Perception, Practice and Cost Burden of Medical Tourism Among Physicians in Public Tertiary Health Facilities in Oyo State, South-West, Nigeria.

BACKGROUND: Physicians are key to the clinical decision-making of their clients. Their perception and practice of medical tourism could influence their clients' uptake of the same. This study assessed the perceptions about medical tourism among physicians practising in public tertiary health facilities in Oyo state. We then assessed its practice and cost burden among physicians who had ever engaged in medical tourism. METHODOLOGY: This cross-sectional study conducted in 2019 involved 360 physicians working in two public tertiary health facilities in Oyo State, selected via a two-stage simple random sampling technique. Quantitative data was collected using a semi-structured pre-tested self-administered tool. Data collected was analysed using STATA 17.0 with statistical significance inferred at p<0.05. FINDINGS: The physicians' mean score on knowledge of medical tourism was 4.0±0.8 of 5 marks obtainable. Organ transplant was the most commonly known reason for engaging in medical tourism. Destination country hospital facilities and equipment ranked highest and cost considerations ranked least of perceived factors promoting it. Twenty-four (6.7%) of the physicians studied ever engaged in medical tourism, while 258 (71.7%) intend to if the need arose. The most popular destination country was India. The mean direct cost of engaging in medical tourism was $3,351±$4,357. The mean indirect cost was $2,389±$774, while the mean total cost was $5,739.6±$4,841.8. The majority of the 24 physicians (83.3%) who engaged in medical tourism suffered catastrophic health spending from it. CONCLUSION: High burden of medical tourism on the physicians. Funds spent on medical tourism by them could be used to strengthen the delivery of health services, such as ensuring children are fully immunised.

CONTEXTE: Les médecins jouent un rôle clé dans la prise de décision clinique de leurs patients. Leur perception et leur pratique du tourisme médical pourraient influencer l'adoption de cette pratique par leurs patients. Cette étude a évalué les perceptions concernant le tourisme médical parmi les médecins exerçant dans des établissements de santé tertiaires publics de l'État d'Oyo. Nous avons ensuite évalué sa pratique et son coût parmi les médecins ayant déjà eu recours au tourisme médical. MÉTHODOLOGIE: Cette étude transversale menée en 2019 a impliqué 360 médecins travaillant dans deux établissements de santé tertiaires publics de l'État d'Oyo, sélectionnés par une technique d'échantillonnage aléatoire simple en deux étapes. Des données quantitatives ont été recueillies à l'aide d'un outil semi-structuré pré-testé et auto-administré. Les données collectées ont été analysées à l'aide de STATA 17.0, avec une signification statistique déduite à p<0,05. RÉSULTATS: Le score moyen des médecins en termes de connaissance du tourisme médical était de 4,0±0,8 sur 5 points possibles. La greffe d'organes était la raison la plus souvent citée pour recourir au tourisme médical. Les infrastructures et équipements hospitaliers du pays de destination étaient les facteurs les plus influents, tandis que les considérations de coût étaient les moins perçues. Vingt-quatre (6,7 %) des médecins étudiés avaient déjà eu recours au tourisme médical, tandis que 258 (71,7 %) avaient l'intention de le faire en cas de besoin. Le pays de destination le plus populaire était l'Inde. Le coût direct moyen du recours au tourisme médical était de 3 351 $±4 357 $. Le coût indirect moyen était de 2 389 $±774 $, tandis que le coût total moyen était de 5 739,6 $±4 841,8$. La majorité des 24 médecins (83,3 %) ayant eu recours au tourisme médical ont subi des dépenses de santé catastrophiques à cause de cela. CONCLUSION: Le fardeau du tourisme médical sur les médecins est élevé. Les fonds dépensés pour le tourisme médical pourraient être utilisés pour renforcer la prestation des services de santé, comme assurer que les enfants soient entièrement vaccinés. MOTS CLÉS: Tourisme médical, Connaissance, Pratique, Fardeau des coûts, Services de santé, Dépenses de santé catastrophiques, Facteurs déterminants du tourisme médical, Touristes médicaux.

