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TropicalMed
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Travel and Tropical Medicine
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Travel and Tropical Medicine

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Travel Medicine".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 58220

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Dr. Harunor Rashid

E-Mail Website
Guest Editor
1. National Centre for Immunisation Research and Surveillance (NCIRS) Kids Research, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia
2. Discipline of Child and Adolescent Health, The University of Sydney, Camperdown, NSW 2006, Australia
Interests: travel vaccine; vaccine-preventable infectious diseases; vaccination evaluation; vaccine prioritisation
Special Issues, Collections and Topics in MDPI journals
Dr. Ameneh Khatami

E-Mail Website
Guest Editor
Discipline of Child and Adolescent Health, The University of Sydney, Sydney, Australia
Interests: pediatric infectious diseases; microbiology; vaccine-preventable diseases in children

Special Issue Information

Dear Colleagues,

Gone are the days when travel was enjoyed only by the privileged. Globalisation and massive expansion of transport technology and systems have enabled even the less privileged section of society to travel far and wide, in search of a better livelihood, for recreation, to advance knowledge, or for spiritual need. Many people in various parts of the world are forced to travel as a consequence of conflict or natural disasters. Irrespective of the purpose, travel is often associated with detrimental health effects: communicable, non-communicable, psychological, and environmental hazards are all recognised threats of travel. On the other hand, increased international trade and travel have opened up new vistas for preventive medicine research. There is more to explore, and what is already known should be disseminated.  

This Special Issue will provide an overview of common health issues and emerging travel-related diseases, with emphasis on the prevention and control of these problems for travellers or expatriates to tropical or resource-poor settings, as well as for attendees of mass-gathering events. Original research works and systematic or integrative reviews on the medical aspects of pre-travel preparation, travellers’ diarrhoea, vaccinations, prevention of vector-borne diseases, refugee health, disaster preparedness, and travel health issues in humanitarian emergencies will be included. Some case reports or case series of exotic diseases may also be considered.    

Dr. Harunor Rashid
Dr. Ameneh Khatami
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • travel medicine
  • tropical medicine
  • vaccine-preventable diseases
  • emerging and re-emerging infections
  • vector-borne diseases
  • mass-gathering medicine
  • refugee health
  • disaster preparedness
  • humanitarian emergencies
  • pre-travel advice

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Published Papers (11 papers)

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Editorial

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3 pages, 184 KiB  
Editorial
Special Issue: Travel and Tropical Medicine
by Harunor Rashid, Al-Mamoon Badahdah and Ameneh Khatami
Trop. Med. Infect. Dis. 2021, 6(2), 53; https://doi.org/10.3390/tropicalmed6020053 - 19 Apr 2021
Cited by 1 | Viewed by 2589
Abstract
Historically, travel is known to be associated with an amplified risk of acquisition and transmission of infectious diseases, including pandemics [...] Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)

