title: Quality of travel health advice in a French travel medicine and vaccine center: a prospective observational study.
abstract: BACKGROUND
  The number of international trips undertaken by French citizens is rising and we wished to assess the appropriateness of advices given to travelers in a vaccine and travel medicine center in France.
  
  
  METHODS
  We conducted a 3-month prospective study in one center in Paris where prescriptions and advice to travelers are given by trained physicians in travel medicine who have access to a computerized decision support system (Edisan). A questionnaire was used to record trip characteristics, patients' demographics, and prescriptions. Main outcome measure was the adequacy of prescriptions for malaria prophylaxis, yellow fever, and hepatitis A vaccines to French guidelines.
  
  
  RESULTS
  A total of 730 subjects were enrolled in this study, with a median age of 28 years. Travel destinations were sub-Saharan Africa (58%), Asia (21%), and South America (18%). Among the 608 patients (83%) traveling to malaria-endemic areas, malaria prophylaxis was in accordance with guidelines in 578/608 patients (95.1%, 95% CI: 93-96.5), and doxycycline was the regimen of choice (48%). Inappropriate malaria prophylaxis was given to eight patients, one of whom developed plasmodium falciparum malaria. All 413 patients (100%, 95% CI: 99-100) traveling to yellow fever-endemic areas who needed vaccination were correctly vaccinated. However, three patients received yellow fever vaccination without indication. Also, 442 of 454 patients (97.4%, 95% CI: 95.4-98.5) eligible to receive hepatitis A vaccination were immunized.
  
  
  CONCLUSIONS
  Appropriate advice for malaria prophylaxis, yellow fever, and hepatitis A vaccinations was provided in a travel medicine and vaccine center where trained physicians used a computerized decision support system. Even in this setting, however, errors can occur and professional practices should be regularly assessed to improve health care.
authors.affiliation: Department of Infectious Diseases, Hospital Saint-Louis, Paris, France. marie-anne.bouldouyre@sls.aphp.fr
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Bouldouyre
authors.forename: Nathalie Colin
authors.initials: NC
authors.lastname: De Verdière
authors.forename: Juliette
authors.initials: J
authors.lastname: Pavie
authors.forename: Nathalie
authors.initials: N
authors.lastname: De Castro
authors.forename: Diane
authors.initials: D
authors.lastname: Ponscarme
authors.forename: Samia
authors.initials: S
authors.lastname: Hamane
authors.forename: Anne
authors.initials: A
authors.lastname: Rachline
authors.forename: Samuel
authors.initials: S
authors.lastname: Ferret
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000554:Ambulatory Care Facilities / Q000592:standards / Q000706:statistics & numerical data; D000962:Antimalarials / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D003253:Consultants / Q000706:statistics & numerical data; D003658:Decision Making, Computer-Assisted; D019353:Endemic Diseases / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006506:Hepatitis A / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D017063:Outcome Assessment, Health Care; D010297:Paris; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011446:Prospective Studies; D011787:Quality of Health Care; D013020:South America / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014195:Travel; D057236:Travel Medicine / Q000379:methods; D014611:Vaccination / Q000379:methods / Q000706:statistics & numerical data; D014612:Vaccines / Q000627:therapeutic use; D015004:Yellow Fever / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000962:Antimalarials; D014612:Vaccines