Coastal marine habitats deterioration according to users' perception: the case of Cap de Creus Marine Protected Area (NE Spain).

Assessing how different users of a Marine Protected Area perceive environmental changes can contribute to design management strategies. We assess how locals and tourists perceive environmental changes in the Cap de Creus protected area (NW Mediterranean, Spain). To identify locally perceived changes, we first conducted semi-structured interviews with locals (n = 38). Reported environmental changes were then used to construct a survey applied to locals and tourists (n = 427). In semi-structured interviews, environmental changes were the least reported changes compared to economic and social changes; reports of negative environmental changes dominated over reports of positive environmental changes. Overall, all survey participants reported a decline of the health status of the local environment, with locals displaying higher levels of agreement with statements referring to coastal environmental deterioration than tourists. The predominance of responses reporting economic versus environmental changes can be explained by the recent radical transformation of the area towards tourism. Reports of coastal marine area deterioration are in line with available instrumental data. Higher levels of agreement with statements referring to environmental deterioration among locals than among tourists highlight the importance of people's connection with nature to assess change. Considering that Cap de Creus has been protected for more than two decades, our findings raise concerns regarding its ongoing deterioration and underscore the importance of monitoring the effectiveness of marine protection to modulate management strategies. Supplementary Information: The online version contains supplementary material available at 10.1007/s10113-024-02322-4.

The Influence of Climate Change on Vector-Borne Diseases in a Wilderness Medicine Context.

The imminent climate crisis has been labeled as the biggest health threat humanity must deal with. Vector-borne disease distribution and transmission as well as the population at risk are influenced to a great degree by environmental and climactic factors affecting both the vectors themselves and the causative pathogens. Paired with an increase in worldwide travel, urbanization, and globalization, along with population displacements and migration, elucidating the effects of anthropogenic climate change on these illnesses is therefore of the essence to stave off potential negative sequelae. Outcomes on different vector-borne diseases will be diverse, but for many of them, these developments will result in a distribution shift or expansion with the possibility of (re-)introduction of vector and pathogen species in previously nonendemic areas. The consequence will be a growing likelihood for novel human, vector, and pathogen interactions with an increased risk for infection, morbidity, and mortality. Wilderness medicine professionals commonly work in close relationship to the natural environment and therefore will experience these alterations most strongly in their practice. Hence, this article attempts to bring awareness to the subject at hand in a wilderness medicine context, with a focus on malaria, the most burdensome of arthropod-borne diseases. For prevention of the potentially dire consequences on human health induced by climate change, concerted and intensified efforts to reduce the burning of fossil fuels and thus greenhouse gas emissions will be imperative on a global scale.

Thrombotic complications following bariatric surgery: how medical tourism poses challenges to comprehensive care in obesity medicine.

The global prevalence of obesity has more than tripled since 1975. Unfortunately, bariatric surgery waiting lists can last many years therefore many patients seek alternative options such as "medical tourism" by venturing abroad for surgery. We describe two cases of porto-mesenteric venous thrombosis in patients who travelled abroad for bariatric surgery. Upon returning both cases required interventional radiological management, and in the first case, the patient underwent a small bowel resection for bowel ischaemia. Porto-mesenteric complications are significant and have profound lifelong consequences. Therefore, it is imperative that patient education is significantly improved, and more stringent regulations by health authorities are put in place to avoid the growing complications of negative health tourism.

The dynamic nexus between economic growth, renewable energy use, urbanization, industrialization, tourism, green supply chain management, and CO2.

