Travel Histories in Children: How Well Do Interns and Medical Students Do?

Blakemore, Shaundra; Hofto, Meghan E; Shah, Nipam; Gaither, Stacy; Chilukuri, Pranaya; Tofil, Nancy M.

doi:10.14423/smj.0000000000001143

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…However, this may not be the reality in centers outside Brussels, 27,41 where physicians treat malaria in exceptional cases, as previously reported by Ladhani et al 22 in their prospective national malaria studies in the United Kingdom and Ireland. The clinical presentation is frequently nonspecific or leads to an incorrect diagnosis.…”

Section: Discussionmentioning

confidence: 89%

Imported Malaria in Children: A Study Over an 11-Year Period in Brussels

Selimaj Kontoni,

Goetghebuer,

Hainaut

et al. 2023

Pediatric Infectious Disease Journal

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Background: Malaria is a major global public health concern in endemic countries and imported childhood malaria is increasing in malaria non-endemic countries. Methods: This was a retrospective case review of all laboratory-confirmed malaria cases in children 0–16 years admitted between 2009 and 2019 in 2 large university teaching Hospitals in Brussels. Results: A total of 160 children with a median age of 6.8 years (range 5–191 months) were included. We identified 109 (68%) children living in Belgium who had acquired malaria during their visit to malaria-endemic countries to visiting friends and relatives (VFRs), 49 children (31%) visitors or newly installed migrants, and 2 Belgian tourists. Peak seasonal incidence occurred between August and September. Plasmodium falciparum was responsible for 89% of all malaria cases. Almost 80% of children living in Belgium visited a travel clinic for advice, but only one-third reported having taken the prophylaxis schedule according to the recommendations. Based on WHO criteria, 31 children (19.3%) developed severe malaria; most of the patients with severe malaria were VFR travelers and were significantly younger, had higher leukocytosis, had more thrombocytopenia, higher CRP, and lower natremia compared with patients with an uncomplicated course. All children recovered fully. Conclusions: Malaria is a significant cause of morbidity among returning travelers and newly arrived immigrants to Belgium. Most of the children had an uncomplicated disease course. Physicians should educate families about traveling to malaria-endemic areas to correct malaria preventive measures and prophylaxis.

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Section: Discussionmentioning

confidence: 89%

Imported Malaria in Children: A Study Over an 11-Year Period in Brussels

Selimaj Kontoni,

Goetghebuer,

Hainaut

et al. 2023

Pediatric Infectious Disease Journal

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“…From June 2016 to July 2017, first-year Pediatrics residents participated in high-fidelity simulation cases of malaria and typhoid fever that hinged on asking for a travel history 14 . All of the interns participated in at least one of these cases during the course of the year.…”

Section: Methodsmentioning

confidence: 99%

“…Previously at our institution, a simulation study was conducted with first-year pediatric resident physicians and medical students to endorse the necessity of travel histories, which found that travel histories are not commonly asked for. 14 The present study evaluated both documentation and elicitation of travel history.…”

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confidence: 99%

“…Prior research has commented on the frequency at which general practitioners record travel histories from patients who require acute medical care 1 ; however, few studies have focused on travel histories in pediatrics. Previously at our institution, a simulation study was conducted with first-year pediatric resident physicians and medical students to endorse the necessity of travel histories, which found that travel histories are not commonly asked for 14 . The present study evaluated both documentation and elicitation of travel history.…”

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confidence: 99%

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Do We Know Where They Go? Obtaining Travel History in Pediatric Patients

Chilukuri¹,

Orr²,

Blakemore³

et al. 2021

Southern Medical Journal

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Objective: To determine how often travel histories are obtained in pediatric patients.Methods: A retrospective medical record review was performed at a single tertiary care children's hospital for patients aged 2 months to 18 years who were admitted October 2015-December 2017 with International Classification of Diseases, 10th Revision codes for potential travel-related illnesses. Demographic information and travel history documentation were obtained, along with travel-related testing. From May to June 2018, prospective, single-blinded, direct observation of a convenience sample of pediatric residents was performed during the initial patient encounter to determine the frequency and quality of travel histories obtained regardless of documentation.Results: Of 249 charts reviewed, 27 (10.8%) patients had a travel history query documented. Patients with complex chronic conditions were significantly less likely to have a travel history documented (37% vs 67%; P = 0.005). Age, sex, length of stay, race, payer status, and critical care admission did not significantly differ between groups. Those with a travel history documented were more likely to have a documented exposure history (100% vs 52%; P < 0.001) and additional testing performed (56% vs 13%, P < 0.001). During this time, a simulation course with residents featuring travel-related diagnoses led to a significant increase in documented travel histories (5% prior versus 21% after, P = 0.03). A total of 37 patient encounters were observed; travel history was asked for 4 times (4/37, 10.8%).Conclusions: Travel histories are rarely asked for in pediatric patients. Missed diagnoses may not only affect the patient but also have broader public health implications. Simulation is an effective tool to improve history-taking skills, yet more work is still needed.

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Travel Histories in Children: How Well Do Interns and Medical Students Do?

Cited by 2 publications

References 17 publications

Imported Malaria in Children: A Study Over an 11-Year Period in Brussels

Imported Malaria in Children: A Study Over an 11-Year Period in Brussels

Do We Know Where They Go? Obtaining Travel History in Pediatric Patients

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