Travel Medicine and Infectious Disease最新文献

{"title":"Travel-associated carbapenemase-producing Enterobacterales: Epidemiology and risk factors in a Finnish cohort","authors":"Mikael Kajova ,&nbsp;Tamim Khawaja ,&nbsp;Katariina Kainulainen ,&nbsp;Anu Kantele","doi":"10.1016/j.tmaid.2025.102926","DOIUrl":"10.1016/j.tmaid.2025.102926","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing Enterobacterales (CPE) are increasing worldwide, with strains associated with difficult-to-treat infections. We previously reported that international travel is a major source of CPE acquisition in the Helsinki region, Finland. To clarify the extent of importation, we investigated the epidemiology and associated risk factors of foreign-acquired CPEs.</div></div><div><h3>Methods</h3><div>We revisited two earlier cohorts. Cohort A (n = 187 after a one-year extension) comprised patients from 2010 through 2024 presumed to have acquired CPE abroad; CPE types were categorized by travel region. Cohort B included 3029 patients screened for CPE from 2010 through 2019 within 12 months after hospitalization abroad. Multivariable analysis identified factors that predispose to colonization.</div></div><div><h3>Results</h3><div>Among patients hospitalized abroad (Cohort B), CPE rates were particularly high for South Asia (14.6 %) and North Africa (13.7 %). Across the 24 individual countries with data, the highest CPE colonization risks were observed for Egypt (20.8 %) and India (16.4 %). In addition to destination, independent risk factors included antibiotic use, travel type, short interval between discharge from a foreign hospital and screening (within one week or one month) and male sex. For South/Southeast Asia and sub-Saharan Africa, over 70 % of CPE carriers (Cohort A) had metallo-β-lactamase-producing Enterobacterales, predominantly NDM, whereas OXA-48–like enzymes predominated in North Africa and the Middle East.</div></div><div><h3>Conclusions</h3><div>Hospitalization in high-prevalence countries and antibiotic use emerged as key risk factors for CPE acquisition. Regional variation was evident: OXA-48–like enzymes dominated among CPEs linked to the Middle East and North Africa, whereas NDM was prevalent elsewhere in Eurasia and Africa.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102926"},"PeriodicalIF":4.7,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of dihydroartemisinin-piperaquine for treating Plasmodium falciparum malaria from sub-Saharan Africa: a retrospective study","authors":"Federica Ciminelli ,&nbsp;Dora Buonfrate ,&nbsp;Cristina Mazzi ,&nbsp;Andreas Neumayr ,&nbsp;Daniel Camprubí-Ferrer ,&nbsp;Federico Gobbi","doi":"10.1016/j.tmaid.2025.102923","DOIUrl":"10.1016/j.tmaid.2025.102923","url":null,"abstract":"<div><h3>Background</h3><div>Artemisinin-based combination therapies (ACTs) are the recommended first-line treatment for uncomplicated malaria. However, growing reports of artemisinin resistance, particularly in Southeast Asia, raise concerns about the efficacy of ACTs. This study aimed to assess potential changes over time in the effectiveness of a three-day regimen of dihydroartemisinin-piperaquine (DHA-PPQ) for treating imported uncomplicated <em>Plasmodium falciparum</em> malaria.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted. We reviewed the records of patients treated for uncomplicated <em>P. falciparum</em> malaria in a single centre in Italy (2013–2024). The inclusion criteria were treatment with DHA-PPQ and available data on parasitaemia at baseline and on day three. The primary objective was to determine the rate of parasitaemia clearance on day three.</div></div><div><h3>Results</h3><div>All 90 patients but one were infected in sub-Saharan Africa. We excluded the patient infected in Yemen to obtain a more homogenous cohort. Baseline median parasitaemia was 0.136 % (IQR 0.029–0.750). On day 3, only 6 patients (6.7 %) still had circulating parasites, though in absence of early treatment failure. Follow-up data (available for 63 patients) excluded also late parasitological failures. No significant trend in day-3 positivity was observed across the three study periods (2013–2015, 2016–2019, 2020–2023; <em>p</em> = 0.339).</div></div><div><h3>Conclusions</h3><div>This study revealed no significant reduction in the effectiveness of DHA-PPQ over time for the treatment of uncomplicated <em>P. falciparum</em> malaria imported from Africa. While ACT failure remains rare in sub-Saharan Africa, continued surveillance is essential, especially to monitor resistance trends and inform treatment protocols.