Travel patterns, risk behaviour and health problems of travellers with rheumatic diseases compared to controls: A multi-centre, observational study.


Journal

Travel medicine and infectious disease
ISSN: 1873-0442
Titre abrégé: Travel Med Infect Dis
Pays: Netherlands
ID NLM: 101230758

Informations de publication

Date de publication:
Historique:
received: 17 03 2020
revised: 29 06 2020
accepted: 30 06 2020
pubmed: 28 7 2020
medline: 2 7 2021
entrez: 27 7 2020
Statut: ppublish

Résumé

Patients with chronic conditions travel around the world more than ever. Only few studies have examined travel patterns and health outcomes of patients with rheumatic diseases during international travel. We conducted a multi-centre prospective cohort study in Switzerland, in which we studied the immunogenicity and safety of vaccinations in patients with rheumatic diseases and travellers without rheumatic diseases (controls). Participants who travelled internationally received questionnaires 1 and 13 weeks post-travel. We compared travel patterns, risk behaviours, and travel-associated problems during and after the trips in both groups. 274 participants returned post-travel questionnaires (65 rheumatic patients, 209 controls). Controls more frequently travelled to subtropical/tropical destinations and stayed longer abroad. 64% of all participants experienced health problems during travel (74% rheumatic patients vs. 62% controls, P = 0.11). Pre-travel, patients reported a higher susceptibility to gastrointestinal infections . During travel, a higher percentage of rheumatic patients cancelled the day programme due to health problems (13% vs. 4%, P = 0.024). The main problems in rheumatic patients occurred due to the underlying rheumatic diseases, or were of psychological nature. Although not statistically significant, infectious disease symptoms (rhinitis, cough) occurred more frequently in controls. When only considering subtropical/tropical destinations, rheumatic patients more frequently had gastrointestinal problems during travel - and skin infections after the trip. This study does not support the notion that patients with rheumatic diseases should avoid international travel for an increased risk of infections. In patients with subtropical/tropical destinations, however, gastrointestinal problems may be increased during travel - and skin infections post-travel.

Sections du résumé

BACKGROUND
Patients with chronic conditions travel around the world more than ever. Only few studies have examined travel patterns and health outcomes of patients with rheumatic diseases during international travel.
METHOD
We conducted a multi-centre prospective cohort study in Switzerland, in which we studied the immunogenicity and safety of vaccinations in patients with rheumatic diseases and travellers without rheumatic diseases (controls). Participants who travelled internationally received questionnaires 1 and 13 weeks post-travel. We compared travel patterns, risk behaviours, and travel-associated problems during and after the trips in both groups.
RESULTS
274 participants returned post-travel questionnaires (65 rheumatic patients, 209 controls). Controls more frequently travelled to subtropical/tropical destinations and stayed longer abroad. 64% of all participants experienced health problems during travel (74% rheumatic patients vs. 62% controls, P = 0.11). Pre-travel, patients reported a higher susceptibility to gastrointestinal infections . During travel, a higher percentage of rheumatic patients cancelled the day programme due to health problems (13% vs. 4%, P = 0.024). The main problems in rheumatic patients occurred due to the underlying rheumatic diseases, or were of psychological nature. Although not statistically significant, infectious disease symptoms (rhinitis, cough) occurred more frequently in controls. When only considering subtropical/tropical destinations, rheumatic patients more frequently had gastrointestinal problems during travel - and skin infections after the trip.
CONCLUSIONS
This study does not support the notion that patients with rheumatic diseases should avoid international travel for an increased risk of infections. In patients with subtropical/tropical destinations, however, gastrointestinal problems may be increased during travel - and skin infections post-travel.

Identifiants

pubmed: 32712263
pii: S1477-8939(20)30314-8
doi: 10.1016/j.tmaid.2020.101818
pii:
doi:

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

101818

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Auteurs

Nathan Schmid (N)

Department of Public Health & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.

Adrian Ciurea (A)

Department of Rheumatology, University Hospital of Zurich, Zurich, Switzerland.

Cem Gabay (C)

Division of Rheumatology, Department of Medicine, University Hospitals of Geneva, Geneva, Switzerland.

Paul Hasler (P)

Division of Rheumatology, University Department of Medicine, University of Basel Medical Faculty, Cantonal Hospital Aarau, Aarau, Switzerland.

Jan Fehr (J)

Department of Public Health & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.

Rüdiger Müller (R)

Division of Rheumatology, University Department of Medicine, University of Basel Medical Faculty, Cantonal Hospital Aarau, Aarau, Switzerland; Division of Rheumatology, Department of Internal Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Peter Villiger (P)

Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, Bern, Switzerland.

Ulrich Walker (U)

Department of Rheumatology, University Hospital Basel, Basel, Switzerland.

Christoph Hatz (C)

Department of Public Health & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Department of Medicine and Diagnostics, Swiss Tropical and Public Health Institute, Basel, Switzerland; Department of Infectious Diseases and Hospital Hygiene, Cantonal Hospital St. Gallen, Switzerland; University of Basel, Switzerland.

Silja Bühler (S)

Department of Public Health & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: silja.buehler@uzh.ch.

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