Since 2012, China has pursued an "ecological civilization" policy to promote green energy, increase environmental protection, and transition to more sustainable growth models. The complicated positive trends in energy consumption, more sustainable economic growth, and ecological management are obscured by China's persistent, significant dependence on fossil fuels, particularly coal. The study aims to analyze how renewable energy use in China affects carbon dioxide emissions and how those impacts change over time, as well as urbanization, industrialization, tourism, and green supply chain management. The DOLS dynamic system method used historical data from 1995 to 2022. The DOLS results show a positive and statistically significant economic growth coefficient in the long term, suggesting that an increase of only one percent in CO2 emissions rise would be proportional to a surge in economic growth. Furthermore, using renewable energy sources correlates with long-term sustainability negatively and significantly. The results show reducing CO2 emissions and boosting renewable energy use by 1 %. Furthermore, the long-run coefficients for industrialization and urbanization are positive and statistically significant, indicating that a 1 % increase in either component results in a comparable increase in CO2 emissions. Sustainable logistics and tourism have negative and statistically significant coefficients, meaning that a one percent increase will gradually decrease carbon dioxide emissions. The estimated findings hold up when using other estimators, such as the commonly used co-integrating regression (CCR) strategy and fully modified least squares (FMOLS). When Granger causality is coupled, the test also catches the variables' causal link. test. To achieve environmental sustainability, the essay suggests using robust regulatory policy tools to curb ecological deterioration.

May a highly touristic tropical island sustain water resources? Navigating troubled waters to berth on a safe shore.

While being a major economic development force for tropical islands, tourism may aggravate disturbances on local water resources (scarcity, pollution) and the surrounding ecosystem. In this work, we used a discrete events modelling approach to characterize trajectories of Cat Ba Island (Vietnam) and its ability to reach specific trajectories. We wanted to assess if a healthy social ecosystem could be compatible with tourism. We found that co-existence between water resources and tourism may be reached; moreover, a systemic state where ecosystem and sociosystem can sustainably coexist may be reached. The implementation of urban ecological infrastructure is a key process to shift from the present state towards more favourable states. Another significant result is that the departure from the present state to reach more favourable ones may lead to a transitory degraded situation; only by keeping in mind the systemic objective significant transformations can be carried out.

Intensification of thermal risk in a changing climate: findings from prominent tourism destinations along the eastern Adriatic coast.

The climate and thermal comfort of а destination greatly influence the tourism industry. Therefore, this study was focused on researching thermal comfort changes and their impacts on visitors in four highly visited coastal destinations along the eastern Adriatic coast (Pula, Zadar, Split, and Dubrovnik) from 1996 to 2020, using the modified physiologically equivalent temperature index (mPET). The specific objective was to assess how the thermal comfort conditions are distributed spatially and temporally and how they are suitable for beach and sightseeing tourism. Results showed that monthly mean mPET values have increased, except in May. In the summer season, tourists were often exposed to uncomfortable heat stress, especially in the middle of the day. Strong and extreme heat stress frequency significantly increased in all sites except in Pula, particularly in July and August. Prevailing neutral and slightly warm/cold conditions were concentrated in two periods, between April and June and in September and October. The maximum occurrence of optimal climatic conditions for enjoying the beach was in the summer, with a decreasing tendency from May to August. The occurrence of favorable conditions for sightseeing significantly increased in April and November while it decreased from July to September. Although the eastern Adriatic coast is primarily a summer tourist area, a relatively small number of tourists take advantage of the period with optimal thermal comfort. Despite the fact that the number of tourists in the shoulder seasons has increased significantly in the past 25 years, the increasing favorable thermal comfort in the changing climate conditions will make these seasons even more appealing in the future, especially for sightseeing activities. New strategies for adapting to a changing climate are therefore needed.

Spatio-temporal effects and influence mechanism of digital technology on tourism efficiency in Chinese provinces.

