Pretravelling Health-Seeking Behavior, Knowledge of Vaccines, and Attitudes Toward Travel Health among Malaysian Travelers

Zulkhairul Naim B. Sidek Ahmad, Khairul Anwar Zarkasi, Nur Zuliani Ramli, Farrah Ilyani Che Jamaludin, Muhammad Kamil Che Hasan


Background: Travelers are at higher risk of developing health‑related problems, especially travel‑related diseases, and this remains a major public health burden. Aims: To assess pretravel health behavior‑seeking factors, knowledge of vaccine, and travel health attitudes. A cross‑sectional design among Malaysian travelers.

Methods: An online survey was conducted from December 2017 till March 2018 among 226 participants. Demographic data, pretraveling health behaviors, knowledge of vaccine‑preventable diseases, and travel health were asked. Independent t‑test and ANOVA were performed using SPSS version 20.

Results: Among travelers, 51.3% and 63.7% used health‑related information on their destination before departure and collected information on possible travel hazards at their destination. Participant age (P = 0.02), monthly income (P = 0.01), predeparture health information (P = 0.03), information on possible hazards (P = 0.04), and travel health advice from medical professionals (P = 0.03) have been reported as a major predictor of knowledge of vaccine‑preventable disease. Travelers’ gender (P = 0.01), household income (P = 0.01), and travel health advice from professionals (P = 0.002) were significantly associated with travel health attitude.

Conclusions: Sociodemographic and pretravel health‑seeking behavior influence knowledge of vaccine‑preventable disease and attitudes towards travel health which requires a public health need for community outreach programs targeting this group.


Attitude to health; communicable diseases; information‑seeking behavior; travel‑related illness; vaccine‑preventable diseases

Full Text:



Schlagenhauf P, Weld L, Goorhuis A, Gautret P, Weber R,

von Sonnenburg F, et al. Travel‑associated infection presenting

in Europe (2008‑12): An analysis of EuroTravNet longitudinal,

surveillance data, and evaluation of the effect of the pre‑travel

consultation. Lancet Infect Dis 2015;15:55‑64.

Greenwood Z, Black J, Weld L, O’Brien D, Leder K,

Von Sonnenburg F, et al. Gastrointestinal infection among

international travelers globally. J Travel Med 2008;15:221‑8.

Dolan SB, Jentes ES, Sotir MJ, Han P, Blanton JD, Rao SR,

et al. Pre‑exposure rabies vaccination among US international

travelers: Findings from the global TravEpiNet consortium.

Vector Borne Zoonotic Dis 2014;14:160‑7.

Heywood AE, Nothdurft H, Tessier D, Moodley M, Rombo L,

Marano C, et al. Pre‑travel advice, attitudes and hepatitis A and

B vaccination rates among travellers from seven countries†


J Travel Med 2016;24:taw069.

Wilder‑Smith A, Khairullah NS, Song JH, Chen CY, Torresi J.

Travel health knowledge, attitudes and practices among

Australasian travelers. J Travel Med 2004;11:9‑15.

Department of Statistics Malaysia Press Release Report of

Household Income and Basic Amenities Survey 2014. 2015

Available from: [Last accessed on

Aug 15].

Herck K, Zuckerman J, Castelli F, Damme P, Walker E,

Steffen R, et al. Travelers’ Knowledge, attitudes, and practices

on prevention of infectious diseases: Results from a pilot study.

J Travel Med 2006;10:75‑8.

Alghamdi AH, Ibrahim AM, Al‑Ghamdi MS, Ryan ET,

Al‑Raddadi R. Travel health in the Kingdom of Saudi Arabia:

Perception and practice of saudi travelers. Int J Health Res Innov


Omer F, Hassan N, Hussain H, Mana S, Awad O. Travel health,

gaps in knowledge, attitudes, and practices among Dubai

travellers, Dubai UAE. Int J Prev Med Res 2015;1:126‑31.

Masic I. Public health aspects of global population health and

well‑being in the 21st century regarding determinants of health.

Int J Prev Med 2018;9 :4.

Provost S, Soto JC. Perception and knowledge about some

infectious diseases among travelers from Québec, Canada.

J Travel Med 2006;9:184‑9.

Heywood AE, Watkins RE, Iamsirithaworn S,

Nilvarangkul K, MacIntyre CR. A cross‑sectional study

of pre‑travel health‑seeking practices among travelers

departing Sydney and Bangkok airports. BMC Public Health


Lopez‐Velez R, Bayas J. Spanish travelers to high‐risk areas in

the tropics: Airport survey of travel health knowledge, attitudes,

and practices in vaccination and malaria prevention. J Travel

Med 2007;14:297‑305.

Toovey S, Jamieson A, Holloway M. Travelers’ knowledge,

attitudes and practices on the prevention of infectious diseases:

Results from a study at Johannesburg International Airport.

J Travel Med 2004;11:16‑22.

LaRocque RC, Rao SR, Tsibris A, Lawton T, Anita Barry M,

Marano N, et al. Pre‐travel health advice‐seeking behavior

among US international travelers departing from Boston Logan

International Airport. J Travel Med 2010;17:387‑91.

Last-Minute Travelers | Travelers’ Health | CDC. (n.d.). from

[Last accessed on 2017 Jan 26].

Mohammed, Y. M. E. Determination of the Knowledge of

Vaccine Preventable Diseases and Routine Immunization

Among Nursing Mothers In Katagum Local Government Area

Bauchi State. IOSR Journal of Nursing and Health Science,


Simon AE, Ahrens KA, Akinbami LJ. Influenza vaccination

among US children with asthma, 2005‑2013. Acad Pediatr


Barker M, O’Hanlon A, McGee HM, Hickey A, Conroy RM,

Levy B, et al. Cross‑sectional validation of the Aging

Perceptions Questionnaire: A multidimensional instrument for assessing self‑perceptions of aging. BMC Geriatr


Brien S, Kwong JC, Charland KM, Verma AD, Brownstein JS,

Buckeridge DL. Neighborhood determinants of 2009 pandemic

A/H1N1 influenza vaccination in Montreal, Quebec, Canada. Am

J Epidemiol 2012;176:897‑908.

Al‑Abri SS, Abdel‑Hady DM, Al‑Abaidani IS. Knowledge,

attitudes, and practices regarding travel health among Muscat

International Airport travelers in Oman: Identifying the gaps

and addressing the challenges. J Epidemiol Glob Health


Chylińska J, Łazarewicz M, Rzadkiewicz M, Adamus M,

Jaworski M, Haugan G, et al. The role of gender in the active

attitude toward treatment and health among older patients in primary

health care—self‑assessed health status and sociodemographic

factors as moderators. BMC Geriatr 2017;17:284.