title: Advice on malaria and yellow fever prevention provided at travel agencies in Cuzco, Peru.
abstract: BACKGROUND
  Travelers receive medical advice from a variety of sources, including travel agencies. The aim of this study is to describe the quality of pre-travel advice provided by travel agencies in Cuzco to travelers interested in visiting malaria and yellow fever endemic areas.
  
  
  METHODS
  Trained medical students posed as tourists and visited travel agencies in Cuzco requesting travel advice for a trip to the southern Amazon of Peru, recording advice regarding risk and prevention of malaria and yellow fever.
  
  
  RESULTS
  A total of 163 registered travel agencies were included in the study. The mean proposed tour duration was 6.8 days (±1.4 days) with a median time to departure of 3 days and a median tour cost of 805 US dollars (USD) [interquartile range (IQR) 580-1,095]. Overall, 45% employees failed to mention the risk for any illness. Eighteen percent of the employees acknowledged risk of malaria and 53% risk of yellow fever. However, 36% denied malaria risk and 2% denied risk of yellow fever in the region. The price of tours from travel agencies that did not mention any health risk was significantly lower [1,009.6 ± 500.5 vs 783.9 ± 402 USD, t (152) = 3, p < 0.01] compared with the price from agencies that did mention health risks. Almost all who acknowledged malaria (97%) and/or yellow fever (100%) were able to provide at least one recommendation for prevention. However, advice was not always accurate or spontaneously volunteered. Only 7% of the employees provided both correct scheduling and location information for administration of the yellow fever vaccine.
  
  
  CONCLUSIONS
  The majority of registered travel agencies in Cuzco did not provide sufficient and accurate information regarding risk and prevention of malaria and yellow fever to travelers inquiring about trips to the southern Amazon of Peru.
authors.affiliation: School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Pablo G
authors.initials: PG
authors.lastname: Villanueva-Meyer
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Garcia-Jasso
authors.forename: Chelsea A
authors.initials: CA
authors.lastname: Springer
authors.forename: Jenna K
authors.initials: JK
authors.lastname: Lane
authors.forename: Bonny S
authors.initials: BS
authors.lastname: Su
authors.forename: Idania S
authors.initials: IS
authors.lastname: Hidalgo
authors.forename: Mary R
authors.initials: MR
authors.lastname: Goodrich
authors.forename: Emily L
authors.initials: EL
authors.lastname: Deichsel
authors.forename: A C
authors.initials: AC
authors.lastname: White
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Cabada
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D010568:Peru; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014195:Travel; D015004:Yellow Fever / Q000453:epidemiology / Q000517:prevention & control*; D022341:Yellow Fever Vaccine / Q000627:therapeutic use*
chemical_list: D000962:Antimalarials; D022341:Yellow Fever Vaccine