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Travel behaviours and health outcomes during travel: Profiling destination-specific risks in a prospective mHealth cohort of Swiss travellers


Farnham, Andrea; Baroutsou, Vasiliki; Hatz, Christoph; Fehr, Jan; Kuenzli, Esther; Blanke, Ulf; Puhan, Milo A; Bühler, Silja (2022). Travel behaviours and health outcomes during travel: Profiling destination-specific risks in a prospective mHealth cohort of Swiss travellers. Travel Medicine and Infectious Disease, 47:102294.

Abstract

BACKGROUND

We used a mobile application to determine the incidence of health events and risk behaviours during travel by country and identify which health risks are significantly elevated during travel compared with at home.

METHOD

TOURIST2 is a prospective cohort study of 1000 adult travellers from Switzerland to Thailand, India, China, Tanzania, Brazil and Peru, planning travel of ≤4 weeks between 09/2017 and 04/2019. The incidence rate ratio (IRR) in each country was calculated.

RESULTS

All countries had significantly higher incidence of health events than at home. The most elevated symptoms were sunburn, itching from mosquitoes, and gastrointestinal disorders (e.g. vomiting, diarrhoea), corresponding with universally high food/drink risk behaviours. Peru had the highest incidence of both overall negative health events and severe health events (172.0/1000 travel-days). Traffic accidents were significantly higher in Peru (IRR: 2.4, 1.2, 4.7), although incidence of transportation risk was highest in India and Thailand. In Tanzania, incidence of negative mental health events was significantly lower than at home, although it was elevated in other countries. Sexual risk behaviours were high in Brazil.

CONCLUSIONS

Our study improves the understanding of the non-infectious disease related health challenges travellers face and provides evidence for more personalised traveller support.

Abstract

BACKGROUND

We used a mobile application to determine the incidence of health events and risk behaviours during travel by country and identify which health risks are significantly elevated during travel compared with at home.

METHOD

TOURIST2 is a prospective cohort study of 1000 adult travellers from Switzerland to Thailand, India, China, Tanzania, Brazil and Peru, planning travel of ≤4 weeks between 09/2017 and 04/2019. The incidence rate ratio (IRR) in each country was calculated.

RESULTS

All countries had significantly higher incidence of health events than at home. The most elevated symptoms were sunburn, itching from mosquitoes, and gastrointestinal disorders (e.g. vomiting, diarrhoea), corresponding with universally high food/drink risk behaviours. Peru had the highest incidence of both overall negative health events and severe health events (172.0/1000 travel-days). Traffic accidents were significantly higher in Peru (IRR: 2.4, 1.2, 4.7), although incidence of transportation risk was highest in India and Thailand. In Tanzania, incidence of negative mental health events was significantly lower than at home, although it was elevated in other countries. Sexual risk behaviours were high in Brazil.

CONCLUSIONS

Our study improves the understanding of the non-infectious disease related health challenges travellers face and provides evidence for more personalised traveller support.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Public Health, Environmental and Occupational Health
Health Sciences > Infectious Diseases
Language:English
Date:May 2022
Deposited On:06 Jan 2023 07:24
Last Modified:28 Jun 2024 01:37
Publisher:Elsevier
ISSN:1477-8939
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.tmaid.2022.102294
PubMed ID:35247578
  • Content: Published Version
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)