Digital technology serves as a new industrial driving force, playing a crucial role in promoting the efficiency of regional tourism. To explore the inherent logic between digital technology and tourism development, the study employed the DEA-BCC model and the entropy-weighted TOPSIS method to measure the tourism efficiency and digital technology development level of 31 provinces (municipalities and districts) in China from 2011 to 2022. The evolutionary characteristics of the relationship between digital technology and tourism efficiency were analyzed from the spatio-temporal dimension, and empirical tests were carried out using the spatial error model (SEM) and the spatial lag model (SLM) to explore the mechanism of the impact of digital technology on tourism efficiency. The results show that: during the study period, the overall trend of digital technology development and tourism efficiency is upward, but there is a certain degree of spatial mismatch between the two; digital technology is not only conducive to the improvement of tourism efficiency in the province, but also acts on neighboring provinces through spatial spillover effects, mechanism of action tests show that digital technology can positively moderate the effects of tourism economic growth and tourism industry structure on tourism efficiency; in western and northeast China, the positive effect of digital technology on tourism efficiency is more obvious. The conclusions provide a new perspective for understanding and analyzing the development of provincial tourism in China, as well as a reference for the rational use of digital technology to promote tourism development.

Limited open information sharing and mobility promotes sustainability of jaguar tourism in Pantanal wetland, Brazil.

Wildlife tourism plays a crucial role in biodiversity conservation. However, long-term sustainability is difficult to achieve. In this paper, we use property theory to produce a mathematical model that aims to better support stakeholders from the wildlife tourism industry to better guarantee a balance between sightings probability, tourists' overall experience and operators' sharing behaviour. We illustrate our model with the case study of Porto Jofre in the Pantanal wetland, Brazil. We show that while dealing with low sighting probability, tourist operators must share information about species' locations, leading to a system of open access regarding mobility and information. However, when sightings become common, sharing must be restricted to a bounded group avoiding overcrowding, a system of limited open access. Finally, when the sighting probability is high, no sharing is needed to achieve maximum overall experience. Our case study in Porto Jofre, Pantanal, Brazil, clearly shows these shifts in terms of governance strategies. We show that by looking at sighting probability it is possible to predict the best optimal social strategy that will guarantee long-term sustainability of the wildlife tourism initiatives. We also show the need for external support on adaptation in cases where current strategies do not match the predicted ones.

An empirical application of the consumer-based authenticity model in heritage tourism of the George Town historic district, Penang, Malaysia.

The primary objective of this paper is to investigate the specific application of the Consumer-based Model of Authenticity (C-BA) in historic districts. The paper building upon the C-BA model and examines the direct effects between the variables, as well as the mediating role of tourists' involvement, and place attachment in the connection between, authenticity (encompassing object-based authenticity and existential authenticity) and revisit intention. This study applied the C-BA model to the context of heritage tourism within a historic district. The analysis utilized structural equation modelling and involved 394 samples. The findings indicate that authenticity, influences tourists' intentions to return from a dual perspective. The results reveal that object-based authenticity mediates the relationship between tourists' involvement and satisfaction, while existential authenticity mediates the connection between place attachment and satisfaction. The study suggests that stakeholders ought to prioritize the preservation of the objective authenticity of the historic district and the provision of high-quality activity experiences.

Modelling the heterogeneity of tourist spending in a mature destination: An approach through infinite mixture.

Identifying tourists' preferences is essential for stakeholders to provide better products and services. Among the tools to classify such choices, expenditure segmentation is valuable for separating tourist groups with shared interests. The underlying idea of the (infinite) mixture model is that tourists spend on a specific activity depending on their preferences. However, the propensity to consume may be based on or influenced by the group to which the tourist belongs. Thus, such a tendency could increase depending on homogeneity or heterogeneity. This paper uses a compound distribution mixture to model the expenditure heterogeneity. The resulting mixture model derives from a multivariate Pareto (Lomax) distribution that is easy to implement and includes zero value in its support since it is empirically proven that a tourist's expenditure on some activity can be zero. Results show that once the spending on transport has been carried out, tourists prefer to spend more on food than other activities. Conditioned to the expense carried out on food, the mean expenditure on leisure activities is more significant than on transport. Finally, tourists would prefer to spend more on food than on transportation once they decide to spend on other activities.

