Travel health care for immigrant children visiting friends and relatives abroad: retrospective analysis of a hospital-based travel health service in a US urban underserved area.

BACKGROUND: There is a lack of studies evaluating pre-travel health care for children who travel to visit friends and relatives (VFR). We evaluated travel health services provided to children VFR travelers (CVFRs) as compared with adult VFR travelers (AVFRs). CVFRs and AVFRs were also compared with children and with adults traveling as tourists (CTs and ATs, respectively), to explore relevant differences within each age group between VFRs and tourist travelers. METHODS: Retrospective chart review of all pre-travel consultations from March 2005 to July 2006 at the Bronx-Lebanon Hospital Center travel health clinic, Bronx, New York. RESULTS: Of 204 pre-travel consultations, 51% comprised CVFRs, 20% AVFRs, 7% CTs, and 23% ATs. About 54, 44, 57, and 30% of CVFRs, AVFRs, CTs, and ATs, respectively, presented within 14 days of departure. CVFRs were more likely than AVFRs and CTs to plan long-term travel (> 6 months). CVFRs and AVFRs traveled mostly to West Africa (75 and 73%) in contrast to CTs and ATs (7 and 35%). Mefloquine was the most frequently prescribed antimalarial medication overall (70%) and among CVFRs (94%). Yellow fever vaccine was most frequently administered overall and to CVFRs and AVFRs followed by hepatitis A, typhoid fever, and meningococcal vaccine. CTs were more likely than CVFRs to receive rabies vaccine. Delayed yellow fever administration (< 10 d before departure) was noted for 48% of CVFRs and 33% of AVFRs. CONCLUSIONS: CVFRs frequently plan to travel for long-term trips to West Africa and present late for pre-travel care. Routine screen for high-risk travel activities and coordination of pre-travel care within the routine preventive health care may improve the effectiveness of the travel health services.