Research

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11 pages, 216 KiB  
Article
Hand Hygiene Knowledge and Practices among Domestic Hajj Pilgrims: Implications for Future Mass Gatherings Amidst COVID-19
by Hashim Mahdi, Amani Alqahtani, Osamah Barasheed, Amjad Alemam, Mohammed Alhakami, Ibrahim Gadah, Hadeel Alkediwi, Khadijah Alzahrani, Lujain Fatani, Lamis Dahlawi, Saeed Alsharif, Ramon Shaban, Robert Booy and Harunor Rashid
Trop. Med. Infect. Dis. 2020, 5(4), 160; https://doi.org/10.3390/tropicalmed5040160 - 16 Oct 2020
Cited by 16 | Viewed by 5374
Abstract
This study examined Hajj pilgrims’ knowledge and reported practice of hand hygiene. In Hajj 2019, a cross-sectional survey was undertaken in Mina, Makkah, Saudi Arabia, of domestic Saudi pilgrims aged ≥18 years by using a self-administered Arabic questionnaire that captured data on pilgrims’ [...] Read more.
This study examined Hajj pilgrims’ knowledge and reported practice of hand hygiene. In Hajj 2019, a cross-sectional survey was undertaken in Mina, Makkah, Saudi Arabia, of domestic Saudi pilgrims aged ≥18 years by using a self-administered Arabic questionnaire that captured data on pilgrims’ socio-demographics, hand hygiene knowledge, and reported practices of hand cleaning following certain actions. A total of 348 respondents aged 18 to 63 (median 32) years completed the survey, of whom 200 (57.5%) were female. The mean (±standard deviation (SD)) hand hygiene knowledge score was 6.7 (±SD 1.9). Two hundred and seventy one (77.9%) and 286 (82.2%) of respondents correctly identified that hand hygiene can prevent respiratory and gastrointestinal infections respectively, but 146 (42%) were not aware that it prevents hand-foot-mouth disease. Eighty-eight (25.3%) respondents erroneously reported that hand hygiene prevents HIV. Washing hands with water and soap was the most preferred method practiced before a meal (67.5% (235/348)), after a meal (80.2% (279/348)), after toilet action (81.6% (284/348)), when hands were visibly soiled (86.2% (300/348)), and after waste disposal (61.5% (214/348)). Hajj pilgrims demonstrated a good knowledge and practice of hand hygiene, but there are gaps that are vital to control outbreaks such as COVID-19. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
13 pages, 935 KiB  
Article
A Rapid Assessment of Health Literacy and Health Status of Rohingya Refugees Living in Cox’s Bazar, Bangladesh Following the August 2017 Exodus from Myanmar: A Cross-Sectional Study
by Md Ridwanur Rahman, Mohammad Abul Faiz, Ma Yin Nu, Md Rafiqul Hassan, Ashish Kumar Chakrabarty, Iqbal Kabir, Khaleda Islam, Abul Kashem Mohammad Jafarullah, Mariam Alakabawy, Ameneh Khatami and Harunor Rashid
Trop. Med. Infect. Dis. 2020, 5(3), 110; https://doi.org/10.3390/tropicalmed5030110 - 1 Jul 2020
Cited by 16 | Viewed by 5948
Abstract
Background: A survey was conducted among Rohingya refugees to assess their overall health literacy and health status. Methods: A questionnaire was developed to conduct face to face interviews among Rohingya refugees in Cox’s Bazar, Bangladesh in November–December 2017. Families were selected using convenience [...] Read more.
Background: A survey was conducted among Rohingya refugees to assess their overall health literacy and health status. Methods: A questionnaire was developed to conduct face to face interviews among Rohingya refugees in Cox’s Bazar, Bangladesh in November–December 2017. Families were selected using convenience sampling from four large refugee camps. Results: Primary respondents aged 10–90 (median 32) years, 56% male, representing 1634 families were interviewed and provided data of themselves and 6268 additional family members, 4163 (66.4%) of whom were children aged <18 years. Of all, only 736 (45%) primary respondents knew how to appropriately treat diarrhoea, 882 (54%) relied on unqualified village “doctors” for treatment, 547 (33.5%) reported a family member suffering injuries in the previous six months, with 8% (42/547) of injuries fatal. One hundred and ninety two (11.8%) primary respondents also reported deaths within their family in the preceding 12 months, with the majority (70% [134/192]) occurring in males, and 44% (85/192) of all deaths were claimed to be homicidal. Conclusion: This survey highlights overall poor health literacy, limited access to qualified health care, and a high rate of injuries and assaults among Rohingyas. However, these data come from an anecdotal survey that excluded some sensitive but important questions. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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8 pages, 193 KiB  
Article
Prevalence of Eye Problems among Young Infants of Rohingya Refugee Camps: Findings from a Cross-Sectional Survey
by AHM Enayet Hussain, Zunayed Al Azdi, Khaleda Islam, ANM Ehtesham Kabir and Rumana Huque
Trop. Med. Infect. Dis. 2020, 5(1), 21; https://doi.org/10.3390/tropicalmed5010021 - 4 Feb 2020
Cited by 3 | Viewed by 3630
Abstract
Early detection of pediatric eye problems can prevent future vision loss. This study was to estimate the prevalence of common eye problems among infants born in a resource-constrained emergency setting with a broader aim to prevent future vision loss or blindness among them [...] Read more.