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102923"},"PeriodicalIF":4.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptospirosis in the United Kingdom: a decade of experience from a large regional hospital","authors":"Andrew Taylor ,&nbsp;Paul N. Newton ,&nbsp;Ivo Elliott","doi":"10.1016/j.tmaid.2025.102920","DOIUrl":"10.1016/j.tmaid.2025.102920","url":null,"abstract":"<div><h3>Background</h3><div>Leptospirosis is one of the most common bacterial zoonoses worldwide, with a broad spectrum of illness from mild and self-resolving to multi-organ failure and death. There have been few reports of the epidemiology, clinical features and outcomes of the disease in the United Kingdom.</div></div><div><h3>Methods</h3><div>We present experience of 29 patients with confirmed leptospirosis from 924 tested patients over a 10-year period at a large tertiary hospital in the UK.</div></div><div><h3>Results</h3><div>All patients reported a fever and eit travel overseas in the 6 weeks prior to illness, or documented exposure to water or animals in the UK. Acute kidney injury occurred in 18/29 (62 %), 6 patients (20 %) required admission to the intensive care unit and 1 died. There were no recorded acquired UK cases during winter when water temperatures are usually below 10 °C.</div></div><div><h3>Conclusions</h3><div>Epidemiological awareness and documented exposure history may increase the proportion of positive tests and offer potential laboratory cost savings.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102920"},"PeriodicalIF":4.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, therapeutic, and stigma-related challenges in leprosy and the emerging role of apremilast in managing leprosy reactions","authors":"Diego Gayoso Cantero ,&nbsp;Pablo Fernández-González ,&nbsp;Sandra Chamorro-Tojeiro ,&nbsp;Carmen Quereda ,&nbsp;Marta Tato ,&nbsp;Emilio Berna-Rico ,&nbsp;Jorge Naharro-Rodríguez ,&nbsp;Jose A. Perez-Molina","doi":"10.1016/j.tmaid.2025.102918","DOIUrl":"10.1016/j.tmaid.2025.102918","url":null,"abstract":"<div><div>Leprosy is a chronic granulomatous infection caused by <em>Mycobacterium leprae</em> (or <em>M. lepromatosis</em>) that targets macrophages and Schwann cells. The resulting neuropathy and skin lesions can lead to lifelong deformities and disabilities. Despite being poorly transmissible and readily treatable, leprosy remains a neglected disease. Management is hampered by delayed diagnosis, multidrug resistance, recalcitrant leprosy reactions, and entrenched social stigma. We report a case of imported multidrug-resistant borderline lepromatous leprosy that progressed with recurrent, steroid-dependent erythema nodosum leprosum (ENL). The patient experienced multiple toxicities secondary to the medications used for treating leprosy and managing ENL. Disease was controlled through a clofazimine–clarithromycin–minocycline regimen combined with the phosphodiesterase-4 inhibitor apremilast, enabling complete withdrawal of corticosteroids and thalidomide while maintaining sustained clinical and microbiological remission. We examine the key clinical challenges in managing this patient and summarise current evidence, including a literature review on apremilast as treatment for refractory leprosy reactions.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102918"},"PeriodicalIF":4.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application value of droplet digital PCR detection of Em-cfDNA in the diagnosis of hepatic alveolar echinococcosis","authors":"Yuan Jiang ,&nbsp;Lingqiang Zhang ,&nbsp;Yaogang Zhang ,&nbsp;Jing Hou ,&nbsp;Zhixin Wang ,&nbsp;Tao Zhang ,&nbsp;Zihan Yang ,&nbsp;Tingting Jia ,&nbsp;Zhiqin Li ,&nbsp;Li Sun ,&nbsp;Yuhu Hou ,&nbsp;Haining Fan ,&nbsp;Yanyan Ma","doi":"10.1016/j.tmaid.2025.102912","DOIUrl":"10.1016/j.tmaid.2025.102912","url":null,"abstract":"<div><h3>Background</h3><div>Alveolar echinococcosis (AE), a parasitic disease caused by the <em>Echinococcus multilocularis</em> (<em>E. multilocularis</em>), primarily affects the liver and has the potential to spread to other organs, which can be quite invasive. This disease has been receiving increasing attention on a global scale. The objective of this study is to evaluate the clinical value of droplet digital polymerase chain reaction (ddPCR) technology in the diagnosis of hepatic alveolar echinococcosis (HAE) through the detection of plasma and to explore the relationship between ddPCR quantitative results and lesion size and staging.