Reasons for seeking care and adherence to pretravel preparation in expatriate or long-term travelers’ children in the tropics: A French prospective study

Abstract

Background: Studies on pediatric travelers' health rarely address expat or long-term travelers’ children. Method: To investigate reasons for seeking care and adherence to pretravel preparation, we prospectively enrolled French children 0–15 years old, either expatriates or staying >6 months in tropical areas, who attended a French health center in Africa, Central America or Southern Pacific regions from October 01, 2011 to October 31, 2012. A standardized questionnaire was completed by a general practitioner at each visit, then anonymized and included in our database. Results: 464 questionnaires were collected from 367 children (sex ratio M/F: 1:1). Median age was 6.4 years (IQR: 3.6; 10.3). Reasons for seeking care were mostly infections (n = 378), of which 12 (3.2%) were tropical. There were no deaths, but one child with tuberculosis was repatriated. Coverage was high for routine immunization, but less for travel-related vaccines. Personal antivectorial protection was significantly lower in children aged >5 y or in non-malarial areas. Where indicated, malarial chemoprophylaxis was prescribed to only one third of the children, of whom 60% were poorly compliant. Advice regarding measures against diarrhea was followed significantly more for stays <2 yrs. Conclusion: Mild cosmopolitan illnesses predominated but protection against tropical threats should be optimized before and during the stay.