Compliance reached ≥80% for the consumption of bottled water, the use of repellents, routine vaccine update, and yellow fever immunization. Factors independently associated with low compliance with antimalarials

were traveling to the Indian Ocean or Asia, age <5 years, and monoparental family. The authors want to thank Mrs Penny Hands for her kind help in the drafting of the manuscript. The BIBW2992 cell line authors state they have no conflicts of interest to declare relevant to this article. “
“Background. Traveling the world may result in infection with tropical or other travel-associated diseases. This applies increasingly also to people with immune-compromising and other medical conditions, as well as to elderly individuals. To reduce exposure and susceptibility to health risks, there is a need for appropriate pre-travel advice for these particular groups of travelers. Methods. In this observational study, we analyzed the overall risk of health problems among travelers with underlying medical conditions who attended the University of Amsterdam’s Academic Medical Center’s (AMC) travel clinic from January to October 2010. Telephone questionnaires were administered to 345 travelers with underlying conditions and 100 healthy travelers. Results. The most common underlying medical conditions studied included: (1) diabetes mellitus; (2) impaired immunity due to use of immune-suppressing

medication; (3) reduced gastric barrier; and (4) HIV infection. The overall incidence of travel-related diseases (TRDs) was higher among those patients with underlying medical conditions compared to healthy travelers [incidence U0126 Cepharanthine rate ratio (IRR) 2.26, 95% CI (1.29–3.98)]. Of all diseases reported, gastrointestinal disease, fever, and respiratory problems were reported most frequently. Travel to Central

America, South Central Asia, Northeast Asia, and North Africa was associated with increased risk of contracting TRD. Hepatitis B protection was absent or unknown in 75% of these travelers. Conclusions. Travelers with medical conditions had a higher risk of obtaining TRD, predominantly gastrointestinal in nature. People travel the world extensively, and increasingly so. Between 20 and 70% of the 50 million people from the industrialized world visiting the developing world report illness associated with their travel. Although most illnesses are mild, 1 to 5% of returned travelers become ill enough to seek medical attention, and 1 in 100, 000 succumbs to travel-related disease (TRD).1 Among patients with underlying medical conditions, diseases acquired during travel may lead to more severe consequences compared to healthy travelers.2–5 Also, depending on the underlying condition there may be diminished immunogenicity and clinical efficacy of vaccinations. Live attenuated vaccines, such as that for yellow fever, may elicit disease.