</div></div><div><h3>Methods</h3><div>Researchers collected blood samples from 57 confirmed HAE patients and 34 control samples from individuals without AE. Subsequently, ddPCR was utilized to detect <em>E. multilocularis</em> circulating free DNA (Em-cfDNA) in the plasma. Furthermore, next-generation sequencing (NGS) and antibody tests were utilized as comparative methods.</div></div><div><h3>Results</h3><div>The sensitivity of ddPCR was found to be 91.22 %, with a 100 % specificity, thereby demonstrating superiority over conventional serum antibody tests, which exhibited a sensitivity of 89.50 % and a specificity of 85.3 %. ddPCR demonstrated a comparable performance to NGS testing, which also demonstrated a sensitivity of 89.50 % and a 100 % specificity.</div></div><div><h3>Conclusions</h3><div>ddPCR is characterized by its ease of operation and cost-effectiveness. It also holds significant value for screening in resource-limited areas, thereby helping to improve early diagnosis rates for HAE and enhance patient prognosis. Subsequent research endeavors will concentrate on the refinement of this technology and the validation of its applications in the domains of diagnosis, monitoring, and follow-up.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102912"},"PeriodicalIF":4.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel Healthy, a mobile app for participatory surveillance among U.S. international travelers","authors":"Andrés Colubri ,&nbsp;Nicole Willing ,&nbsp;Andonaq Grozdani ,&nbsp;Yinan Dong ,&nbsp;Hung Hong ,&nbsp;Mansi Khandpekar ,&nbsp;Elizabeth Oliver ,&nbsp;Julie Thwing ,&nbsp;Edward T. Ryan ,&nbsp;Regina C. LaRocque","doi":"10.1016/j.tmaid.2025.102922","DOIUrl":"10.1016/j.tmaid.2025.102922","url":null,"abstract":"<div><h3>Background</h3><div>Global travel plays a role in the spread of infectious diseases. Existing travel surveillance programs collect data before and after trips, resulting in data incompleteness and recall bias. We developed the Travel Healthy mobile app to address these gaps, by enabling U.S. travelers to report daily symptom surveys including GPS location. The app offers traveler tools, including outbreak notices, a travel wallet, and a malaria medication reminder.</div></div><div><h3>Methods</h3><div>We developed Travel Healthy following a user-centric approach. We recruited study participants through an online platform and at the Travelers’ Advice and Immunization Center at Massachusetts General Hospital, between July 2023 and August 2024. We analyzed demographic, GPS, and self-reported symptom data from the first 50 participants. Data were collected starting one day before the trip and ending three days after. A post-travel feedback survey was performed.</div></div><div><h3>Results</h3><div>Participants visited 204 locations in Asia, Africa, the Americas, and Europe. Mean age was 33 years and 66 % were female. The most common purposes of travel were leisure and/or business, with 46 (92 %) of participants listing these as traveling reasons. A total of 755 daily symptom surveys were entered, with 105 reporting symptoms, corresponding to 29 of the 50 (58 %) participants. Among all symptoms with GPS data, 58 % were upper respiratory symptoms, 25 % were gastrointestinal (clustered in South Asia), and 17 % were other. Post-travel questionnaires showed that participants found the application easy to use.</div></div><div><h3>Conclusion</h3><div>This pilot study underscores the potential of participatory surveillance tools to complement traditional public health surveillance methods for travel-related illness.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102922"},"PeriodicalIF":4.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of contact tracing interventions for international arrivals by air, sea, or land","authors":"Rosalie Allison ,&nbsp;Anjali Pai ,&nbsp;Bharat Sibal ,&nbsp;Robert Sookoo ,&nbsp;Sarah R. Anderson","doi":"10.1016/j.tmaid.2025.102924","DOIUrl":"10.1016/j.tmaid.2025.102924","url":null,"abstract":"<div><h3>Introduction</h3><div>As part of the public health response, one role of health protection specialists is to identify contacts of people who have travelled whilst infectious, and provide advice or other public health actions.