Research and application of tourism management in the IoT industry under the background of sustainable blockchain.

In the contemporary era, there is a heightened awareness of the significance of a spiritual life, and travel is a popular choice for many. The Internet is driving rapid diversification in people's travel choices. At the same time, the traditional tourism industry's Tourism Management (TM) model, which has been in place for decades, is no longer able to satisfy people's diversified choices for tourism. This is due to a number of factors, including the trust crisis caused by asymmetric information, the outdated nature of the TM model, and the insecure personal information that is shared between intermediaries. This paper discusses the application of sustainable blockchain technology in tourism management and sets up a tourism management system based on blockchain and the Internet of Things. It takes 20 scenic spots as examples to study the application of the TM model. This paper evaluates the TM model from four key aspects: tourist satisfaction, tourism infrastructure completeness, tourism consumption level and tourism service content richness. It compares the results with those of the traditional TM system. The experimental results are clear: tourist satisfaction at scenic spots 5, 10 and 15 in the sustainable blockchain TM mode is 68 %, 87 % and 71 % respectively, which is higher than that in the traditional TM mode. In the context of sustainable blockchain, the TM mode is the optimal approach for serving tourists and enhancing their travel experience. This study also assists Chinese tourism business operators in recognizing the potential impact of blockchain technology on the development of the tourism industry. They can then formulate strategies at an early stage to cope with the information technology changes in the era of the digital economy.

Tourism promotion during emergency response to Omicron subvariant outbreak.

This study aimed to explore optimal ways to promote all kinds of tourism during the phase of emergency response to the current outbreak of Omicron subvariants. A framework-based systematic literature review was conducted as the primary methodology, supported by the preferred reporting items for systematic reviews and meta-analyses checklist. Four analytical units were allocated to include United Nations agencies, governments, tour businesses, and local communities. Economic interest-based tourism promotion was examined to develop local temperature-based tourism promotion via the same four variables. The study found that the pursuit of economic interests was not a productive solution for tourism promotion any longer due to the matter of local weather. It concluded that the four stakeholders should work to replace economic interest-based tourism promotion with local temperature-based tourism promotion. Results of this study can guide the positive effects of warm temperatures, brand image, psychological impacts, digital marketing, and others.

A serological survey of COVID-19 among predominantly aboriginal residents of a tourist island in southern Thailand.

BACKGROUND: The current survey describes the seroprevalence, history of coronavirus disease 2019 (COVID-19), and vaccination status among predominantly aboriginal residents on a tourist island in southern Thailand. This information can be translated into COVID-19 vaccination and control plans for this population. METHODS: We implemented questionnaire interviews and collected blood samples from 249 residents of Lipe Island, Satun Province, in January 2022. We measured the anti-nucleocapsid protein and anti-spike (anti-S) receptor-binding protein levels of immunoglobulin (Ig) M and IgG. The differences in antibody levels among participants with different histories of vaccination and infection were analyzed using one-way analysis of variance with multiple comparisons. RESULTS: During the 2-year pandemic period, no island residents with COVID-19 required hospitalization despite the high prevalence of hypertension (33.3%) and diabetes mellitus (21.7%). Approximately 18.8% of the participants reported a history of COVID-19 diagnosis. In total, 95.1% of the participants had a history of complete vaccination, of which 93.5% were seropositive. The anti-S IgG geometric means (geometric standard deviation) were 3945.8 (2.0), 829.8 (9.7) AU/mL, 789.9 (5.3) AU/mL, and 22.7 (7.1) AU/mL, respectively, in participants with a history of both COVID-19 diagnosis and complete vaccination (group 1), incomplete vaccination and subsequent COVID-19 diagnosis (group 2), complete vaccination but no previous infection (group 3), or neither previous COVID-19 and complete vaccination (group 4). Significant pairwise differences in anti-S IgG levels were found between certain groups (1 vs 3, 1 vs 4, 2 vs 4, and 3 vs 4). CONCLUSIONS: The high coverage of vaccination, high levels of population antibody titers, variable antibody levels among completely vaccinated non-infected residents, and high prevalence of non-communicable diseases (NCDs) suggested that the local health systems could control the pandemic. However, continuing surveillance, booster vaccinations, and NCD prevention programs were still required.

