title: Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis.
abstract: BACKGROUND
  The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important.
  
  
  METHODS
  In this cross-sectional study, data of a 20% sample of travellers visiting the Academic Medical Center (AMC) travel clinic Amsterdam from July 2011 to July 2012 was collected. Itineraries and protection versus exposure rates of preventable infectious diseases were mapped and reported according to STROBE guidelines.
  
  
  RESULTS
  1749 travellers were included. South-Eastern Asia, South-America and West-Africa were most frequently visited. 26.2% of the population had pre-existing medical conditions (often cardiovascular). Young and VFR travellers had a longer median travel time (28 and 30 days) compared to the overall population (21 days). Young adult travellers were relatively often vaccinated against hepatitis B (43.9% vs. 20.5%, p < .001) and rabies (16.6% vs. 4.3%, p < .001). VFRs were less often vaccinated against hepatitis B (11.6% vs. 30.6%, p < .001) and rabies (1.3% vs. 9.0%, p .012) compared to non-VFR travellers.
  
  
  CONCLUSIONS
  Pre-travel guidelines were well adhered to. Young adult travellers had high-risk itineraries but were adequately protected. Improvement of hepatitis B and rabies protection would be desirable, specifically for VFRs.
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1).
authors.forename: Rosanne W
authors.initials: RW
authors.lastname: Wieten
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1).
authors.forename: Maurice
authors.initials: M
authors.lastname: van der Schalie
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1).
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Visser
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1). Electronic address: m.p.grobusch@amc.uva.nl.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1).
authors.forename: Michèle
authors.initials: M
authors.lastname: van Vugt
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011314:Preventive Health Services; D011819:Rabies Vaccines; D018570:Risk Assessment; D012307:Risk Factors; D014195:Travel / Q000706:statistics & numerical data*; D057236:Travel Medicine; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines; D011819:Rabies Vaccines
keywords: Hepatitis; Pre-travel health care; Rabies; Risk patterns; Travel medicine