</div><div>This paper aims to review the latest evidence for contact tracing of specific infectious diseases on incoming international travel by air, sea, or land. Twenty key gastrointestinal, respiratory, rash, and high consequence infectious diseases were included in this systematic review.</div></div><div><h3>Methods</h3><div>Electronic databases were systematically searched for studies published between 2008 and 2023, that focused on people arriving from international destinations with an infectious disease, and their contacts. Results were exported to Endnote; duplicates removed; eligible studies identified and critically appraised by two independent reviewers; and data extracted. Due to heterogeneity across studies, results were presented narratively.</div></div><div><h3>Results</h3><div>There was some evidence for contact tracing to reduce community transmission for international arrivals by aircrafts, but less rigorous evidence for those arriving by sea-vessels, and even less for ground crossings.</div></div><div><h3>Conclusions</h3><div>Informed by this systematic review, public health agencies should consider developing or reviewing their national disease-specific guidance, ensuring guidance for all key modes of international transport is included. Higher quality studies are required to inform the effectiveness of contact tracing for preventing further transmission related to international travel. Strategic efforts should continue to concentrate on improving the relationship between public health organisations and transport providers to facilitate timely public health actions.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102924"},"PeriodicalIF":4.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ZIeKA monitor study: travel-related arbovirus infections among Dutch travellers, 2018–2020","authors":"Chiara de Bellegarde de Saint Lary ,&nbsp;Marieke L.A. de Hoog ,&nbsp;Lotte Jonker ,&nbsp;Johan Reimerink ,&nbsp;Renée A.H. van Schaijk ,&nbsp;Leo G. Visser ,&nbsp;Susan Hahné ,&nbsp;Patricia C.J.L. Bruijning-Verhagen","doi":"10.1016/j.tmaid.2025.102921","DOIUrl":"10.1016/j.tmaid.2025.102921","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to estimate the incidence of arbovirus infections among Dutch travellers and subsequent potential risk of importation.</div></div><div><h3>Methods</h3><div>For this prospective, fully remote study, Dutch travellers visiting arbovirus endemic countries between August 2018 to March 2020 were recruited through (social) media and travel-clinics. Interested travellers could register online. Participants completed questionnaires and kept a daily symptom log during travel using a custom-made study app. Travellers reporting symptoms suggestive of arbovirus infection were invited to self-collect a dry-blood spot sample (DBS) upon return. In a sub-cohort of participants, post-travel DBS were also collected if asymptomatic. Participants mailed the DBS to the laboratory to be tested by PCR for ZIKV, DENV and CHIKV, along with IgG and IgM antibody testing.</div></div><div><h3>Results</h3><div>Of 1222 subjects registering online, 737 (60.3 %) completed the baseline questionnaire and ≥60 % of symptom diaries and were included in the analysis. Arbovirus-like symptoms were reported by 73 participants (9.9 %). A post-travel DBS was obtained from 67 symptomatic and 154 asymptomatic travellers. None were RT-PCR positive for ZIKV, DENV or CHIKV. Two symptomatic travellers were IgM positive indicating probable recent arbovirus infection. An additional ten cases were IgG positive/IgM negative suggesting possible previous arbovirus exposure. The estimated incidence proportion and rate of travel-related arbovirus infection were 2.7–16.3/1000 trips and 3.9–23.4/1000 person-months, respectively.</div></div><div><h3>Conclusion</h3><div>While a small proportion of travellers to arbovirus endemic areas have evidence of recent infection, the risk of arbovirus importation by returning travellers appears low as viraemia was not detected in any participant upon return.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102921"},"PeriodicalIF":4.