Pre-travel care for immunocompromised and chronically ill travellers: A retrospective study

• Published in: Travel medicine and infectious disease Vol. 19; pp. 37 - 48
• Main Authors: van Aalst, Mariëlle, Verhoeven, Roos, Omar, Freshta, Stijnis, Cornelis, van Vugt, Michèle, de Bree, Godelieve J., Goorhuis, Abraham, Grobusch, Martin P.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-09-2017; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; AIDS; Antibiotic Prophylaxis; Antibiotics; Antibodies - blood; Chronic Disease; Chronically ill; Family medical history; Fever; Hepatitis; HIV; Human immunodeficiency virus; Humans; Immunocompromised; Immunocompromised Host; Immunoglobulins; Infectious diseases; Malaria; Medical records; Netherlands; Patients; Rabies; Retrospective Studies; Transplants & implants; Travel; Travel medicine; Travel Medicine - standards; Travel Medicine - statistics & numerical data; Travel-Related Illness; Tropical diseases; Vaccination; Vaccines; Travel; Antibiotics; Vaccination; Chronically ill; Immunocompromised
• ISSN: 1477-8939; 1873-0442
• DOI: 10.1016/j.tmaid.2017.07.006

Immunocompromised and chronically ill travellers (ICCITs) are susceptible to travel related diseases. In ICCITs, pre-travel care regarding vaccinations and prophylactics is complex.
We evaluated the protection level by preventive measures in ICCITs by analysing rates of vaccination protection, antibody titres, and the prescription of standby antibiotics.
We analysed, and reported according to STROBE guidelines, pre-travel care data for ICCITs visiting the medical pre-travel clinic at the Academic Medical Centre, The Netherlands from 2011 to 2016.
We analysed 2104 visits of 1826 ICCITs. Mean age was 46.6 years and mean travel duration 34.5 days. ICCITs on immunosuppressive treatment (29.7%), HIV (17.2%) or diabetes mellitus (10.2%) comprised the largest groups. Most frequently visited countries were Suriname, Indonesia, and Ghana. Most vaccination rates were >90%. Of travellers in high need of hepatitis A and B protection, 56.6 and 75.7%, underwent titre assessments, respectively. Of ICCITs with a respective indication, 50.6% received a prescription for standby antibiotics.
Vaccination rates in our study population were overall comparable to those of healthy travellers studied previously in our centre. However, regarding antibody titre assessments and prescription of standby antibiotics, this study demonstrates that uniform pre-travel guidelines for ICCITs are highly needed.