Climate change and tourism demand: Risks for extreme heat?

Extremely high temperatures have become a major hurdle to tourists' experiences in various destinations. In this study, we present the first nationwide estimation of the temperature-tourism response function using a fine-grained panel dataset constructed by matching tourism data and daily meteorological datasets for 280 cities from 2005 to 2019 in China. Results show a non-linear relationship between temperature and tourism employing the temperature bins method, which is not sensitive to response equations. In addition, we conduct a rich heterogeneity analysis in the article to further analyse the effects of other external conditions on the temperature-tourism relationship, including the destination's level of tourism economic development, population, infrastructure development, and tourism resource endowment. We also observed that increasing summer temperatures result in decreased tourism arrivals and revenue, while rising autumn temperatures lead to increased tourism arrivals and revenue. This research contributes to a deeper understanding of the complex relationship between temperature dynamics and tourism patterns, offering insights into destination management and adaptation strategies.

Secular Changes in Growth in the Maya Village of Yalcoba: 1986-2023.

OBJECTIVE: To analyze the changes in children's height, weight, BMI and rates of stunting and overweight and obesity over three periods: 1986­1987, 1996­1998, and 2023 for the community of Yalcoba in the Yucatan Peninsula. MATERIAL AND METHODS: Four hundred forty (6­to­15 years) children measured in 2023 were compared with data obtained in 1986­1987 (n = 675) and 1996­1998 (n = 628). Z­scores of height and BMI were calculated to estimate percentages of stunting and high BMI­for­age (overweight and obesity). Comparisons of anthropometric parameters by sex and age groups between years of measurement were performed through one way ANOVAs. RESULTS: Differences in anthropometric parameters were significant in all age groups of both sexes. Boys measured in 2023 were, on average, 6.4 and 3.3 cm taller than boys measured in the 1980s and 1990s, respectively. Increases in girls were 12 and 7.3 cm, respectively. Average increases in weight of boys measured in 2023 were 7.9 kg compared to the 1980s and 5.8 kg compared to 1990s. Average increases in girls measured in 2023 were 11.3 kg compared to the 1980s, and 7.6 kg compared to the 1990s. Stunting between the 1980s and 1990s decreased by 15 percentage points and between the 1990s and 2023 decreased by 47 percentage points. The percent of children deemed overweight/obese during these periods increased from 8 to 12­50 by 2023. CONCLUSION: Results reflect the overall trends seen in the Yucatan where stunting has decreased substantially but the numbers of overweight/obese youths have increased dramatically in the past 30 years.

The microbial etiology and resistance patterns of cosmetic tourism-related infections in Ireland.

BACKGROUND: Cosmetic tourism is an increasingly common phenomenon, both in Ireland and internationally. Complications associated with procedures performed abroad may manifest after the patient has traveled back to their home country with patients often presenting to local health services. Such complications can be infectious in nature requiring either antimicrobial therapy and/or source control in the form of wound debridement or radiologically guided interventional procedures. METHODS: Patients who had presented to a regional plastic surgery unit between September 2021 and December 2022 with complications related to aesthetic procedures performed outside Ireland were identified in this retrospective-prospective design. Medical records were reviewed to ascertain what procedures were performed, where the procedure had taken place, the nature of complications, and microbial culture and sensitivity results. RESULTS: Thirty patients were identified during the study timeframe, predominantly female (n = 28) with a mean age of 40.27 years (SD 10.6). Abdominoplasty was the most common procedure (n = 17), and Turkey was the most frequently cited destination (70%). Wound dehiscence accounted for the majority of complications (n = 18). Wound cultures were obtained in 80% (n = 24) of patients and a causative organism was isolated in 85% (n = 34) of cultures. Eighteen species of bacteria were identified and antimicrobial sensitivities were obtained for 16 of these. Antimicrobial resistance to commonly prescribed empiric antibiotics was noted in several isolates. CONCLUSION: Post-operative infections related to cosmetic tourism are a growing concern in plastic surgery. The bacterial etiology is varied, and antimicrobial resistance poses significant challenges, highlighting the need for early intervention and wound cultures to guide effective management.

