Travelers' compliance to prophylactic measures and behavior during stay abroad: Results of a retrospective study of subjects returning to a travel medicine center in Italy

Background. Many sources of health advice are consulted by travelers, but in Europe, only 35% go to a travel clinic. Travel to countries outside Europe increases daily, and from 2001 to 2004, there was a marked increase in the number of travelers from the Florentine area crossing the borders (+18.0%), taking a plane (+81.4% of international travelers in Pisa airport), and applying to the Centre of Travel and Migration Medicine (CTMM) (+96%). Methods. An anonymous survey was carried out at CTMM among those travelers returning to complete vaccinations for which the first dose had been given before going abroad. The survey included questions on vaccination status, adherence to recommended antimalaria prophylaxis, occurrence of other health problems, and food and drink consumption. Results. The study population (which represents a "best case scenario") was composed of 1,237 subjects and had a very high compliance to the proposed questionnaire (95%). Approximately 55% of travelers took malaria chemoprophylactic measures, and 88% of them followed the indications given. Approximately 28% reported one or more secondary effects following antimalarial medication, and approximately 69% reported constant attention regarding safe consumption of food and drinks. Notwithstanding these measures, 236 cases of travelers' diarrhea were reported. Conclusions.Our results are conditioned by the self-selection of the study population (those who seek advice are likely to follow it through). However, since no certainty exists about other sources of health advice for the remainder of the traveler population in our region, both the importance of counseling offered by travel clinics as well as the recommendation to the ever-increasing number of travelers to consult these clinics are stressed.