الفهرس | Only 14 pages are availabe for public view |
Abstract Travel medicine is often related to the purview of infectious diseases. However, its emphasis is prevention—not only of tropical disease, but also of common disease—and it takes into consideration preexisting chronic conditions, behavioral risk factors, non-biologic health threats, and the individual traveler’s risk tolerance. Multidisciplinary in its scope, travel medicine lends itself well to the family physician’s broad training, counseling skills, and focus on prevention and continuity. This review was conducted with aim to clarify the most common health problems encountered by the subjects travelling abroad and the role of family physician in its prevention and management. An access to the Cochrane data base and the Ovid-midline to review the last and most recent papers and review articles in this era Effective pretravel consultation begins with a process of assessing and conveying the epidemiologic likelihood of disease and injury connected with the trip, which depends on traveler- and itinerary-specific factors. A two-week trip through Western Europe has a far different risk profile than a two-year Peace Corps tour in West Africa . Minor ailments are quite prevalent, with traveler’s diarrhea by far the most common. Patients should be counseled that average mortality rates for travelers to developing nations may actually be lower than those of nontravelers . Summary - 88 - The trauma, not infectious disease, is the leading cause of death in younger travelers; and that cardiovascular disease is the greatest threat in older travelers . Vector-borne disease is a significant source of traveler morbidity. Although reasonably effective malaria prophylaxis regimens are available, other diseases can be prevented only by insect avoidance. N,N-diethyl- m-toluamide (DEET, 30%) is the most effective and safest insect repellent available, and should be recommended to all travelers. Other agents, such as picaridin, have also been shown to offer some protection Role of Family Physician in Travel Medicine Pre-travel consultations Each practitioner providing pre-travel consultations, he must receive training in travel medicine that includes both education and experience. There is evidence that health care personnel who are not familiar with the important issues in travel medicine make errors in judgment and recommendations, particularly about the prevention of malaria . Advice and Education After completing a travel health risk assessment, the health care provider can give specific health advice. Because an adequate pre-travel consultation will require 15–45 min, it may not be possible to review all possible health and safety scenarios. Therefore, it is necessary to prioritize the health topics on the basis of the likely health risks and the level of risk tolerance of the traveler. The task of the travel medicine provider is to inform and educate. It is then the responsibility of the traveler to act upon the information once the potential risks of travel are understood. |