فهرست مطالب

Travel Medicine and Global Health - Volume:5 Issue: 3, Summer 2017
  • Volume:5 Issue: 3, Summer 2017
  • تاریخ انتشار: 1396/06/20
  • تعداد عناوین: 7
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  • Viroj Wiwanitkit Pages 72-73

    New emerging diseases usually pose big problems in medicine. At present, the Zika virus is a global public health problem attacking more than 50 countries around the world. The disease can cause dengue-like clinical problems and induce neurological abnormalities and congenital syndromes in some cases.1 From its first outbreak, the Zika infection has occurred around the world and has become the focus issue of today’s public health. McCloskey and Endericks noted that response to the Zika virus outbreak was an international issue and could be a lesson for future outbreaks.2 The movement of the disease from one setting to another is a very interesting phenomenon. Zika infection already occurs worldwide, and travel is usually mentioned in relation to the spread of disease. Human travel is usually mentioned in relation to the disease migrating from an endemic setting to a new setting causing an emerging infectious disease outbreak. The greatest concern is usually given to mass gathering events, such as the Olympic Games3-5 and Hajj.6,7 Nevertheless, the regular maintenance for disease surveillance is necessary. Tunali and Turgay8 mentioned that traveling is an important way in which disease can be transmitted from one area to another. They further stated that traveling was an important cause of the migration of the Zika virus to new settings and that international traveling could cause the migration of infectious diseases from developing countries to other regions; exotic travelers who have an exotic travel style are at an increased risk. Díaz-Menéndez et al found that travelers to endemic areas usually seek information about the risk of acquiring infectious diseases before traveling.9 Undoubtedly, the Zika virus is already known worldwide, and travel medicine clinics can be expected to be prepared for consultation and the promotion of safe travel and disease prevention during travel. Certainly, several cases of Zika virus infection have already been imported to new settings by travelers. Katanami et al suggested that a good disease surveillance system be established to prevent the importation of diseases from other areas.10 In general, the recommendation is usually to include the Zika virus infection “in the differential diagnosis, especially in febrile patients with a rash returning from an endemic area.”11 In fact, control and screening should be implemented at any international port and should focus on any direction of travel. Wiwanitkit noted that the infected case might be a traveler from either an endemic or a non-endemic area, and the traveler returning to an endemic area might carry the disease from other areas.12 Nevertheless, a usually forgotten issue is the travel of the vector of the disease. In this short editorial, the specific issues of vector importation and its relation to disease migration and occurrences in new settings are discussed. Although there are many methods for controlling disease migration, most usually focus on the migration of human hosts; very few methods are applied for vector control. Despite some attempts to control vector transportation, the occurrence of vectors in a transportation vehicle is still observable. Although disinfection might be applied, this method has proven to be ineffective in managing the problem of vector existence in international transportation vehicles.13 Due to the high volume of international transportation in the present day, the migration of disease due to vector transportation can be expected. This is a really interesting but forgotten issue in travel medicine.

    Keywords: Vectors, Transportation, Travel Medicine, Zika Virus
  • John Zhi Ming Tang, Gerard Flaherty * Pages 74-76

    Travellers are at risk of a diverse range of environmental and infectious conditions, some of which may affect the eyes and lead to blindness in severe cases. Travel-related ocular infections include onchocerciasis, leishmaniasis, cysticercosis, trachoma, dengue, loiasis, and leptospirosis. The travel medicine adviser should also recognise other hazards encountered during travel which may adversely affect the eye. These include recreational activities such as high altitude trekking, bungee jumping, skiing, scuba diving, and sun exposure. There is a subset of travellers who have underlying eye conditions, which predispose them to complications during international travel, including angle-closure glaucoma, and expansion of intraocular gas from previous vitreoretinal surgery. Contact lens wearers have a greater risk of ocular infection and corneal erosion during travel, especially where hygiene standards are low. Despite the susceptibility of the eye to infection, traumatic injury and environmental damage during international travel, this topic is not frequently discussed in the context of pre-travel consultations. Travel medicine professionals should have a reasonable knowledge of the major ocular risks associated with travel overseas.

