• 1.

    Toovey S, Jamieson A, Holloway M, 2004. Travelers’ knowledge, attitudes and practices on the prevention of infectious diseases: results from a study at Johannesburg International Airport. J Travel Med 11: 1622.

    • Search Google Scholar
    • Export Citation
  • 2.

    Van Herck K et al., 2004. Knowledge, attitudes and practices in travel-related infectious diseases: the European airport survey. J Travel Med 11: 38.

    • Search Google Scholar
    • Export Citation
  • 3.

    Kittitrakul C, Lawpoolsri S, Kusolsuk T, Olanwijitwong J, Tangkanakul W, Piyaphanee W, 2015. Traveler’s diarrhea in foreign travelers in Southeast Asia: a cross-sectional survey study in Bangkok, Thailand. Am J Trop Med Hyg 93: 485490.

    • Search Google Scholar
    • Export Citation
  • 4.

    Hamer DH, Connor BA, 2004. Travel health knowledge, attitudes and practices among United States travelers. J Travel Med 11: 2326.

  • 5.

    Lopez-Velez R, Bayas JM, 2007. Spanish travelers to high-risk areas in the tropics: airport survey of travel health knowledge, attitudes, and practices in vaccination and malaria prevention. J Travel Med 14: 297305.

    • Search Google Scholar
    • Export Citation
  • 6.

    Van Herck K, Zuckerman J, Castelli F, Van Damme P, Walker E, Steffen R, 2003. Travelers’ knowledge, attitudes, and practices on prevention of infectious diseases: results from a pilot study. J Travel Med 10: 7578.

    • Search Google Scholar
    • Export Citation
  • 7.

    Hill DR, 2000. Health problems in a large cohort of Americans traveling to developing countries. J Travel Med 7: 259266.

  • 8.

    LaRocque RC, Rao SR, Tsibris A, Lawton T, Barry MA, Marano N, Brunette G, Yanni E, Ryan ET, 2010. Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport. J Travel Med 17: 387391.

    • Search Google Scholar
    • Export Citation
  • 9.

    Hartjes LB, Baumann LC, Henriques JB, 2009. Travel health risk perceptions and prevention behaviors of US study abroad students. J Travel Med 16: 338343.

    • Search Google Scholar
    • Export Citation
  • 10.

    Kupper T, Rieke B, Neppach K, Morrison A, Martin J, 2014. Health hazards and medical treatment of volunteers aged 18–30 years working in international social projects of non-governmental organizations (NGO). Travel Med Infect Dis 12: 385395.

    • Search Google Scholar
    • Export Citation
  • 11.

    Vora N, Chang M, Pandya H, Hasham A, Lazarus C, 2010. A student-initiated and student-facilitated international health elective for preclinical medical students. Med Educ Online 15.

    • Search Google Scholar
    • Export Citation
  • 12.

    Maltezou HC, Pavli A, 2018. Adolescents traveling to high-risk destinations: review and considerations for clinicians. Int J Travel Med Glob Health 6: 141148.

    • Search Google Scholar
    • Export Citation
  • 13.

    Hagmann S, Neugebauer R, Schwartz E, Perret C, Castelli F, Barnett ED, Stauffer WM, 2010. Illness in children after international travel: analysis from the GeoSentinel Surveillance Network. Pediatrics 125: e1072e1080.

    • Search Google Scholar
    • Export Citation
  • 14.

    Herbinger KH, Drerup L, Alberer M, Nothdurft HD, von Sonnenburg F, Löscher T, 2012. Spectrum of imported infectious diseases among children and adolescents returning from the tropics and subtropics. J Travel Med 19: 150157.

    • Search Google Scholar
    • Export Citation
  • 15.

    van Rijn SF, Driessen G, Overbosch D, van Genderen PJJ, 2011. Travel‐related morbidity in children: a prospective observational study. J Travel Med 19: 144149.

    • Search Google Scholar
    • Export Citation
  • 16.

    Han P, Balaban V, Marano C, 2010. Travel characteristics and risk-taking attitudes in youths traveling to nonindustrialized countries. J Travel Med 17: 316321.

    • Search Google Scholar
    • Export Citation
  • 17.

    Harris PA et al., 2019. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 95: 103208.

  • 18.

    Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG, 2009. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42: 377381.

    • Search Google Scholar
    • Export Citation
  • 19.

    Scutari M, 2010. Learning Bayesian networks with the bnlearn R package. J Stat Softw 35: 22.

  • 20.