Early detection of pediatric eye problems can prevent future vision loss. This study was to estimate the prevalence of common eye problems among infants born in a resource-constrained emergency setting with a broader aim to prevent future vision loss or blindness among them through early detection and referral. We conducted a cross-sectional survey among 670 infants (0–59 days old) born in Rohingya refugee camps in Bangladesh between March and June of 2019. The most common eye problem found was watering from the eye and accumulation of discharge by which 14.8% of the children were suffering (95% CI: 12.2–17.7). More than 5% of the infants had visual inattention (95% CI: 3.5–7.0), and 4% had redness in their eyes (95% CI: 2.7–5.8). Only 1.9% of infants (95% CI: 1–3.3) had whitish or brown eyeballs, and 1.8% of children might have whitish pupillary reflex (95% CI: 0.9–3.1). None of the eye problems was associated with the gender of the infants. The prevalent eye problems demand eye care set up for the screening of eye problems in the camps with proper referral and availability of referral centres with higher service in the districts. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
11 pages, 772 KiB  
Article
Pilot Survey of Knowledge, Attitudes and Perceptions of Hajj Deployed Health Care Workers on Antibiotics and Antibiotic Prescriptions for Upper Respiratory Tract Infections: Results from Two Hajj Seasons
by Hamid Bokhary, Osamah Barasheed, Moataz Abd El Ghany, Ameneh Khatami, Grant A. Hill-Cawthorne, Harunor Rasheed and Hajj Research Team
Trop. Med. Infect. Dis. 2020, 5(1), 18; https://doi.org/10.3390/tropicalmed5010018 - 29 Jan 2020
Cited by 9 | Viewed by 3842
Abstract
Antimicrobial resistance (AMR) is a global public health issue. Upper respiratory tract infections (URTIs) are common illnesses during Hajj, for which antibiotics are often inappropriately prescribed. Hajj healthcare workers’ (HCW) knowledge, attitudes and perceptions (KAP) about AMR and antibiotic use for URTIs are [...] Read more.
Antimicrobial resistance (AMR) is a global public health issue. Upper respiratory tract infections (URTIs) are common illnesses during Hajj, for which antibiotics are often inappropriately prescribed. Hajj healthcare workers’ (HCW) knowledge, attitudes and perceptions (KAP) about AMR and antibiotic use for URTIs are not known. We conducted a survey among HCWs during Hajj to explore their KAP regarding antibiotic use for URTIs in pilgrims. Electronic or paper-based surveys were distributed to HCWs during the Hajj in 2016 and 2017. A total of 85 respondents aged 25 to 63 (median 40) years completed the surveys. Most participants were male (78.8%) and were physicians by profession (95.3%). Around 85% and 19% of respondents claimed to have heard about AMR and antimicrobial stewardship programs, respectively, among whom most had obtained their knowledge during their qualification. Implementation of URTI treatment guidelines was very low. In conclusion, HCWs at Hajj have significant knowledge gaps regarding AMR, often do not use standard clinical criteria to diagnose URTIs and display a tendency to prescribe antibiotics for URTIs. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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13 pages, 978 KiB  
Article
Meningococcal Vaccine for Hajj Pilgrims: Compliance, Predictors, and Barriers
by Al-Mamoon Badahdah, Fatimah Alghabban, Wajd Falemban, Abdullah Albishri, Gouri Rani Banik, Tariq Alhawassi, Hatem Abuelizz, Marwan A. Bakarman, Ameneh Khatami, Robert Booy and Harunor Rashid
Trop. Med. Infect. Dis. 2019, 4(4), 127; https://doi.org/10.3390/tropicalmed4040127 - 15 Oct 2019
Cited by 12 | Viewed by 5026
Abstract
Background: Major intercontinental outbreaks of invasive meningococcal disease associated with the Hajj occurred in 1987, 2000, and 2001. Mandatory meningococcal vaccination for all pilgrims against serogroups A and C and, subsequently, A, C, W, and Y controlled the epidemics. Overseas pilgrims show excellent [...] Read more.
Background: Major intercontinental outbreaks of invasive meningococcal disease associated with the Hajj occurred in 1987, 2000, and 2001. Mandatory meningococcal vaccination for all pilgrims against serogroups A and C and, subsequently, A, C, W, and Y controlled the epidemics. Overseas pilgrims show excellent adherence to the policy; however, vaccine uptake among domestic pilgrims is suboptimal. This survey aimed to evaluate meningococcal vaccine uptake among Hajj pilgrims and to identify key factors affecting this. Methods: An anonymous cross-sectional survey was conducted among pilgrims in Greater Makkah during the Hajj in 2017–2018. Data on socio-demographic characteristics, vaccination status, cost of vaccination, and reasons behind non-receipt of the vaccine were collected. Results: A total of 509 respondents aged 13 to 82 (median 33.8) years participated in the survey: 86% male, 85% domestic pilgrims. Only 389/476 (81.7%) confirmed their meningococcal vaccination status; 64 individuals (13.4%), all domestic pilgrims, did not receive the vaccine, and 23 (4.8%) were unsure. Among overseas pilgrims, 93.5% certainly received the vaccine (6.5% were unsure) compared to 80.9% of domestic pilgrims (p < 0.01). Being employed and having a tertiary qualification were significant predictors of vaccination adherence (odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.3–3.8, p < 0.01; and OR = 1.7, CI = 1–2.5, p < 0.05, respectively). Those who obtained pre-Hajj health advice were more than three times as likely to be vaccinated than those who did not (OR = 3.3, CI = 1.9–5.9, p < 0.001). Lack of awareness (63.2%, 36/57) and lack of time (15.8%, 9/57) were the most common reasons reported for non-receipt of vaccine. Conclusion: Many domestic pilgrims missed the compulsory meningococcal vaccine; in this regard, lack of awareness is a key barrier. Being an overseas pilgrim (or living at a distance from Makkah), receipt of pre-Hajj health advice, and employment were predictors of greater compliance with the vaccination policy. Opportunities remain to reduce the policy–practice gap among domestic pilgrims. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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Review

