Date Published: April 12, 2019
Publisher: Public Library of Science
Author(s): Abdoulkader Ali Adou, Francesco Napolitano, Alessandra Vastola, Italo Francesco Angelillo, Catherin Nisha.
The objectives of this investigation were to examine the travelers’ knowledge, attitudes, and behavior about travel-related diseases and to evaluate the factors that influence their knowledge, attitudes, and behavior. A cross-sectional study was performed between May and September 2018 among a random sample of individuals attending randomly selected travel agencies in the geographical areas of Caserta and Naples, Italy. One fourth of participants (25.6%) had a poor level of knowledge, 50.2% a moderate, and only 24.2% a good level about the most common infectious diseases in the destination country. Those who had received information from physicians about the most common infectious diseases in the destination country and who do not need additional information were significantly more likely to have a good level of knowledge. A large majority (91%) showed no concern about the risk of getting an infectious disease during the travel. Almost half of the respondents had received information concerning the most common infectious diseases in the destination country and the related prevention measures. This information was more likely acquired by those graduated, those who know the foods that can cause the infectious diseases, and those who self-perceived a well health status, and less likely by those who had a poor level of knowledge about the most common infectious diseases in the destination country and who were going to Asia and South America. Education and communication activities regarding all aspects of travel-related diseases are needed to increase the knowledge and the access to preventive measures.
The annual number of international travelers has steadily increased over the last decade all around the world  and the acquisition of travel-associated infectious and non-infectious diseases is one of the major public health consequences for them [2,3]. In particular, travel to tropical and sub-tropical geographic areas cause an increased probability of exposure to endemic infectious diseases [4–6]. Moreover, it is well known that the diffusion of travel-related infectious diseases is favored by a higher likelihood of visiting rural and remote areas, activities during travel, greater consumption of high-risk food and drink, and lower likelihood of seeking medical consultation prior to their journey or follow recommended vaccinations [7–10]. For these reasons, it is increasingly important that travelers of high-risk international trips know the impact of infectious and non-infectious diseases in these countries and have a real awareness of the risks of acquiring a travel-related illness, as many of these diseases can be prevented through vaccinations, antimicrobial drugs, and advices from health-care professionals. The World Health Organization (WHO) recommends that travelers, before departure, should be advised about the risk of disease in the country or countries they plan to visit and the steps to be taken to prevent the associated illness . In Italy, travel health counseling are usually delivered in general medical practices.
To our knowledge, ours is the first investigation that aimed at describing the knowledge, attitudes, and behavior about travel-related diseases and the potential role played by several factors among travelers in Italy and the findings could offer an insight on the strategies required to effectively address this important public health theme.
The results of the current study showed that travelers had a low level of knowledge related to infectious diseases and rarely practiced preventive measure before their travel. These findings underlined the importance that healthcare workers should implement clear education and communication activities regarding all aspects of travel-related diseases to increase the knowledge and the access to preventive measures.