    Keywords: Altitude, Contact Lenses, Eye Diseases, Eye Infections, Travel
  • Zahra Danial, Abbas Abbaspour *, Hamid Rahimian, Nasrin Shaarbafchi Zadeh, Mostafa Niknami Pages 77-83
    Introduction

    Today, medical tourism is becoming popularized through the upgrading of quality standards essential to providing appropriate and high quality services to those in need. Training is an essential factor in improving the current standards. Medical tourism can provide state-of-the-art treatment for patients.

    Methods

    This study is a narrative review of studies aimed at investigating the importance of training in medical tourism and to address the question of whether training in the development of medical tourism and attracting medical tourists is feasible.

    Results

    Medical tourism can provide state-of-the-art treatment for patients. Experts in the field of medical tourism can help a tourist select his/her destination country. The development of medical tourism in Iran means providing high-tech facilities and personnel who are highly-trained in medical tourism, familiarization with the culture of medical tourists, the cooperation of stakeholders, advertisement of medical tourism, and so on.

    Conclusion

    To develop medical tourism in Iran, in addition to the necessary equipment, the necessary training should also be provided, such as an introduction to medical tourism and the medical tourist and knowledge of the rules and regulations of medical tourism. Participants in training should be stakeholders in both the medical and the tourism sectors. It is necessary to design a training model for Iranian medical tourism.

    Keywords: Training, Medical tourism, staff development, Iran
  • Sri Masyeni *, Hegard Sukmawati, Lila Paramasatiari, Sri Agung Aryastuti, Ketut Agus Somia, Gede Kambayana, Nyoman Astika, Renny Duarsa, Tuti Parwati Merati Pages 84-88
    Introduction
    Diarrhea is a common illness among travelers to developing countries. Located in a tropical region, Bali has a potentially high prevalence of travelers diarrhea. This hospital-based cross-sectional study was carried out to assess the clinical and microbiological profiles of diarrhea among travelers admitted to Kasih Ibu hospital, Denpasar-Bali.
    Methods
    This study enrolled a total of 71 patients at Kasih Ibu hospital between April 2015 and August 2016. All patients completed an epidemiologic questionnaire; their clinical histories were taken, and physical examinations were performed. Stool samples were collected for bacterial and parasitologic studies and susceptibility testing.
    Results
    Most patients were female (70.4%), and the nationality of most patients was Dutch (15.5%). Secretory diarrhea was the most frequently found diarrheal type (88.7%), with only 5.6% of cases having severe dehydration which developed into acute kidney injury. A high percentage of Entamoeba spp. was also seen in this study (54.9%). Of the 37 stool samples available for microbiological testing, 62.2% showed growth; Escherichia coli was the most commonly isolated bacteria (54.1%). Patients not infected by Entamoeba spp. were found more likely to experience nausea and vomiting (P<0.005).
    Conclusion
    Secretory diarrhea was the most prevalent type of diarrhea among travelers admitted to Kasih Ibu hospital, Bali. The most frequently found pathogens were Entamoeba spp. and E. coli. Although most patients had only mild dehydration as a complication, acute kidney injury did occur in some cases.
    Keywords: Diarrhea, Entamoeba, Escherichia coli
  • Reza Azimi, Ghahraman Mahmoudi *, Habib-Allah Esmaeili Pages 89-93
    Introduction

    It is predicted that tourism will be the most profitable industry in the world in 2020. The current study aimed to evaluate the influence of advertising on attracting foreign medical tourists based on the marketing mix model.

    Methods

    In this descriptive study, participants (n=136) completed a standard questionnaire containing items on demographic characteristics and advertising practices adopted by Mashhad hospitals (13 hospitals) to attract Arabic tourists (male-female) from seven nations in the period from March 2015 to August 2016. Data description was performed using charts and tables. The software used was spss21.

