ARTICLE IN PRESS

Abstracts404

P04Health problems among international travellers: Froma subtropical region to tropical and non-tropicalregions

H.H. Paia,�, W.T. Wanga, J.L. Laib

aDepartment of Kinesiology, Health, and LeisureStudies, National University of Kaohsiung, Kaohsiung,Taiwan, ROC, TaiwanbCenter for Disease Control, Department of Health,Taiwan, ROC, Taiwan

International travel may be associated with the risk of awide range of infectious diseases. This study was designed toobtain information on the health problems among interna-tional travellers from a subtropical region to the neighbour-ing tropical, subtropical, and temperate regions.

The population was travellers (aged over 15 years)returning from the neighbouring Asian regions and enteringthe Kaohsiung International Airport in November 1999.A random sample of 150 travellers was selected from eachof nine airlines (from the Philippines, Malaysia, Indonesia,Singapore, Vietnam, Thailand, Hong Kong, Macao, andJapan).

Telephone numbers of these travellers were obtainedfrom the airport. Health problems among internationaltravellers from Taiwan to the Philippines, Malaysia, Indone-sia, Singapore, Vietnam, Thailand (tropical group), HongKong, Macao, China and Japan (non-tropical group) weresurveyed through the telephone. Of 649 travellers surveyed,8.2% had one or more health problems and insect bite (3.4%)and coughing or sore throats (3.2%) were the most importantones. The rate of coughing or sore throats was significantlyhigher among those returned from the non-tropical regions.However, no associations were found between healthproblems and the demographic factors, travelling style ortravelling duration.

KEYWORDSHealth problems; Travellers; Tropical; Subtropical

10.1016/j.tmaid.2007.09.018

P05Recent import of malaria in a romanian westerncounty

R. Neghina�, A.M. Neghina, L. Tirnea, R. Olariu,I. Iacobiciu

Victor Babes University of Medicine and PharmacyTimisoara, Romania

Introduction: Malaria is not a concern for Romania nowadaysbecause it was eradicated in 1965, but yearly appear someimported cases especially from people travelling in Africa.

For the most of this cases, the etiological agent isPlasmodium falciparum. Timis is the most extensive of theRomanian counties, a western gate of the country fromwhich a lot of people travel abroad.

The aim of this study is to inform about some importedcases of malaria discovered in an universitary laboratory inthe past decade and to describe two recent, severe cases.Material and methods: There were analysed the results ofthe blood exams (Giemsa-stained thin and thick smears)performed in an universitary parasitological laboratory from1998 until present and the medical recordings of the last twoclinical cases from an universitary Infectious ClinicalHospital.Results: Malaria was diagnosed in the 4 of the 6 blood filmsperformed (in 3 cases—75%—the parasitic agent wasP. falciparum). The most recent cases (2006–2007) were: a50 years old male, christian missionary returned fromUganda who refused the prophylaxis, and a 40 years oldmale, worker in constructions who returned from Republicof Equatorial Guinea. Both were diagnosed with P. falcipar-um malaria and both died.Discussion: P. falciparum, the main parasitic agent of thisimported Romanian cases was found in a similar percentagelike in other studies. We perform a comparison between the2 cases emphasizing on the clinical aspects, complicationsand the laboratory tests.

Although in Romania malaria does not represent a publichealth concern, the imported cases are difficult to managein terms of early diagnosis and treatment. Also it isimportant for people who travel in tropical countries tounderstand the importance of the preventive measures andto apply them unconditionally.

KEYWORDSMalaria; Plasmodium falciparum; Import; Romania

10.1016/j.tmaid.2007.09.019

P06The Royal College of Nursing of the United Kingdom(RCN UK) Travel Health Forum

S. Grieve�, J. Skeet, L. Boyne, C. Driver, A. Jordan

Royal College of Nursing, UK

Travel Medicine in the United Kingdom is a nurse-ledspeciality, with services provided mainly in Primary Care,but also in Occupational Health (NHS and Industry) ArmedServices, schools, universities, independent clinics andcharitable organisations.

The Royal College of Nursing (RCN) is a professional bodyfor nurses, within which are 75 Forums supporting thespectrum of specialist areas of practice.

The Travel Health Forum (THF) Steering Committee consistsof seven elected nurse members with a shared objective tosupport nurses in the field, disseminate knowledge, promoteeducation and best standards of practice and influence relatedNational Policies. Forum membership is currently 5309.

