Background Although Johannesburg International Airport (JIA) acts as a hub for travel into Africa, little was known of the knowledge, attitudes, and practices (KAP) with respect to infectious disease prevention of departing travelers.
Methods The study was conducted among departing passengers at JIA from August to October 2003. Travelers aged at least 18 years, resident in non-malarious developed countries and departing from JIA for risk destinations, were given either a malaria (Q-mal, n= 219) or vaccine-preventable disease (Q-vac, n= 200) questionnaire. European Travel Health Advisory Board traveler KAP questionnaires were used.
Results African destinations accounted for 99% of the total. Traveler mean age was 42 years, with 30% aged 50 years or above. Leisure (42%) and business (37%) were the commonest travel reasons; 8% of subjects were visiting friends or relatives. Forty-six per cent of travelers prepared for their trip at least 1 month in advance; 86% had sought pre-travel health advice, with travel clinics and the Iinternet being rated highest by travelers for quality of advice. World Health Organization immunization guidelines were followed poorly: only 37% and 27%, respectively, of travelers had demonstrable proof of protection against hepatitis A and B, with 40% of all Q-vac travelers unable to produce a vaccination certificate. Of travelers to yellow fever- endemic countries, 76% were able to produce a valid vaccination certificate; 22% of travelers to countries not endemic for yellow fever had nevertheless been specifically immunized against yellow fever for their journeys. Forty-nine per cent of Q-mal travelers carried either no or inappropriate antimalarials.
Conclusions Considerable deficiencies in KAP were documented with regard to travel vaccinations and malaria protection in travelers departing JIA. Improved vaccine uptake and antimalarial prescribing are required for travelers to Africa.