Determinants of carbon emissions in Kenya and policy implications.

Carbon dioxide emissions are the primary greenhouse gasses behind global climate change and its associated effects. Climate change adversely impacts the environment, biodiversity, and human health. The ability to tame carbon dioxide emissions will help in the fight against climate change. However, the recent pace of rising carbon dioxide emissions raises concerns about winning the war against climate change. World leaders are determined to take actions that will lower emissions. Thus, there is a worldwide effort to achieve net-zero emissions. Consequently, it is crucial to comprehend the specific factors that contribute to carbon emissions of specific economies so that countries can develop and enforce effective strategies for reducing carbon output, mitigating the effects of climate change, and improving recovery programs. Despite many empirical studies conducted in Africa on the determinants of carbon emissions, the results remain inconclusive and inadequate, leaving a void for further research. This study seeks to fill this knowledge gap by modeling the relationship between Kenya's carbon emissions (which have been increasing since the early 2000s), and mobile technology adoption, renewable energy mix, tourism development, development assistance, income, and global financial crises, utilizing the most current data from 1995 to 2021 from the World Bank's database. The ARDL, FMOLS, CCR, and DOLS analysis results reveal that mobile technology, tourism, development aid, and global financial crises increase Kenya's carbon emissions in the long run. At the same time, income and renewable energy reduce short- and long-term impacts. The significant insight from these results is that enhancing renewable energy development, mobile technology, and development assistance can promote a sustainable environment. From these findings, the study proposes many policy recommendations to help decision-makers, communities, companies, and the government in Kenya allocate resources and implement resilience and mitigation policies and programs in the areas most susceptible to the effects of climate change.

Microbial laden mobile phones from international conference attendees pose potential risks to public health and biosecurity.

INTRODUCTION: Mobile phones, contaminated with pathogenic microorganisms, have the potential to act as "trojan horses". The microbial signatures present on their surfaces most probably vary across different geographical regions. As a result, mobile phones belonging to international conference attendees may serve as a model for global microbial dissemination, posing potential risks to public health and biosecurity. AIM: This study aimed to profile the microbes present on mobile phones belonging to delegates attending an international scientific conference through use of metagenomic shotgun DNA sequencing. METHODS: Twenty mobile phones, representing ten different geographical zones from around the world, were swabbed and pooled together into ten geographical-specific samples for high definition next-generation DNA sequencing. WONCA council members were invited to participate and provided verbal consent. Following DNA extraction, next generation sequencing, to a depth of approximately 10Gbp per sample, was undertaken on a v1.5 Illumina NovaSeq6000 system. Bioinformatic analysis was performed via the CosmosID platform. RESULTS: A total of 2204 microbial hits were accumulated across 20 mobile phones inclusive of 882 bacteria, 1229 viruses, 88 fungi and 5 protozoa. Of particular concern was the identification of 65 distinct antibiotic resistance genes and 86 virulence genes. Plant, animal and human pathogens, including ESKAPE and HACEK bacteria were found on mobile phones. DISCUSSION/CONCLUSION: Mobile phones of international attendees are contaminated with many & varied microorganisms. Further research is required to characterize the risks these devices pose for biosecurity and public health. Development of new policies which appropriately address and prevent such risks maybe warranted.