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Enquiries to the United Kingdom National Travel Advice Line by healthcare professionals regarding immunocompromised travellers.
J Travel Med. 2016 Mar; 23(3)JT

Abstract

BACKGROUND

People who travel while immunocompromised are more at risk of serious travel-related infection. Their condition, medications or treatments can contraindicate, decrease the effectiveness of or increase the toxicity of vaccinations or malaria chemoprophylaxis. Therefore, immunocompromised travellers require careful assessment and specialized pre-travel advice. The aims of this study were to investigate enquiries by healthcare professionals (HCPs) to the UK National Travel Health Network and Centre (NaTHNaC) advice line regarding travellers with immunocompromise and to identify their most common concerns.

METHODS

Documentation for all calls taken by advisers at the London office during 2013 was reviewed.

RESULTS

Of the 4910 enquiries to the London NaTHNaC advice line, 397 calls concerned immunocompromised travellers (8.1%). The majority of immunocompromised travellers were planning to visit Sub-Saharan Africa (53%) for the purpose of tourism (43%). Sixty-seven percent of enquiries concerned vaccine use, 11% were about malaria chemoprophylaxis, 20% were about both and 2% were for other reasons. Causes of immunocompromise included inflammatory or autoimmune conditions (43%), cancer (18%), splenic dysfunction (13%), immunosuppressive drugs (12%), human immunodeficiency virus (11%), primary immunodeficiency (1%), neutropenia (0.5%) and thymus abnormalities (0.5%).

CONCLUSIONS

There were frequent enquires to the advice line by UK HCPs regarding immunocompromised travellers. The travellers in this study had a wide range of underlying medical conditions and varying levels of immunocompromise. These enquiries may reflect a lack of clarity in current national guidelines, difficulties in interpreting them or both. Establishing the reasons for these deficiencies as well as the reasons behind UK HCP concerns and lack of confidence requires further investigation. This research has highlighted potential knowledge gaps and will help inform future guidance and educational activities for UK HCPs advising travellers.

Authors+Show Affiliations

Hospital for Tropical Diseases, London, UK joanna.allen6@nhs.net.National Travel Health Network and Centre, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27021497

Citation

Allen, Joanna E., and Dipti Patel. "Enquiries to the United Kingdom National Travel Advice Line By Healthcare Professionals Regarding Immunocompromised Travellers." Journal of Travel Medicine, vol. 23, no. 3, 2016.
Allen JE, Patel D. Enquiries to the United Kingdom National Travel Advice Line by healthcare professionals regarding immunocompromised travellers. J Travel Med. 2016;23(3).
Allen, J. E., & Patel, D. (2016). Enquiries to the United Kingdom National Travel Advice Line by healthcare professionals regarding immunocompromised travellers. Journal of Travel Medicine, 23(3). https://doi.org/10.1093/jtm/taw016
Allen JE, Patel D. Enquiries to the United Kingdom National Travel Advice Line By Healthcare Professionals Regarding Immunocompromised Travellers. J Travel Med. 2016;23(3) PubMed PMID: 27021497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enquiries to the United Kingdom National Travel Advice Line by healthcare professionals regarding immunocompromised travellers. AU - Allen,Joanna E, AU - Patel,Dipti, Y1 - 2016/03/28/ PY - 2016/03/04/accepted PY - 2016/3/30/entrez PY - 2016/3/30/pubmed PY - 2016/12/15/medline KW - Travel medicine KW - immunocompromised patient KW - yellow fever vaccine JF - Journal of travel medicine JO - J Travel Med VL - 23 IS - 3 N2 - BACKGROUND: People who travel while immunocompromised are more at risk of serious travel-related infection. Their condition, medications or treatments can contraindicate, decrease the effectiveness of or increase the toxicity of vaccinations or malaria chemoprophylaxis. Therefore, immunocompromised travellers require careful assessment and specialized pre-travel advice. The aims of this study were to investigate enquiries by healthcare professionals (HCPs) to the UK National Travel Health Network and Centre (NaTHNaC) advice line regarding travellers with immunocompromise and to identify their most common concerns. METHODS: Documentation for all calls taken by advisers at the London office during 2013 was reviewed. RESULTS: Of the 4910 enquiries to the London NaTHNaC advice line, 397 calls concerned immunocompromised travellers (8.1%). The majority of immunocompromised travellers were planning to visit Sub-Saharan Africa (53%) for the purpose of tourism (43%). Sixty-seven percent of enquiries concerned vaccine use, 11% were about malaria chemoprophylaxis, 20% were about both and 2% were for other reasons. Causes of immunocompromise included inflammatory or autoimmune conditions (43%), cancer (18%), splenic dysfunction (13%), immunosuppressive drugs (12%), human immunodeficiency virus (11%), primary immunodeficiency (1%), neutropenia (0.5%) and thymus abnormalities (0.5%). CONCLUSIONS: There were frequent enquires to the advice line by UK HCPs regarding immunocompromised travellers. The travellers in this study had a wide range of underlying medical conditions and varying levels of immunocompromise. These enquiries may reflect a lack of clarity in current national guidelines, difficulties in interpreting them or both. Establishing the reasons for these deficiencies as well as the reasons behind UK HCP concerns and lack of confidence requires further investigation. This research has highlighted potential knowledge gaps and will help inform future guidance and educational activities for UK HCPs advising travellers. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/27021497/Enquiries_to_the_United_Kingdom_National_Travel_Advice_Line_by_healthcare_professionals_regarding_immunocompromised_travellers_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/taw016 DB - PRIME DP - Unbound Medicine ER -