Utilization of Pre-Travel Health Services among Kenyan Travelers Departing Jomo Kenyatta International Airport, Nairobi - Kenya

Abstract

Geographical movement of people poses a threat to the transmission of infectious diseases. Kenya is among the vulnerable countries with regard to disease transmission since it’s a major transport hub in East Africa, yet data about availability and uptake of pre-travel health services is limited. The main objective of this study was to assess utilization of pre-travel health services among departing international travelers at Jomo Kenyatta International airport. A cross-sectional analytical study was conducted to determine uptake of pre-travel health services. Systematic sampling method was used to get a sample of 384 participants among international departing travelers at the waiting lounge while 4 key informants were chosen purposively to determine availability of pre-travel health services. Self-administered questionnaires were used amongst travelers and key informant interviews were conducted amongst managers at the port health department in Jomo Kenyatta international airport. Data analysis was performed using Stata 15.0 (StataCorp, Limited Liability Company, 2017) for quantitative data and thematic content analysis was used for qualitative data to address the objective on availability. Results were presented in form of tables, graphs, charts and text. Descriptive analysis and logistic regression on the dependent variable was done to determine the predictors of seeking pre-travel health services where p<0.05 was considered significant. This study received ethical approval from Kenyatta National Hospital/University of Nairobi ethical committee. Informed consent was sought from the respondents before agreeing to participate in the study on a voluntary basis. Of the respondents, 70.6% (271/384) knew at least one health service offered to international travelers. The most sought after pre-travel health service was vaccination 71% (266/375) while only 13.9% (52/375) travelers sought pre-travel health advice on how to stay healthy while abroad. Generally, travelers had a positive attitude towards pre-travel health services with 348 (90.6%) perceiving vaccination before travel as important. Adjusted for other variables knowledge of health services [OR=0.09, p=<0.001], history of travel [OR=3.4, p=0.017] and perception on importance of travel vaccination [OR=0.31, p=0.001] were found to be predictors of seeking pre-travel health services. Main responses from key informant interviews were used to report on availability of pre-travel health services where it was determined that Kenya focuses more on international arrivals and there are no travel clinics to offer a comprehensive pre-travel health service package in a one stop place. This study concludes that travelers know and go for vaccination but drugs for self-medication and pre-travel health advice were not popular hence remained underutilized. Awareness on importance of travel vaccination and existence of pre-travel health services increases likelihood of a traveler going for pre-travel health services. Additionally, pre- travel health services available to international travelers departing the country are not comprehensive and little attention is paid to them compared international arrivals thus exposing those departing to travel related hazards. This study recommends that the port health department explores more avenues of reaching out to international travelers including media, mobile applications and internet with information on the role of pre-travel health advice as well as drugs for self-medication in ensuring a healthy stay abroad. There is need to fund more research to ascertain factors associated with utilization of pre-travel health services and causes of variations across various groups and finally, the government needs to develop structures and travel clinics that will ensure all pre-travel health services are offered to international travelers in a holistic approach under one roof.