HEALTHCARE DURING TRAVEL: A GEOSENTINEL DESCRIPTIVE ANALYSIS, 2017-2020

Abstract

Intro: International travelers may seek care abroad to address health problems that arise during their trip or plan healthcare outside their country of residence as medical tourists. Methods: Data were collected on travelers evaluated at GeoSentinel Network sites who reported healthcare during travel. Both unplanned and planned healthcare were analyzed, including the reason and nature of healthcare sought, characteristics of the treatment provided, and outcomes. Travelers that presented for rabies post-exposure prophylaxis were described elsewhere and were excluded from detailed analysis. Findings: From May 2017 through June 2020, after excluding travelers obtaining rabies post-exposure prophylaxis (n=415), 1,093 travelers reported care for a medical or dental issue that was an unanticipated part of the travelers’ planned itinerary (unplanned healthcare). Travelers who sought unplanned healthcare abroad had frequent diagnoses of acute diarrhea, dengue, falciparum malaria, and unspecified viral syndrome, and obtained care in 131 countries. Thirty-four (3%) reported subsequent deterioration and 230 (21%) reported no change in condition; a third (n=405; 37%) had a pre-travel health encounter. Forty-one travelers had sufficient data on planned healthcare abroad for analysis. The most common destinations were the US, France, Dominican Republic, Belgium, and Mexico. The top reasons for their planned healthcare abroad were unavailability of procedure at home (n=9; 19%), expertise abroad (n=9; 19%), lower cost (n=8; 17%), and convenience (n=7; 15%); a third (n=13; 32%) reported cosmetic or surgical procedures. Early and late complications occurred in 14 (33%) and 4 (10%) travelers, respectively. Four travelers (10%) had a pre-travel health encounter. Conclusion: A substantial number of travelers developed health problems abroad. International travelers encounter health problems during travel that often could be prevented by pre-travel consultation. Travelers obtaining planned healthcare abroad can experience negative health consequences associated with treatments abroad, for which pre-travel consultations could provide advice and potentially help to prevent complications.