Research Article: Trends in the travelers’ demand for pre-travel medical advice at a Spanish International Vaccination Center between 2000 and 2017

Date Published: May 30, 2019

Publisher: Public Library of Science

Author(s): Marina Segura, Rosa Lopez-Gigosos, Eloisa Mariscal-Lopez, Mario Gutierrez-Bedmar, Alberto Mariscal, Madhavi Bhargava.


Crises and disasters affect the numbers of people traveling either for tourism or other reasons. Many studies have been published on the effects of such events on travel, especially on tourism, and based on the arrivals or departures of travelers to or from countries. Our aim was to assess the influence of these events on the demand for pre-travel medical consultation in an International Vaccination Centre (IVC). Data on 94683 international travelers who visited 113529 international destinations attended at the IVC of Malaga (Spain) during 2000–2017 were studied. A descriptive and time series analyses was conducted. The demand to IVC was 3.47 times higher in 2017 than in 2000. The increase has not been the same for all destinations: Travel to South-East Asia and Western Pacific World Health Organization (WHO) regions has multiplied by 10, while in the same period, Africa WHO region has declined from 36% to 20% of total demand. Thailand, India and Brazil were the countries with the highest demand (21% of all pre-travel consultations). We found out three periods, concurrent with some socioeconomic or health events, in which the number of travellers attend decline with respect to the previous years, or the growth was very slow. Growth in the demand for pre-travel medical advice in parallel with a foreseeable increase in the number of travelers is expected. Pre-travel medical services must be adapted to this increase. This study of the trend of demand for pre-travel medical information should new related problems to travel to be identified and quantified, and should assist improvement of policies and programs aimed at care of travelers.

Partial Text

During the past six decades, international travel, especially tourism, has undergone unprecedented growth and diversification. Economically, tourism has become one of the most important and fastest growing sectors in the world.

The IVCMa, in southern Spain, covers a population of approximately one million residents, and is the only information center for travelers in the region. In the past 3 years, 9,000–10,000 travelers a year have visited it, accounting for approximately 3%–5% of people accessing the 107 IVCs nationwide.

A total of 94,683 people requested pre-travel medical advice at the IVCMa between January 2000 and December 2017. Table 1 shows the annual distribution of the number of TAs, the number of countries about which they requested information, along with the number of medical professionals attending the pre-travel consultations, and the number of vaccines prescribed for each year studied. From the beginning of the study until 2017, the number of TAs increased by 325.2%, and vaccines by 576.8%. However, between 2000 and 2004, SISAEX only gave data on the monthly number of travelers and prescribed vaccinations, though not on destinations; therefore, in Table 1, the number of travelers and destinations is the same for that period. From 2005, monthly number of travel destinations were included in SISAEX, although between 2005 and 2007, some faults in the recording system led to losses ranging from 3% in 2007 to 10% in 2005 and 2006 for destination data. In the following years, there were no such losses and all destination countries were recorded.

This is the first population-based study that used the SISAEX database to analyze specific variables related to demand for health information at an IVC in Spain. For the period 2000–2017, the demand for pre-travel consultation at the IVCMa increased 347%, from 2,885 travelers (2000) to around 10,000 in 2017 (Table 1). The IVCMa services one of the largest internationally traveling populations in Spain; it accounted for approximately 3%–5% of all annual international pre-travel consultations by residents in Spain. Between 2000 and 2017, the number of trips abroad increased 420% across all of Spain’s population[8]. This increase, however, was not continuous throughout the study period, with years in which the number of travelers decreased year-on-year and others with increases of more than 30% (2005–2006 and 2006–2007). Between 2015 and 2017 the average increase in TAs at the IVCMa was 10%; an increase higher than the 3.9% recorded worldwide in the number of international tourist arrivals (overnight visitors) in the same period[1]. However, travelers who requested information at the IVCs are almost exclusively those who will travel to countries that pose health risks. Thus, when taking the UNWTO region visited into account, the increase at the IVCMa was similar to that for UNWTO Asia and the Pacific (9%) and Africa (8%) regions[1].