Oct 24, Singapore, ITB Asia:
Topic:
A Doctor in Your Pocket: Using Mobile Technology to Transform Global Travelers Access to Quality Healthcare
http://www.itb-asia.com/en/EventsAndConferences/EventProgram/EventDetails.jsp?fairID=270764&eventDateId=277339&lang=en
11. 880
million travelers a year
:
Source: Han, P.,Yanni, E., Jentes, E. S., Hamer, D. H., Chen, L. H., Wilson, M. E., et al. (2012). Health challenges of young travelers visiting friends and relatives compared
with those traveling for other purposes. The Pediatric Infectious Disease Journal, 31(9), 915-919.
12. 880
million travelers a year
563M
with health impairments
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J.,
Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
13. 88M
seek medical care
880M
travelers a year
563M
with health impairments
Source: Lerdal A, Harding T, Kjolstad S. Illness and injury presenting to a norwegian travel insurance company’s helpline. Travel Med Infect Dis. 2007;5(3):165-170.
14. 176M
seek medical care
1.6bn
International arrivals by 2020
563M
1.02bn
with health impairments
with health impairments
Source: http://www.mint.hr/UserDocsImages/08-C-Wohlmuther.pdf
17. 73.3%!
had sought general
information about
destination
Source: Van Herck, K.,Van Damme, P., Castelli, F., Zuckerman, J., Nothdurft, H., Dahlgren, A. L., et al. (2004). Knowledge, attitudes and practices in travel-related
infectious diseases: The european airport survey. Journal of Travel Medicine, 11(1), 3-8.
18. 52.1%!
had sought travel
health advice
Source: Van Herck, K.,Van Damme, P., Castelli, F., Zuckerman, J., Nothdurft, H., Dahlgren, A. L., et al. (2004). Knowledge, attitudes and practices in travel-related
infectious diseases: The european airport survey. Journal of Travel Medicine, 11(1), 3-8.
19. 20.2%!
were not aware
Source: Van Herck, K.,Van Damme, P., Castelli, F., Zuckerman, J., Nothdurft, H., Dahlgren, A. L., et al. (2004). Knowledge, attitudes and practices in travel-related
infectious diseases: The european airport survey. Journal of Travel Medicine, 11(1), 3-8.
20. 18.7%!
no risk to health
Source: Van Herck, K.,Van Damme, P., Castelli, F., Zuckerman, J., Nothdurft, H., Dahlgren, A. L., et al. (2004). Knowledge, attitudes and practices in travel-related
infectious diseases: The european airport survey. Journal of Travel Medicine, 11(1), 3-8.
21. 6.3%!
too busy
Source: Van Herck, K.,Van Damme, P., Castelli, F., Zuckerman, J., Nothdurft, H., Dahlgren, A. L., et al. (2004). Knowledge, attitudes and practices in travel-related
infectious diseases: The european airport survey. Journal of Travel Medicine, 11(1), 3-8.
26. Pre-Travel
Review of the itinerary
Immunizations
Past medication history
Prevention and self-treatment
Prescriptions and medical records
Source: Bomsztyk M, Arnold RW. Infections in travelers. Med Clin North Am. 2013;97(4):697-720, xi.
27. Diseases
Allergic Rash
Hepatitis B
Pharyngitis
Tuberculosis
Blood Clot
Hepatitis C
Pneumonia
Typhoid fever
Dengue
HIV
Sexual Assault
Yellow fever
Diarrhea
Leishmaniasis
Schistosomiasis
Encephalitis
Leptospirosis
Sunburn
Heart attack
Meningitis
Skin Abscess
Hepatitis A
Malaria
Trypanosomiasis
Source: Bomsztyk M, Arnold RW. Infections in travelers. Med Clin North Am. 2013;97(4):697-720, xi.
30. Gastrointestinal
33% !
Source:: Field V, Gautret P, Schlagenhauf P, et al. Travel and migration associated infectious diseases morbidity in europe, 2008. BMC Infect Dis.
2010;10:330-2334-10-330.
31. Gastrointestinal
Diarrhea
Giardiasis
33% !
Amebasis
Source:: Field V, Gautret P, Schlagenhauf P, et al. Travel and migration associated infectious diseases morbidity in europe, 2008. BMC Infect Dis.
2010;10:330-2334-10-330.
32. Diarrhea
45%!
:
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J.,
Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
33. Diarrhea
45%!
40% change
travel plans
:
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J., Schonfeld, C., et al.
(2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
34. Diarrhea
45%!
40% change
travel plans
20% are confined
to bed
:
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J.,
Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
35. Diarrhea
45%!
