title: Epidemiologic and biogeographic analysis of 542 VFR traveling children in Catalonia (Spain). A rising new population with specific needs.
abstract: BACKGROUND
  Imported diseases recorded in the European Union (EU) increasingly involve traveling immigrants returning from visits to their relatives and friends (VFR). Children of these immigrant families can represent a population of extreme vulnerability.
  
  
  METHODS
  A randomized cross-sectional study of 698 traveling children under the age of 15 was performed. VFR traveling children and non-VFR (or tourist) children groups were compared.
  
  
  RESULTS
  A total of 698 individuals were analyzed: 354 males (50.7%) and 344 females (49.3%), with a median age (interquartile range) of 4 (2-9) years. Of these, 578 (82.8%) had been born in the EU with 542 (77.7%) being considered as VFR, whereas 156 (22.3%) were considered tourists. VFR children were younger (4.7 vs 8.2 yr; p < 0.001), they had more frequently been born in the EU (62.8% vs 20.1%; p < 0.01) and were more frequently lodged in private homes (76.6% vs 3.2%: p < 0.001) and rural areas (23.2% vs 1.6%; p < 0.001). Furthermore, VFR remained abroad longer (51.6 vs 16.6 d; p < 0.001), the visit/travel time interval was shorter (21.8 vs 32.2 d; p < 0.001) than tourists, and consultation was within 10 days prior to the departure (26.4% vs 2.7%; p < 0.001). The risk factor most differentiating VFR children from tourists was accommodation in a rural setting [odds ratio(OR) = 5.26;95%CI = 2.704-10.262;p < 0.001].
  
  
  CONCLUSIONS
  VFR traveling children showed a greater risk of exposure to infectious diseases compared with tourists. Immigrant families may represent a target group to prioritize international preventive activities.
authors: North Metropolitan International Health Unit, Institut Català de la Salut, Santa Coloma de Gramanet, Catalonia, Spain. lvalerio.bnm.ics@gencat.cat
authors: Lluís
authors: L
authors: Valerio
authors: Sílvia
authors: S
authors: Roure
authors: Miquel
authors: M
authors: Sabrià
authors: Xavier
authors: X
authors: de Balanzó
authors: Nemesio
authors: N
authors: Moreno
authors: Octavio
authors: O
authors: Martinez-Cuevas
authors: Carme
authors: C
authors: Peguero
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D033062:Friends / Q000208:ethnology*; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D009017:Morbidity / Q000639:trends; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014195:Travel; D014611:Vaccination / Q000639:trends*