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Preparing children for international travel: need for training and pediatric-focused research.
[typhoid]
The
International
Society
of
Travel
Medicine
(
ISTM
)
Pediatric
Interest
Group
(
PedIG
)
was
created
in
2010
.
We
studied
the
group
's
professional
characteristics
and
practice
patterns
to
identify
clinical
areas
requiring
further
training
and
research
related
to
pediatric
international
travel
.
PedIG
members
were
emailed
a
two
-part
online
questionnaire
in
September
2011
,
which
comprised
questions
about
professional
and
practice
details
,
followed
by
a
survey
regarding
decisions
on
nine
patient
scenarios
that
represent
common
pediatric
pre-travel
health
challenges
.
Ninety
-
three
(
34
%
)
of
273
members
completed
the
survey
.
Most
were
physicians
(
80
%
)
having
a
primary
specialization
in
pediatrics
(
55
%
)
and
family
medicine
(
19
%
)
.
About
a
third
(
37
%
)
had
acquired
the
ISTM
Certificate
in
Travel
Health
(
®
)
(
CTH
(
®
)
)
;
14
and
11
%
chose
not
to
provide
malaria
chemoprophylaxis
for
a
2
-
month
-old
infant
and
a
13
-
year
-old
child
traveling
to
West
Africa
,
respectively
.
Azithromycin
for
empiric
treatment
of
travelers
'
diarrhea
in
a
2
-
year
-old
traveler
to
Thailand
and
Mexico
was
suggested
by
74
and
58
%
,
respectively
,
while
the
use
of
acetazolamide
for
a
2
-
month
old
infant
traveling
to
a
high
-altitude
destination
was
rarely
(
13
%
)
chosen
.
In
vaccine-focused
scenarios
,
71
,
69
,
21
,
and
10
%
would
prescribe
the
meningococcal
vaccine
for
a
6
-
month
-old
traveler
to
Burkina
Faso
,
Japanese
encephalitis
vaccine
to
a
10
-
year
-old
traveler
to
Cambodia
,
hepatitis
A
vaccine
to
a
6
-
month
-old
traveler
to
El
Salvador
,
and
the
typhoid
vaccine
to
a
1
-
year
-old
traveler
to
India
,
respectively
.
Members
of
the
PedIG
have
diverse
professional
and
practice
backgrounds
.
Lack
of
awareness
of
established
guidelines
may
place
international
pediatric
travelers
at
risk
for
travel-associated
morbidity
.
Strategies
are
needed
to
facilitate
education
and
support
research
in
pediatric
travel
medicine
to
formulate
evidence-based
guidelines
wherever
they
are
currently
missing
.
Diseases
Validation
Diseases presenting
"diarrhea"
symptom
acute rheumatic fever
adrenomyeloneuropathy
benign recurrent intrahepatic cholestasis
cutaneous mastocytosis
esophageal carcinoma
fabry disease
familial mediterranean fever
hirschsprung disease
kabuki syndrome
legionellosis
lymphangioleiomyomatosis
omenn syndrome
pendred syndrome
phenylketonuria
primary effusion lymphoma
primary hyperoxaluria type 1
scrub typhus
systemic capillary leak syndrome
triple a syndrome
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
wiskott-aldrich syndrome
This symptom has already been validated