title: Understanding of Altitude Illness and Use of Pharmacotherapy Among Trekkers and Porters in the Annapurna Region of Nepal.
abstract: We surveyed Nepali porters and guides as well as English- and non-English-speaking trekkers on their knowledge of altitude illness and its treatment during trekking expeditions to the Annapurna region of Nepal. From March 15 to April 15, 2014, Nepali porters and visiting trekkers were surveyed regarding their ability to recognize and treat altitude illness in Manang, Nepal (3540 m). Their personal use of medications and home remedies and presence of acute mountain sickness (AMS) symptoms were also assessed. 504 subjects were surveyed, including 108 Nepalis. Overall incidence of AMS symptoms was 16%, 5% among Nepalis, and 21% among trekkers. Subjects recognized that headache (88%) was one of the symptoms of AMS, however many reported not knowing the symptoms of high altitude pulmonary edema (40%) or high altitude cerebral edema (42%). 58% of subjects reported carrying and 16% reported taking acetazolamide, while only 2 (0.4%) respondents took dexamethasone. The majority of subjects reported that they would be able to recognize (67%) and treat (62%) altitude illness. Trekkers reported a higher incidence of AMS symptoms than Nepalis. Although most respondents recognized symptoms of AMS, both Nepalis and trekkers lacked knowledge regarding more serious presentations of altitude illness, thus both groups were overconfident in their ability to recognize and treat altitude illness.
authors.affiliation: 1 Mount Sinai St. Luke's-Roosevelt Hospital Center , New York, New York.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Havryliuk
authors.affiliation: 2 Himalayan Rescue Association , Kathmandu, Nepal .
authors.forename: Bhuwan
authors.initials: B
authors.lastname: Acharya
authors.affiliation: 3 Denver Health Medical Center , Denver, Colorado.
authors.forename: Emily
authors.initials: E
authors.lastname: Caruso
authors.affiliation: 4 University of Colorado School of Medicine , Aurora, Colorado.
authors.forename: Tracy
authors.initials: T
authors.lastname: Cushing
mesh_terms: D000086:Acetazolamide / Q000627:therapeutic use; D000328:Adult; D000532:Altitude Sickness / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D009051:Mountaineering / Q000523:psychology* / Q000706:statistics & numerical data; D009390:Nepal / Q000453:epidemiology; D063189:Symptom Assessment / Q000523:psychology*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D000086:Acetazolamide
keywords: altitude medications; altitude pharmacotherapy; confidence; knowledge of altitude illness; porter education; trekker education