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13 pages, 3060 KiB  
Review
The COVID-19 Pandemic: Disproportionate Thrombotic Tendency and Management Recommendations
by Sabina Karim, Amin Islam, Shafquat Rafiq and Ismail Laher
Trop. Med. Infect. Dis. 2021, 6(1), 26; https://doi.org/10.3390/tropicalmed6010026 - 18 Feb 2021
Cited by 11 | Viewed by 4694
Abstract
COVID-19 is an infectious disease caused by the SARS COV-2 virus. Patients with COVID-19 are susceptible to thrombosis due to excessive inflammation, platelet activation, endothelial dysfunction, and circulatory stasis, resulting in an increased risk of death due to associated coagulopathies. In addition, many [...] Read more.
COVID-19 is an infectious disease caused by the SARS COV-2 virus. Patients with COVID-19 are susceptible to thrombosis due to excessive inflammation, platelet activation, endothelial dysfunction, and circulatory stasis, resulting in an increased risk of death due to associated coagulopathies. In addition, many patients receiving antithrombotic therapy for pre-existing thrombotic diseases can develop COVID-19, which can further complicate dose adjustment, choice and laboratory monitoring of antithrombotic treatment. This review summarizes the laboratory findings, the prohemostatic state, incidence of thromboembolic events and some potential therapeutic interventions of COVID-19 associated coagulopathy. We explore the roles of biomarkers of thrombosis and inflammation according to the severity of COVID-19. While therapeutic anticoagulation has been used empirically in some patients with severe COVID-19 but without thrombosis, it may be preferable to provide supportive care based on evidence-based randomized clinical trials. The likely lifting of travel restrictions will accelerate the spread of COVID-19, increasing morbidity and mortality across nations. Many individuals will continue to receive anticoagulation therapy regardless of their location, requiring on-going treatment with low-molecular weight heparin, vitamin K antagonist or direct-acting anticoagulants. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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18 pages, 440 KiB  
Review
Knowledge, Attitudes and Perceptions of Immigrant Parents Towards Human Papillomavirus (HPV) Vaccination: A Systematic Review
by Faeza Netfa, Mohamed Tashani, Robert Booy, Catherine King, Harunor Rashid and Susan R. Skinner
Trop. Med. Infect. Dis. 2020, 5(2), 58; https://doi.org/10.3390/tropicalmed5020058 - 9 Apr 2020
Cited by 47 | Viewed by 8574
Abstract
Background: Our understanding about knowledge, attitudes and perceptions (KAP) of immigrants regarding human papillomavirus (HPV) vaccine is poor. We present the first systematic review on KAP of immigrant parents towards HPV vaccine offered to their children. Methods: Major bio-medical databases (Medline, Embase, Scopus [...] Read more.
Background: Our understanding about knowledge, attitudes and perceptions (KAP) of immigrants regarding human papillomavirus (HPV) vaccine is poor. We present the first systematic review on KAP of immigrant parents towards HPV vaccine offered to their children. Methods: Major bio-medical databases (Medline, Embase, Scopus and PsycINFO) were searched using a combination of keyword and database-specific terms. Following identification of studies, data were extracted, checked for accuracy, and synthesised. Quality of the studies was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment tool. Results: A total of 311 titles were screened against eligibility criteria; after excluding 292 titles/full texts, 19 studies were included. The included studies contained data on 2206 adults. Participants’ knowledge was explored in 16 studies and ranged from none to limited knowledge. Attitudes about HPV vaccination were assessed in 13 studies and were mixed: four reported negative attitudes fearing it would encourage sexual activity; however, this attitude often changed once parents were given vaccine information. Perceptions were reported in 10 studies; most had misconceptions and concerns regarding HPV vaccination mostly influenced by cultural values. Conclusion: The knowledge of HPV-related diseases and its vaccine among immigrant parents in this study was generally low and often had negative attitude or perception. A well-designed HPV vaccine health educational program on safety and efficacy of HPV vaccination targeting immigrant parents is recommended. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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25 pages, 552 KiB  
Review
The Contribution of Wastewater to the Transmission of Antimicrobial Resistance in the Environment: Implications of Mass Gathering Settings
by Nour Fouz, Krisna N. A. Pangesti, Muhammad Yasir, Abdulrahman L. Al-Malki, Esam I. Azhar, Grant A. Hill-Cawthorne and Moataz Abd El Ghany
Trop. Med. Infect. Dis. 2020, 5(1), 33; https://doi.org/10.3390/tropicalmed5010033 - 25 Feb 2020
Cited by 116 | Viewed by 9584
Abstract
Antimicrobial resistance (AMR) is the major issue posing a serious global health threat. Low- and middle-income countries are likely to be the most affected, both in terms of impact on public health and economic burden. Recent studies highlighted the role of resistance networks [...] Read more.
Antimicrobial resistance (AMR) is the major issue posing a serious global health threat. Low- and middle-income countries are likely to be the most affected, both in terms of impact on public health and economic burden. Recent studies highlighted the role of resistance networks on the transmission of AMR organisms, with this network being driven by complex interactions between clinical (e.g., human health, animal husbandry and veterinary medicine) and other components, including environmental factors (e.g., persistence of AMR in wastewater). Many studies have highlighted the role of wastewater as a significant environmental reservoir of AMR as it represents an ideal environment for AMR bacteria (ARB) and antimicrobial resistant genes (ARGs) to persist. Although the treatment process can help in removing or reducing the ARB load, it has limited impact on ARGs. ARGs are not degradable; therefore, they can be spread among microbial communities in the environment through horizontal gene transfer, which is the main resistance mechanism in most Gram-negative bacteria. Here we analysed the recent literature to highlight the contribution of wastewater to the emergence, persistence and transmission of AMR under different settings, particularly those associated with mass gathering events (e.g., Hajj and Kumbh Mela). Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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Other

