title: Dengue fever, tuberculosis, human immunodeficiency virus, and hepatitis C virus conversion in a group of long-term development aid workers.
abstract: BACKGROUND
  Development and humanitarian aid workers are a diverse group of travelers who, because of the nature of their travel, may have specific travel-related health risks. The main objective of this study was to quantify the risk of dengue fever virus (DFV), tuberculosis (TB), human immunodeficiency virus (HIV), and hepatitis C virus (HCV) infections in a group of long-term development aid volunteers.
  
  
  METHODS
  Medical files of Volunteer Service Abroad (VSA) volunteers and their accompanying family/partner/spouse serving over 17 years (1995-2011) were reviewed. Demographics, destination, months spent in-country, and, where available, results of pre- and post-assignment testing for DFV, TB, HCV and HIV infections were extracted.
  
  
  RESULTS
  Results from 652 assignments were audited. Conversion rates were calculated when both pre- and post-assignment results were available. Evidence of dengue fever seroconversion was found in 6.3% of 205 volunteers [at a rate of 3.4 per 1,000 person months (pm) on assignment], with assignments in Southeast Asia having the highest risk. Evidence of TB during assignment was found in 2.9% of 336 volunteers converting at a rate of 1.4 per 1,000 pm. There were no HIV or HCV infections detected. On post-assignment questioning, 6.7% of volunteers reported unprotected sex with someone other than their regular partner and 9.8% reported a potential exposure to blood and/or blood products.
  
  
  CONCLUSIONS
  Infection with DFV and TB occurred in this group at rates similar to that seen in other groups of long-term travelers, and screening would appear to be warranted. While none contracted HIV or HCV infection, reported behavior did put them at risk of blood- and body fluid-borne diseases. It is important that pre-assignment travel health preparation in this group focuses on strategies to minimize these risks.
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
authors.forename: Jenny T
authors.initials: JT
authors.lastname: Visser
authors.forename: Ciaran A
authors.initials: CA
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001210:Asia, Southeastern / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000208:ethnology*; D003715:Dengue / Q000208:ethnology*; D003716:Dengue Virus; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000208:ethnology*; D006526:Hepatitis C / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014195:Travel; D014376:Tuberculosis / Q000208:ethnology*; D014838:Volunteers / Q000706:statistics & numerical data*; D055815:Young Adult