). Medical assistance was sought by 18%, mostly post-travel from their general practitioner (87%). Self-reported physical and mental health-related quality of life significantly improved during and after travel. Predictors for an increased risk of travel-related morbidity were higher CCI score, more travel experience, longer travel duration, higher number of daily medications, visiting northern Africa or South-East and East Asia, and phone- and social media use. Conclusions: Older Dutch travelers are generally fit, well-prepared and suffer not only from common infectious health problems, but also from injuries. Travel improved their self-perceived health. The predictors could be used to identify the more at-risk older traveler and to decrease travel-related morbidity by optimizing pre-travel advice.

Hospital-Based Care And/Or Death Followed by Repatriation in Dutch Travelers: The HAZARD Study

“…In a study of Wieten et al 26% of the travelers visiting the travel clinic for pre-travel advice had a medical condition (often cardiovascular); this was doubled in older travelers [39]. However, in a prospective cohort study we found that exacerbations of pre-existing illness as a health problem while being abroad was only rarely reported by older travelers to the tropics [30]. In addition, the post-travel health status of affected travelers was unknown since no (medical) follow up was done by the MAC after discharging from the hospital or after the repatriation.…”

“…Individuals with known or high risk for mental illness can travel, but are strongly advised to discuss their travel plan with a mental health professional [27,28]. Rofaiel et al [29] reported that very few mental health patient organizations have pre-travel information available online, while travel can have both negative and positive effects on (mental) health [30]. It is estimated that 10-20% of all repatriations concerned Data are presented as N (%).…”

Do people living with HIV travel safely? Assessment of travel patterns and advice‐seeking behaviour in a cohort of people living with HIV in Belgium

“…In addition, across Europe, the average age of PLWH is increasing [2]; there are multiple lines of evidence that comorbidities are highly prevalent in ageing PLWH, adding age-related risks to HIV-related vulnerabilities [1,17]. Within the subpopulation treated with cardiovascular and/or diabetic drugs, the rate of pre-travel consultation was not higher, which means that these patients may not be aware of their increased vulnerability.…”

Morbidity of Returning Travelers Seen in Community Urgent Care Centers throughout Israel

“…Although the COVID pandemic caused a significant decline in worldwide travel [ 2 , 3 , 4 ], the growth in international travel is spiking again. Over the years, the profile of the passengers has also changed and includes an increasing number of children and the elderly, those with chronic illnesses, and an increased rate of travel to exotic destinations, including low–middle-income countries (LMIC) [ 5 , 6 , 7 , 8 , 9 ]. Information about travel-related morbidity is important for health practitioners to diagnose disease in returning travelers and for consulting those seeking pre-travel advice.…”