623. Pre-travel healthcare utilization among travellers who visit friends and relatives (VFRs)
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
Background: Immigrants to the United States who return home to visit friends and relatives (VFRs) have higher rates of travel-related infectious diseases compared to tourist or business travellers. Possible reasons include failure to receive preventive immunizations and medications due to a perception of low risk, financial and cultural barriers, and low rate of pre-travel healthcare utilization. We hypothesized that VFRs seen at our Travel and Tropical Medicine Clinic (TTMC) will have lower rates of adherence to recommendations directed toward behavior modifications intended for risk reduction, lower rates of acceptance of recommended vaccines and lower rates of adherence to chemoprophylaxis recommendations.

Methods: This was a retrospective cohort study of all patients (VFRs and non-VFRs) who received pre-travel healthcare at the TTMC from 2012-2013. Data on demographic information, duration and destination of travel, immunizations and preventive medication prescriptions was obtained from medical records. Demographics and rates of completing recommended immunizations were compared using chi-square tests.

Results: There were 393 VFRs and 1680 non-VFRs seen in the TTMC during the study period. VFRs were younger and more likely to use interpreters (19.1%) and have Medicare (27.7%) insurance. There were more VFRs traveling to Africa (47% VFR vs 30% non-VFR, p<0.0001), Asia (39% vs 30%, p=0.0005), and the Middle East (11% vs 6%, p=0.0014). VFRs had longer durations of travel: 51% for >4 weeks compared to 21% for non-VFRs (p<0.0001). VFRs had lower rates (P<0.05) of completion of tetanus (81% VFR vs 91% non-VFR), polio (86.1% vs 93%), rabies (12% vs 27%), and zoster vaccinations (54% vs 71%). VFRs had higher rates of completion of MMR vaccinations (87% vs 68%, p=0.01). There were no significant differences between VFRs and non-VFRs for other recommended vaccinations or antimalarial and antidiarrheal prescriptions.

Conclusion: VFRs who accessed pre-travel healthcare were found to have longer travel durations and lower rates of vaccine completion than non-VFRs. More research is needed to understand the reasons for this disparity, to inform appropriate changes in pre-travel counselling for VFRs, and the effects of these reduced vaccination rates on infections rates.

Eugene M. Tan, MD1, Jane Njeru, MB, ChB2, Debra Jacobson, MS2, Patrick Wilson, BS2, Chun Fan, BS2, Jasmine R. Marcelin, MD3, Donna Springer, APRN, CNS, MS2, Mark Wieland, MD2 and Irene Sia, MD3, (1)Internal Medicine, Mayo Clinic, Rochester, MN, (2)Mayo Clinic, Rochester, MN, (3)Division of Infectious Diseases, Mayo Clinic, Rochester, MN

Disclosures:

E. M. Tan, None

J. Njeru, None

D. Jacobson, None

P. Wilson, None

C. Fan, None

J. R. Marcelin, None

D. Springer, None

M. Wieland, None

I. Sia, None

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