The objective of this study is to determine frequency, duration and morbidity of (travel-related) health problems and/or exacerbations of underlying illnesses among Dutch travelers of 60 years and older visiting (sub)tropical destinations for a…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
Infecties, verergering onderliggend medisch lijden
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The main endpoints of the primary objective are the occurrence, duration in
days and morbidity of an acquired illness during travel and four weeks after
return. The focus will be on different type of health complaints:
- Fever
- Gastrointestinal
- Respiratory
- Dermatological
- Cardiovascular
- Genitourinary tract
Other endpoints of the objective are:
- Hand grip strength in kilograms before travel (vitality).
- Patient-reported health before, during and after travel (SF-36 and Charlson
Comorbidity Index).
- Independence in activities of daily living (Katz-ADL).
- Cognitive functioning before travel (6CIT).
Secondary outcome
- Frequency of medical conditions before travel (e.g. diabetes mellitus, COPD,
cardiovascular disease)
- Frequency of medication use before travel
- Number of medicines used before travel (e.g. polypharmacy)
- Frequency of infectious or non-infectious illnesses during travel or in the
Netherlands until four weeks after return
- Frequency of a new medical condition or an exacerbation of underlying medical
condition during travel or in the Netherlands until four weeks after return
- Percentage of medication adjustments during travel and four weeks or in the
Netherlands until four weeks after return
- Frequency of self-reported compliance with prescribed antimalarials during
travel
- Frequency of doctor visits abroad or in the Netherlands until four weeks
after return
- Frequency and duration of hospitalizations abroad or in the Netherlands until
four weeks after return
Other study parameters
Demographical parameters
- Gender
- Age
- Education level
- Weight (in kilograms)
- Length (in centimetres)
- Body Mass Index (BMI), weight/(length in meter2)
- Immigrant
Travel parameters
- Destination
- Duration
- Type of travel
- Type of accommodation
- Self-reported risk behaviour during travel (nutrition, hygiene, activities)
- Jetlag
- Travel health insurance, covering medical costs and repatriation.
Background summary
People live longer in better health and are fit to travel at increasing ages.
Many elderly travelers are exposed to a variety of health risks during
international travel such as gastrointestinal or respiratory problems, poorly
regulated diabetes mellitus, cardiovascular disease or (traffic) accidents.
About ten to fifteen percent of the travelers visiting a Dutch travel clinic is
60 years or older. Statistics Netherlands reported that between 2002 and 2013
the number of individuals 65 years and above traveling to destinations outside
Western-Europe increased from 382.000 to 500.000. South East Asia is a popular
destination and travel to this continent is often accompanied by
gastrointestinal infections.
Comorbidity and accompanying polypharmacy make elderly travelers vulnerable for
diseases both at home and abroad. Over 80% of persons 60 years or older are
taking medically prescribed drugs. Acquiring an infectious disease during
travel could cause serious health problems, particularly in elderly travelers
on diuretics, ACE-blockers and NSAIDS. These kinds of drugs could lead to more
severe symptoms in case of diarrhea or other diseases. In addition,
exacerbation of underlying chronic medical conditions increase susceptibility
for other health problems adding to the burden of travel-related disease.
Previous studies demonstrated that between 10% and 15% of the elderly travelers
develop diarrhea during travel. Travelers might be hospitalized for several
reasons during travel and sometimes repatriation to their home country is
required. However, the travel insurance status of Dutch travelers is not well
known.
Pre-travel counseling in the Netherlands is primarily aimed at providing advice
to reduce (sub)tropical travel-related health risks and administering
vaccinations. A few small studies reported that elderly travelers often
undertake pre-arranged and well organized trips instead of adventurous travel.
Because of their travel type and age related health problems they have to deal
with other health risks than younger travelers. We hypothesize that the group
of elderly travelers is not getting the tailored advice appropriate for their
needs and might need other information in the pre-travel advice.
The aim of the project is therefore to determine the frequency, duration and
morbidity of the most common travel-related health problems among elderly Dutch
travelers visiting (sub)tropical destinations for a short-term stay (35 days or
less). With this information we will develop possible risk profiles of elderly
travelers, which could be used for tailoring current medical and non-medical
pre-travel advice to reduce illness or exacerbation of an underlying medical
condition while abroad. Travel medicine guidelines could then be adjusted for
this specific group of travelers. Also tailored behavioral risk reducing
measures could be developed.
Study objective
The objective of this study is to determine frequency, duration and morbidity
of (travel-related) health problems and/or exacerbations of underlying
illnesses among Dutch travelers of 60 years and older visiting (sub)tropical
destinations for a short-term stay to establish risk profiles characterized by
vitality, health status and cognitive functioning.
Study design
Multicenter prospective (observational) cohort study.
Study burden and risks
In this study there are no medical risks nor benefits for the participants. All
participants will receive the standard pre-travel advice according to the Dutch
national coordination center for travelers health advice (LCR). The study
consists of two parts: A) Participation in a cognitive- and physical
functioning test and B) Participation in questionnaires and diary. For part A
travelers will be informed while visiting the travel clinic or MHS for the
pre-travel advice and provide written informed consent before tests are being
conducted. For part B travelers will be contacted by the study team and decide
at home if they are willing to participate. Only when a traveler is interested,
study documents (information letter, informed consent, questionnaires, diary
and medicine list) will be sent by post. All documents can be filled in at
home; only the diary has to be filled in during travel. No extra visits are
required to the travel clinic where the pre-travel consult was received.
Albinusdreef 2
Leiden 2333 ZA
NL
Albinusdreef 2
Leiden 2333 ZA
NL
Listed location countries
Age
Inclusion criteria
- 60 years and older;
- Planned travel to the (sub)tropics. (Sub)tropical areas are defined as countries where hepatitis A is endemic and for which vaccination is recommended according to the LCR.
-Travel duration of five weeks (35 days) or less.
- Ability to complete the questionnaires and diary.
- Ability to speak and read Dutch fluently.
- Ability to sign the informed consent form.
Exclusion criteria
- 59 years or younger.
- Travel to a destination for which no hepatitis A vaccination is recommended according to the LCR.
- Inability to complete questionnaires and diary.
- Travel duration longer than 5 weeks (>35 days)
- Visit to travel clinic is less than two weeks before departure.
- Inability to speak or read Dutch.
- Inability to complete questionnaire and diary.
- Incapacitated travelers.
- Absence of written informed consent.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
In other registers
| Register | ID |
|---|---|
| CCMO | NL54793.058.16 |
| OMON | NL-OMON26025 |