    Lago K, Telu K, Tribble D, Ganesan A, Kunz A, Geist C, Fraser J, Mitra I, Lalani T, Yun HC, For The Infectious Disease Clinical Research Program TravMil Study Group , 2020. Doxycycline malaria prophylaxis impact on risk of travelers’ diarrhea among international travelers. Am J Trop Med Hyg 103: 18641870.

    • Search Google Scholar
    • Export Citation
  • 21.

    Sack RB, Santosham M, Froehlich JL, Medina C, Orskov F, Orskov I, 1984. Doxycycline prophylaxis of travelers’ diarrhea in Honduras, an area where resistance to doxycycline is common among enterotoxigenic Escherichia coli. Am J Trop Med Hyg 33: 460466.

    • Search Google Scholar
    • Export Citation
  • 22.

    Winer L, Alkan M, 2002. Incidence and precipitating factors of morbidity among Israeli travelers abroad. J Travel Med 9: 227232.

  • 23.

    Angelo KM, Kozarsky PE, Ryan ET, Chen LH, Sotir MJ, 2017. What proportion of international travellers acquire a travel-related illness? A review of the literature. J Travel Med 24. Available at: https://doi.org/10.1093/jtm/tax046.

    • Search Google Scholar
    • Export Citation
  • 24.

    Vilkman K, Pakkanen SH, Laaveri T, Siikamaki H, Kantele A, 2016. Travelers’ health problems and behavior: prospective study with post-travel follow-up. BMC Infect Dis 16: 328.

    • Search Google Scholar
    • Export Citation
  • 25.

    Kain D, Findlater A, Lightfoot D, Maxim T, Kraemer MUG, Brady OJ, Watts A, Khan K, Bogoch II, 2019. Factors affecting pre-travel health seeking behaviour and adherence to pre-travel health advice: a systematic review. J Travel Med 26. Available at: https://doi.org/10.1093/jtm/taz059.

    • Search Google Scholar
    • Export Citation
 
 

 

 

 

 

 

 

Travel-Related Behaviors and Health Outcomes of Adolescents Compared with Adults on Short-Term International Service Missions

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  • 1 Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah;
  • | 2 Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah;
  • | 3 Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah;
  • | 4 Youthlinc, Salt Lake City, Utah

ABSTRACT.

With an increasing number of adolescents participating in international travel, little is known about travel-related behaviors and health risks in this age group. In the years 2015–2016, we conducted an anonymous, posttravel, questionnaire-based survey with the aim to compare self-reported practices and travel-related symptoms between adolescents (< 18 years old, N = 87) and adults (≥ 18 years old, N = 149) who came to our travel clinic before their humanitarian missions. They had the same pretravel health education, and traveled together to perform similar activities. In univariate analysis, compared with adults, we found that adolescents reported less prior international travel (P < 0.001), more often wore long-sleeved clothing for malaria prevention (P < 0.001) but less often for sun protection (P = 0.009), more often used insect repellents (P = 0.011), and less often had diarrhea (P = 0.024). All other practices and health outcomes were similar between the groups. Multivariate analyses using Bayesian network show strong associations between adults and prior travel experience, and not wearing long-sleeve clothing for malaria prevention. We also found strong associations between prior international travel and sustaining an injury, and having jet lag, as well as between taking malaria prophylaxis and not having diarrhea. Overall, most practices and health outcomes were similar between age groups. Adolescent age and lack of prior international travel experience did not have significant impacts on practices and health outcomes. Our findings highlight the need for more effective strategies to improve the behaviors and health outcomes in both adolescents and adults.

Author Notes

Address correspondence to Jakrapun Pupaibool, Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E, Room 4B319, Salt Lake City, UT 84132-2101. E-mail: jakrapun.pupaibool@hsc.utah.edu

Financial support: This investigation was supported by the University of Utah Population Health Research (PHR) Foundation, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health, through Grant UL1TR002538 (formerly 5UL1TR001067-05, 8UL1TR000105, and UL1RR025764). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Authors’ addresses: Jakrapun Pupaibool, Hemantha Walaliyadda, Benjamin Tasevac, In Kyu Park, Michael Graves, Peter Hale, and Daniel T. Leung, Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, E-mails: jakrapun.pupaibool@hsc.utah.edu, hemwala@gmail.com, tasevac_ben@hotmail.com, ben.brintz@hsc.utah.edu, ikpark@umich.edu, michael.c.graves@dmu.edu, peter.hale@hci.utah.edu, and daniel.leung@utah.edu. Ben J. Brintz, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, E-mail: ben.brintz@hsc.utah.edu. L. Scott Benson, Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, E-mail: scott.benson@hotmail.com. Justin Powell, Youthlinc, Salt Lake City, UT, E-mail: justin@youthlinc.org.

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