40% change
travel plans
20% are confined
to bed
1% require
hospital admission
:
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J.,
Schonfeld, C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
38. Febrile Illnesses
Malaria
Dengue
Viral Hepatitis
20% !
Source:: Field V, Gautret P, Schlagenhauf P, et al. Travel and migration associated infectious diseases morbidity in europe, 2008. BMC Infect Dis.
2010;10:330-2334-10-330.
39. Malaria
1M+
!
100+ countries worldwide
Affects 500M people
80-90 million travelers
Deaths per Year
:
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J., Schonfeld,
C., et al. (2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
40. Skin Conditions
Bacterial Infections
Rash
Sunburn
12% !
Source:: Field V, Gautret P, Schlagenhauf P, et al. Travel and migration associated infectious diseases morbidity in europe, 2008. BMC Infect Dis.
2010;10:330-2334-10-330.
41. Skin Conditions
40%
Bacterial
25%
Fungal
Source: Hochedez P, et al. Changes in the pattern of health disorders diagnosed among two cohorts of French travelers to Nepal, 17 years apart. J Travel Med.
2004;341-346.
43. Tuberculosis
Expatriates higher risk
Only 30-66%
Latent TB risk ~1 to 4 cases
per 1000 person months.
receive appropriate
screening and counseling
Health care expats 8 cases
per 1000 person months
Sources: Lim P, Han P, Chen LH, et al. Expatriates ill after travel: results from the Geosentinel Surveillance Network. BMC Infect Dis. 2012;12:386.
Dijkstra J, Chappuis F, Loutan L.Vaccine-preventable diseases in long-term expatriates. J Travel Med. 2005;12:S47–57.
Gardner A, Cohen T, Carter EJ. Tuberculosis among participants in an academic global health medical exchange program. J Gen Intern Med. 2011;26:841–5.
47. STI
60+% report inconsistent
condom use
59% of Dutch expatriates
paid for sex at least once
50%!
of travelers report sex
with new partner
:
Source: Patel, D. (2011). Occupational travel. Occupational Medicine (Oxford, England), 61(1), 6-18Rack, J., Wichmann, O., Kamara, B., Gunther, M., Cramer, J., Schonfeld, C., et al.
(2005). Risk and spectrum of diseases in travelers to popular tourist destinations. Journal of Travel Medicine, 12(5), 248-253.
48. HIV Post-Exposure Prophylaxis
Reduce HIV transmission by reducing HIV in bloodstream
CDC recommends post-exposure prophylaxis after high (or moderate)
risk exposure.
22%
at rapid HIV testing aware
Sources: Otten, R. et al. (2000). Efficacy of postexposure prophylaxis after intravaginal exposure of pig-tailed macaques to a human-derived retrovirus (human
immunodeficiency virus type 2). Journal of Virology, 74(20), 9771-9775.
Smith, D. K., et al. (2005). Antiretroviral postexposure prophylaxis after sexual, injectiondrug use, or other nonoccupational exposure to HIV in the United States:
Recommendations from the U.S. Department of Health and Human Services. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report,
Recommendations and Reports. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm
Awareness and use of nonoccupational HIV post-exposure prophylaxis among people receiving rapid HIV testing in Spain. HIV Med. 2013 Apr;14(4);252-7.
49. Chronic Illnesses
70%!
of all travel-related death due to
cardiovascular disease
Avg age of people who die during travel is 60
22.5% of international travelers are 60
Sources: Carl J. Lawson, MPH, Deaths in International Travelers Arriving in the United States, July 1, 2005 to June 30, 2008, Journal of Travel Medicine 2012;
Volume 19 (Issue 2): 96–103
50. “It is essential that travelers are aware of
mortality risk associated with their underlying
diseases and that they are properly prepared to
handle them while traveling.”
51. “Persons with chronic medical conditions and
the elderly should promptly seek medical care if
they become ill during travel.”
52. Reasons for Sickness
Length
of stay
Age
Delays in
seeking
medical care
Gender
Physical
exertion
Season of
travel
Medication
adherence
Climatic and
cultural contrast
Excess alcohol
Level of travel experience
Dietary
indiscretion
Destination
Sources: Novaro GM et al. Cardiovascular emergencies in cruise ship passengers.
Am J Cardiol 2010; 105:153–157. Lawson CJ et al. Deaths in International Travelers Arriving in the United States, July 1, 2005 to June 30, 2008. J Travel Med 2012; 19: 96–103.
58. Patient Experience
She found Dr. Tuakli
Booked an
appointment with
her online
Used her text message
reminder to find
directions to Dr.
Tuakli’s practice