    Results

    The results showed that 44.1% of medical tourists were satisfied with advertising practices. In terms of education, 85 (62.8%) tourists did not have a high school diploma. Seventy-six subjects (55.9%) were referred to hospitals by friends and acquaintances, 38.2% were referred by their physicians, and only 5.9% of tourists were attracted by other advertising methods.

    Conclusions

    According to the results, most patients did not consider advertising strategies effective, and the advertising methods seemed to be unsuccessful in attracting people with a higher education. Therefore, it is suggested that advertising practices be revised and novel methods be adopted to appeal to a greater range of potential tourists.

    Keywords: Medical tourism, Hospitals, Marketing
  • Inam Danish Khan *, Shazia Khan, Majid Ali Khan, Muhammad Shaikhoo Mustafa, MS Kidwai, Shahbaz Ali Khan, Bushra Asima Pages 94-101
    Introduction
    Hajj is an annual mass gathering of over 3.5 million pilgrims congregating from 200 countries in the desert climate of Saudi Arabia. Mass gathering medicine at Hajj is challenged by issues of healthcare accessibility, infection control, on-site treatment, referral, evacuation, and response to disasters and public health emergencies. The Indian Medical Mission at Hajj 2016 established, operated, and coordinated a strategic network of mass gathering medical operations, the proceeds of which are discussed herein.
    Methods
    The mission was designed to provide holistic health security through health intelligence for pre-existing chronic diseases, epidemic intelligence for endemic and exotic diseases, public-health and disaster-health preparedness, and tiered healthcare through mobile medical task forces, static clinics, tent clinics, secondary care hospitals, and evacuation capabilities.
    Results
    Primary care, secondary care, and tertiary care treated 374 475, 930, and 523 patients, respectively. Patients exhibited limited compliance with pre-instituted treatments and precautionary protocols. Respiratory and gastrointestinal infections, cardiorespiratory, trauma, and heat illnesses were seen. Epidemic intelligence revealed an outbreak of food poisoning. Respiratory infections were reported by 90% of the healthcare personnel. Surge capacity was overwhelmed with patient throughput and ambulance transfers. Crude unadjusted mortality was 11.99/10 000.
    Conclusion
    The Indian Medical Mission at Hajj 2016 yielded solutions to the challenges faced during the 2016 Hajj pilgrimage. The mission posture of the Indian Medical Mission in Hajj presents a modus operandi for handling crisis scenarios in mass gathering. The situational analysis of the Hajj health mission calls for dynamic interventions in preparedness, clientele, and health systems.
    Keywords: Hajj, Mass Gathering Medicine, Travel Medicine, Public Health Preparedness, Disaster Health Preparedness, Medical Mission
  • Elham Naghshineh, Parastoo Golshiri *, Zahra Hadi Sichani Pages 102-106
    Introduction
    Maintaining and promoting health during puberty is among the most important educational matters and demands sufficient awareness. This is while, the knowledge of parents in this regard and its problems is not enough. Therefore, the present study investigated the knowledge of mothers regarding their daughters’ puberty health.
    Methods
    In this cross-sectional study, the mothers of 200 girls’ aged 10-15 years and living in the center of Iran were chosen using the random sampling method and surveyed using a researcher-made questionnaire. The reliability of the questionnaire was calculated using Cronbach alpha (0.844).
    Results
    The mean score of mother’s knowledge regarding social puberty was 83.61 ± 15.38, regarding psychological puberty was 79.94 ± 20.20, regarding physical puberty was 72.22 ± 18.00, and regarding nutrition during puberty was 76.55 ± 17.60. There was a direct correlation between mother’s education and mother’s knowledge scores (P < 0.001, r = 0.285), but no significant correlation was seen between mother’s knowledge and mother’s age or father’s job.
    Conclusion
    The results indicated that mothers are well-informed of their daughters’ experience with puberty. Since mothers are considered the educational source for their daughters in most cases, their level of knowledge is important.
    Keywords: Puberty, Knowledge, Mothers, girls, Adolescent, Health, Iran