title: Vaccinations and malaria prophylaxis for long-term travellers travelling from Greece: a prospective, questionnaire-based analysis.
abstract: The purpose of this prospective, questionnaire-based study is to assess pre-travel vaccinations and malaria prophylaxis for long-term travellers who receive pre-travel advice in Greece. A total of 4721 travellers were studied from January 1, 2009 through December 31, 2012. Travellers sought pre-travel advice at a mean of 19.7 days (range: 0-349 days) before departure. Long-term travellers (≥ 1 month) accounted for 2205 (46.7%) of all travellers. Long-term travellers had a mean age of 34.5 years. The majority of them were men (79.8%). In terms of destinations, 84% were visiting malaria-endemic countries and sub-Saharan Africa was the most common destination (17.7%). Most long-term travellers pursued trips for work purposes (70%), visited urban areas (79.6%) and stayed in hotels (29.2%). Yellow fever, typhoid fever, hepatitis A and tetanus/diphtheria vaccines were administered to 1647 (74.7%), 741 (33.6%), 652 (29.5%), and 589 (26.7%) travellers, respectively. Yellow fever vaccine was administered to 339 (87%) and 132 (71%) of long-term travellers to sub-Saharan Africa and South America respectively, whereas typhoid vaccine to 119 (90.8%) and 330 (84.6%) of those travelling to the Indian subcontinent and sub-Saharan Africa respectively. Rabies vaccine was administered to 14 (0.6%) of them. Malaria prophylaxis was recommended to 446 (20%) of long-term travellers. Mefloquine was the most commonly (49%) prescribed agent, and was prescribed to 26.7% of long-term travellers to sub-Sahara Africa. In conclusion, this study revealed that recommendations for vaccine and malaria prophylaxis for long-term travellers to developing countries should be more selective, based on the assessment of all travellers' and travel characteristics, in order to provide adequate pre-travel preparation for this high risk group of travellers. More focused studies are suggested in order to understand the particular needs of long-term travellers. Increasing awareness of travellers and travel health consultants is very important.
authors: Travel Medicine Office.
authors: Androula
authors: A
authors: Pavli
authors: Travel Medicine Office.
authors: Paraskevi
authors: P
authors: Smeti
authors: Travel Medicine Office.
authors: Athina
authors: A
authors: Spilioti
authors: Travel Medicine Office.
authors: Chrysovalantis
authors: C
authors: Silvestros
authors: Department for Interventions in Health Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
authors: Panagiotis
authors: P
authors: Katerelos
authors: Department for Interventions in Health Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece. Electronic address: helen-maltezou@ath.forthnet.gr.
authors: Helena C
authors: HC
authors: Maltezou
mesh_terms: D017954:Africa South of the Sahara; D000962:Antimalarials / Q000627:therapeutic use*; D022422:Diphtheria-Tetanus Vaccine / Q000008:administration & dosage; D005260:Female; D006115:Greece / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006506:Hepatitis A / Q000517:prevention & control; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D065129:Pre-Exposure Prophylaxis; D011446:Prospective Studies; D011819:Rabies Vaccines / Q000008:administration & dosage; D013020:South America; D011795:Surveys and Questionnaires; D013997:Time Factors; D014195:Travel; D014435:Typhoid Fever / Q000517:prevention & control; D014611:Vaccination; D015004:Yellow Fever / Q000517:prevention & control; D022341:Yellow Fever Vaccine / Q000008:administration & dosage
chemical_list: D000962:Antimalarials; D022422:Diphtheria-Tetanus Vaccine; D011819:Rabies Vaccines; D022341:Yellow Fever Vaccine; D015767:Mefloquine
keywords: Long-term travellers; Malaria; Prophylaxis; Typhoid; Vaccine