Fiebre

3
ORIGINAL ARTICLES
Knowledge, Attitudes and Practices in Travel-related
Infectious Diseases: The European Airport Survey
Koen Van Herck, Francesco Castelli, Jane Zuckerman, Hans Nothdurft,
Pierre Van Damme,Atti-La Dahlgren, Panagiotis Gargalianos, Rogelio Lopéz-Vélez,
David Overbosch, Eric Caumes, Eric Walker, Sandra Gisler, and Robert Steffen
Koen Van Herck, MD, and Pierre Van Damme, MD,PhD: WHO
Collaborating Centre for Prevention and Control of Viral Hepatitis,
Unit of Epidemiology and Social Medicine, University of Antwerp,
Antwerp, Belgium; Francesco Castelli, MD, PhD: Postgraduate
School of Tropical Medicine, University of Brescia, Brescia, Italy;
Jane Zuckerman, MD, FFPM, FBiol, FRCPath: WHO Collaborating
Centre for Travel Medicine, Royal Free & University CollegeMedical School, London, UK; Hans Nothdurft, MD, PhD:
Department of Infectious Diseases and Tropical Medicine,
University of Munich, Munich, Germany; Atti-La Dahlgren, MD,
MPH, Sandra Gisler, Medical Student and Robert Steffen, MD,
PhD: WHO Collaborating Centre for Travelers’ Health, Division of
Epidemiology and Prevention of Communicable Diseases,
University of Zurich, Zurich, Switzerland;Panagiotis Gargalianos,
MD, PhD: Department of Internal Medicine, Special Infections
Unit, General Hospital “G. Genimatas”, Athens, Greece; Rogelio
Lopéz-Vélez, MD, DTM&H, PhD: Tropical Medicine & Clinical
Parasitology, Infectious Diseases Department, Hospital Ramon y
Background: The European Travel Health Advisory Board conducted a cross-sectional pilot survey to evaluate current travel
healthknowledge, attitudes and practices (KAP) and to determine where travelers going to developing countries obtain
travel health information, what information they receive, and what preventive travel health measures they employ.
Subsequently, the questionnaire used was improved and a cross-sectional, multicenter study was undertaken in airports
in Europe, Asia, South Africa and the United States.This paper describes the methods used everywhere, and results from
the European airports.
Method: Between September 2002 and September 2003, 5,465 passengers residing in Europe and boarding an intercontinental
flight to a developing country were surveyed at the departure gates of nine major airports in Europe.
Questionnaires were self-administered, and checked for completeness and validated bytrained interviewers.
Results: Although the majority of travelers (73.3%) had sought general information about their destination prior to departure,
only just over half of the responders (52.1%) had sought travel health advice. Tourists and people traveling for religious reasons
had sought travel health advice more often, whereas travelers visiting friends and relatives were less likely to doso.
Hepatitis A was perceived as the most probable among the infectious diseases investigated, followed by HIV and hepatitis
B. In spite of a generally positive attitude towards vaccines, 58.4% and 68.7% of travelers could not report any protection against
hepatitis A or hepatitis B, respectively. Only one in three travelers to a destination country with at least some malaria endemicity
werecarrying antimalarial drugs. Almost one in four travelers visiting a high-risk area had an inaccurate risk perception
and even one in two going to a no-risk destination were unnecessarily concerned about malaria.
Conclusions: The large variation in destinations, age of the travelers and reasons for traveling illustrates that traveling
to a developing country has become common practice. Theresults of this large-scale airport survey clearly demonstrate
an important educational need among those traveling to risk destinations. Initiatives to improve such education should
target all groups of travelers, including business travelers, those visiting friends and relatives, and the elderly. Additionally,
travel health advice providers should continue their efforts to make travelers comply...