ARTICLE IN PRESS

Abstracts 405

The poster describes some of the methods employed,including the biannual Newsletter, informative website andestablished annual conference. The THF participated in theorganisation and scientific programme for the 2006 NorthernEuropean Conference on Travel Medicine (NECTM) in Edinburghand similarly with the proposed 2008 NECTM2 in Helsinki.

The committee acts as a professional source of expertopinion to the RCN and advises on policy and accreditationmatters when approached. The forum collaborates with theBritish Travel Health Association and other RCN Forums whereareas of practice cross. The Guidance for Practice Documentproduced in 2005 was the first of its kind available to describeminimum standards of practice for nurses working in the field.Competencies encompassing the skills and expertise required tomanage and advise travellers, to promote best practice inpatient centred care and to contribute to the health outcomesin UK travellers were developed and published in May 2007. TheFaculty of Travel Medicine (FTM) established in 2006 at theRoyal College of Physicians and Surgeons of Glasgow (RCPSG)was the first Medical College to recognise the speciality andadmit nurses.

KEYWORDSCompetencies; Guidelines; Newsletter; Conference

10.1016/j.tmaid.2007.09.020

P07Perceptions and home management practices ofmalaria in some rural communities in Abeokuta,Nigeria

O.A. Idowu�, C.F. Mafiana, I.J. Luwoye,O. Adehanloye

University of Agriculture, Abeokuta, Nigeria, Nigeria

A survey was carried out in five rural communities thatenjoy Agricultural extension services from the University ofAgriculture Abeokuta. Questionnaires and Focus GroupDiscussions (FGDs) were used to assess perceptions andhome management practices of malaria infection. Theinhabitants consider malaria (which they refer to as ‘‘IbaOtutu’’) has the least dangerous of other types of commonfever such as yellow fever and Thyphoid fever. A vastmajority of the respondents (73%) attributed malariainfection to doing of strenuous jobs in the hot sun, whileonly 11.7% attributed it to mosquito bites. Hunger, eating ordrinking of contaminated food or water were other sourcesof malaria infection mentioned by the respondent.

During the FGDs, other source of infection of malariadescribed includes excessive exposure to heat of fire used infrying cassava (garri). Those frying garri and spreadingcassava flakes in the sun were identified as most vulnerableto malaria infection. High level of malaria infection inchildren was attributed to children playful activities in thesun. It is believed that malaria infection will occur evenwithout mosquito bites but with exposure to these otherfactors especially the intense heat of the sun. Respondents

showed good knowledge of malaria symptoms even in infantsand children; however in the event of malaria infectionconsumption of herbal preparation is the first line oftreatment. Health is also sought from drug hawkers thatsell modern drugs in the communities.

The antimalarial drugs bought were wrongly used andnone of the respondents were aware of the current trend inmalaria management with modern drugs. Hospital visitationis usually after many days of persistent illness withoutimprovement despite all forms of self medication.

The main measure used against malaria vectors wasinsecticide coils (74.6%). None of the respondents usedinsecticide treated net (ITN). Distance, cost and poorquality of hospital treatment were reasons for refusal toseek proper medical care. We recommend health educationand improved health care services for these farmers in orderfor them to be able to translate extension services providedinto maximum agricultural yields.

KEYWORDSMalaria; Perceptions; Agriculture; Knowledge

10.1016/j.tmaid.2007.09.021

P08Disease severity, host characteristics and Plasmodiumfalciparum multiple infections in malaria affectedtravellers returning from Africa

E. Nicastria, M.G. Pagliaa, C. Severinib,�, P. Ghirgaa,N. Bevilacquaa

aIstituto Nazionale per le Malattie Infettive LazzaroSpallanzani, ItalybIstituto Superiore di Sanita, Italy

Introduction: The pathogenesis of malaria is the result ofcomplex interactions between parasites, host and environ-ment. Several studies have assessed the role of geneticcharacteristics of P. falciparum infection in the clinicalseverity of malaria infection comparing different genotypicdeterminants in mild and severe cases. The MSP-1, MSP- 2and DHFR encoding genes have been extensively used asmolecular markers to investigate genetic diversity andpopulation structure of P. falciparum. Aim of this studywas to assess the epidemiological, clinical, host- andparasite-related determinant factor of the genetic diversityof P. falciparum infections in travellers returning fromAfrica.Methods: We have retrospectively studied 64 inpatients allreturning to Italy from African malaria-endemic countries.Designation of severe malaria was determined according toWHO definition. P. falciparum infections detected byspecies-specific PCR were genotyped at the msp-1 andmsp-2 loci and a number of clones were determined. PCR-RFLP method was used to screen the mutation occurring atcodon 108 of dhfr gene.