title: Acute mountain sickness in travelers who consulted a pre-travel clinic.
abstract: BACKGROUND
  The main objective of this study was to investigate the incidence and predictors of acute mountain sickness (AMS) in travelers who consulted a pre-travel clinic and the compliance with advices concerning this condition.
  
  
  METHODS
  A post-travel questionnaire was sent to clients of five travel clinics who planned to climb above 2,000 m.
  
  
  RESULTS
  The response was 77% and the data of all 744 respondents who stayed above 2,500 m were used for the analysis. Eighty-seven percent (646) read and understood the written advices on AMS. The incidence of AMS was 25% (184), and the predictors were previous AMS [odds ratio (OR) 2.2], female sex (OR 1.6), age (OR 0.98 per year), maximum sleeping altitude (OR 1.2 per 500 m), and the number of nights between 1,500 and 2,500 m (OR 0.9 per night). Eighty-seven percent of respondents understood the written advices about AMS but 21% did not read or understand the use of acetazolamide. Forty percent spent less than two nights between 1,500 and 2,500 m and 43% climbed more than 500 m/d once above 2,500 m. Acetazolamide was brought along by 541 respondents (72%) and 116 (16%) took it preventively. Of those with AMS 62 (34%) took acetazolamide treatment and 87 (47%) climbed higher despite AMS symptoms. The average preventive dose of acetazolamide was 250 mg/d, while the average curative dose was 375 mg/d. We found no relation between acetazolamide prevention and AMS (p = 0.540).
  
  
  CONCLUSIONS
  The incidence of AMS in travelers who stayed above 2,500 m was 25%. Predictors were previous AMS, female sex, age, maximum overnight altitude, and the number of nights between 1,500 and 2,500 m. Only half of these travelers followed the preventive and curative advices and 21% did not read or understand the use of acetazolamide. We found no preventive effect of a low dose of acetazolamide in this retrospective observational study.
authors: GGD Hart voor Brabant, Community Health Service,'s-Hertogenbosch, The Netherlands. m.croughs@ggdhvb.nl
authors: Mieke
authors: M
authors: Croughs
authors: Alfons
authors: A
authors: Van Gompel
authors: Jef
authors: J
authors: Van den Ende
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000532:Altitude Sickness / Q000453:epidemiology* / Q000517:prevention & control; D001530:Belgium / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D010349:Patient Compliance; D011379:Prognosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014195:Travel; D055815:Young Adult