Retrospective analysis of older travellers attending a specialist travel health clinic

Darrat, Milad; Flaherty, Gerard

doi:10.1186/s40794-019-0094-8

Cited by 8 publications

(3 citation statements)

References 43 publications

(43 reference statements)

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“…The rapid global spread of the SARS-CoV-2 infection has challenged traditional efforts to communicate medical information in a timely manner to older patients living with chronic illness. The majority of older travellers attending a specialist travel clinic in Ireland were found to have a pre-existing medical condition [ 16 ]. In the early stages of this pandemic, many adults with co-morbid diseases were poorly aware of COVID-19 and had not adapted their routines or self-management plans [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

Flaherty

Hession

Liew

et al. 2020

Trop Dis Travel Med Vaccines

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Background: A high burden of severe disease and death from the coronavirus disease 2019 (COVID-19) has been consistently observed in older patients, especially those with pre-existing medical co-morbidities. The global pandemic lockdown has isolated many patients with chronic illnesses from their routine medical care. This narrative review article analyses the multitude of issues faced by individuals with underlying medical conditions during the COVID-19 pandemic. Methods: Sources for this publication were identified through searches of PubMed for articles published between 31st December 2019 and 4th June 2020, using combinations of search terms. Guidelines and updates from reputable agencies were also consulted. Only articles published in the English language were included. Results: The volume of literature on COVID-19 continues to expand, with 17,845 articles indexed on PubMed by 4th June 2020, 130 of which were deemed particularly relevant to the subject matter of this review. Older patients are more likely to progress to severe COVID-19 disease requiring intensive care unit (ICU) admission. Patients with preexisting cardiovascular disease, especially hypertension and coronary heart disease, are at greatly increased risk of developing severe and fatal COVID-19 disease. A controversial aspect of the management of COVID-19 disease has been the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Obese COVID-19 patients are more likely to require complex ICU management. Putative mechanisms of increased COVID-19 disease severity in diabetes include hyperglycaemia, altered immune function, sub-optimal glycaemic control during hospitalisation, a pro-thrombotic and pro-inflammatory state. Patients with mental health disorders are particularly vulnerable to social isolation, and this has been compounded by the suspension of non-emergency care in hospitals around the world, making it difficult for patients with chronic mental illness to attend outpatient appointments.

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Section: Resultsmentioning

confidence: 99%

COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

Flaherty

Hession

Liew

et al. 2020

Trop Dis Travel Med Vaccines

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“…South Eastern Asia and South America as popular destinations, travel duration of 3 weeks, mostly traveling for leisure or visiting friends or family) as in this ELDEST cohort. 59 …”

Section: Discussionmentioning

confidence: 99%

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

Vlot

Vive

Brockhoff

et al. 2020

Journal of Travel Medicine

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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.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Itzkowitz,

Alpert,

Farojeh

et al. 2023

TropicalMed

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Information regarding post-travel morbidity is usually reported via dedicated post-travel clinics and mainly relates to travelers returning from low–middle-income countries (LMIC), however, the spectrum of morbidity seen within the community setting is scarcely reported. This prospective observational study among visitors to 17 community Urgent Care Centers (UCC) was designed to evaluate the reasons for post-travel community clinic visits and to compare travelers returning from LMIC to high-income countries (HIC). All visitors within one-month post-travel to all destinations were included. A total of 1580 post-travel visits were analyzed during 25 months. Travelers to LMICs were younger (mean 36.8 years old vs. 41.4 in the HIC group) and stayed longer periods abroad (30.1 ± 41.2 vs. 10.0 ± 10.6 in the HIC group) but more of them had pre-travel vaccines (35.5% vs. 6.6%). Travel-related morbidity was significantly more common in the LMIC group 58.3% (253/434) vs. 34.1% (391/1146) in the HIC group, (p < 0.001). Acute diarrhea was the leading cause of morbidity after visiting LMIC (28.8%) and was significantly more common than in the HIC (6.6%, p < 0.001). Other common morbidities in the LMIC cohort were respiratory (23.3%), cutaneous (15.8%), and injuries (9.9%). In the HIC group, the common morbidities were respiratory (37.3%), and diarrhea composed only 6.6% of the complaints. Our study group represents a less biased sample of travelers to LMIC as well as HIC, therefore, data from the UCC setting and at the specialized travel clinics complete each other in understanding the true extent of morbidity in travelers.

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Retrospective analysis of older travellers attending a specialist travel health clinic

Cited by 8 publications

References 43 publications

COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

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

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

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