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and outcomes of dengue and scrub typhus in hospitalized adults in the Maldives","authors":"Rajib Kumar Dey ,&nbsp;Fernando Mosler ,&nbsp;Rifau Adam ,&nbsp;Isha Ali ,&nbsp;Aishath Sausan ,&nbsp;Zaidhoon Jaleel ,&nbsp;Rashda Mahir ,&nbsp;Izza Abdul Habeeb ,&nbsp;Aishath Maeesha ,&nbsp;Nihla Ali Rasheed ,&nbsp;Aminath Aroosha ,&nbsp;Wasin Matsee ,&nbsp;Hisham Ahmed Imad","doi":"10.1016/j.tmaid.2025.102914","DOIUrl":"10.1016/j.tmaid.2025.102914","url":null,"abstract":"<div><h3>Background</h3><div>Dengue and scrub typhus are common causes of acute undifferentiated febrile illness in the Maldives.</div></div><div><h3>Methods</h3><div>This retrospective study compared the clinical characteristics of 184 hospitalized adults diagnosed with dengue (n = 94) or scrub typhus (n = 90) at a national referral hospital in the Maldives. Clinical data were collected from 2013 to 2021 for scrub typhus and from 2018 to 2021 for dengue, identified using ICD-10 codes from both physical and electronic records. National dengue and scrub typhus data from 2015 to 2024 were obtained from the Health Protection Agency of the Maldives.</div></div><div><h3>Results</h3><div>Scrub typhus patients were generally older, with a median age of 42.5 years compared to 27 years in dengue, were more often locals, and tended to present later in the course of illness, on day 10 compared to day 4. Furthermore, scrub typhus patients experienced more complications, 23.9 % compared to 3.2 % in dengue, which resulted in longer hospital stays. An eschar was observed in 63.1 % of scrub typhus cases, serving as a useful diagnostic clue. In contrast, dengue patients more often presented with chills, myalgia, arthralgia, bleeding, and thrombocytopenia. There were no fatalities in this cohort.</div></div><div><h3>Conclusions</h3><div>In acute undifferentiated febrile illness in the Maldives, certain clinical indicators, including eschar for scrub typhus and bleeding with severe thrombocytopenia can aid in bedside diagnosis. Identifying these features can help clinicians in resource-limited settings provide timely and appropriate care.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102914"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ready for takeoff? exploring United States health care providers’ pretravel consultation priorities, gaps, barriers, and opportunities","authors":"Katherine A. Reifler ,&nbsp;Swati S. Sharma ,&nbsp;Nicholas A. Bergren ,&nbsp;Elizabeth D. Barnett ,&nbsp;Lin H. Chen ,&nbsp;Jeffery A. Goad ,&nbsp;William B. Macleod ,&nbsp;Laura Kogelman ,&nbsp;Davidson H. Hamer","doi":"10.1016/j.tmaid.2025.102911","DOIUrl":"10.1016/j.tmaid.2025.102911","url":null,"abstract":"<div><div>Pretravel consultation by healthcare providers (HCPs) with travel medicine expertise can mitigate travel-related health risks. This analysis aimed to understand US-based HCPs' pretravel consultation educational gaps, priorities, barriers, and opportunities. An electronic survey was conducted May–June 2024, using a convenience sample of HCPs identified through the Med Learning Group and travel specialists from the International Society of Travel Medicine and American Society of Tropical Medicine and Hygiene. In total, 205 HCPs completed the survey, including physicians (50 %), nurse practitioners (19 %), nurses (12 %), pharmacists (11 %), physician associates (7 %). Most (66 %) provided pretravel consultations and only 21 % held formal travel medicine certification. HCPs not providing pretravel consultation were less comfortable with traveler's diarrhea self-treatment, malaria chemoprophylaxis, altitude illness prevention, yellow fever, Japanese encephalitis, rabies, and typhoid vaccination management. The most desired topics for education were travel vaccinations (94, 46 %), travel medicine insurance (89, 43 %), and altitude illness prevention (86, 42 %). Major barriers to providing pretravel consultation were lack of clarity about reimbursement (110, 54 %), lack of insurance coverage (89, 43 %), and inability to stock travel vaccines (73, 36 %). Top interventions suggested to increase access to and awareness of pretravel consultation included primary care physician education and community outreach. Most HCPs were interested in pretravel educational opportunities, but comfort varied by experience and certification, highlighting need for targeted training, especially for primary care providers. Top barriers were insurance coverage for pretravel consultation and access to travel vaccines, underscoring critical gaps in the US healthcare system.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"68 ","pages":"Article 102911"},"PeriodicalIF":4.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}