A population-based comparison between travelers who consulted travel clinics and those who did not.
BACKGROUND
Travel to hepatitis A-endemic countries is frequent among North Americans. Such travel carries significant risks for the individuals themselves and for the general population. We documented the patterns of use of travel clinics in a large Canadian adult population.


METHODS
Travelers who had visited a hepatitis A-endemic country between 1990 and the time of the survey in 1999 were eligible. Subjects were identified from a representative sample of 4,002 adults from the two largest Canadian provinces. They were contacted by random digit dialing and interviewed by telephone.


RESULTS
Only 15% of trips had been preceded by a visit to a travel clinic. The probability of visiting a travel clinic was approximately 10 times greater for travelers considered to be in the high-risk category than for those in the low-risk category, but the former represented only 2% of the total. The probability of visiting a travel clinic was approximately 23 times greater for travelers who were aware of the health risks in their country of destination. Income level was not associated with attendance at a travel clinic, and cost was rarely mentioned as a reason for not attending such a travel clinic before departure.


CONCLUSIONS
Each year, millions of Canadian travelers go to hepatitis A-endemic countries without consulting a travel clinic. Active steps must be taken by public health authorities to improve their utilization of health services and prevent the accrued health risk for these travelers.
Institut National de Santé Publique du Québec, Canada.
Bernard
B
Duval
Gaston
G
De Serre
Ramak
R
Shadmani
Nicole
N
Boulianne
Gina
G
Pohani
Monika
M
Naus
Louis
L
Rochette
Monique Douville
MD
Fradet
Kevin C
KC
Kain
Brian J
BJ
Ward
D000328:Adult; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D019538:Health Care Surveys; D006506:Hepatitis A / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011336:Probability; D011792:Quebec / Q000453:epidemiology; D011897:Random Allocation; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014195:Travel