4 pages, 509 KiB  
Case Report
Acute Pulmonary Histoplasmosis Outbreak in A Documentary Film Crew Travelling from Guatemala to Australia
by Stephen Muhi, Amy Crowe and John Daffy
Trop. Med. Infect. Dis. 2019, 4(1), 25; https://doi.org/10.3390/tropicalmed4010025 - 1 Feb 2019
Cited by 7 | Viewed by 3375
Abstract
Histoplasma capsulatum is an endemic mycosis with a widespread distribution, although it is infrequently reported in travellers. In April 2018, five television crew members developed an acute febrile illness after filming a documentary about vampire bats in Guatemala. Patients developed symptoms after travelling [...] Read more.
Histoplasma capsulatum is an endemic mycosis with a widespread distribution, although it is infrequently reported in travellers. In April 2018, five television crew members developed an acute febrile illness after filming a documentary about vampire bats in Guatemala. Patients developed symptoms after travelling to Australia, where they presented for medical care. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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6 pages, 183 KiB  
Case Report
Persistent Burkholderia pseudomallei Bacteremia in A Filipino Immigrant to the United States: A Case Report
by Sumbul Meraj, Brandy Rodenberg, Stephanie Thannum, Jared Sheley and Jena Foreman
Trop. Med. Infect. Dis. 2019, 4(1), 20; https://doi.org/10.3390/tropicalmed4010020 - 28 Jan 2019
Cited by 3 | Viewed by 3090
Abstract
Melioidosis is rare in the United States and endemic to Southeast Asia and Australia. Treatment includes an initial intensive phase of intravenous ceftazidime or meropenem monotherapy depending on severity. The following report describes a case of persistent bacteremia with ceftazidime failure and prolonged [...] Read more.
Melioidosis is rare in the United States and endemic to Southeast Asia and Australia. Treatment includes an initial intensive phase of intravenous ceftazidime or meropenem monotherapy depending on severity. The following report describes a case of persistent bacteremia with ceftazidime failure and prolonged meropenem therapy on a ceftazidime-susceptible strain of Burkholderia pseudomallei. Full article
(This article belongs to the Special Issue Travel and Tropical Medicine)
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