Publicaties

@article{e083065,
title = {Surveillance of global, travel-related illness using a novel app: a multivariable, cross-sectional study},
author = {Thibault Lovey and Nadja Hedrich and Martin Peter Grobusch and Julian Bernhard and Patricia Schlagenhauf and The ITIT Global Network},
url = {https://bmjopen.bmj.com/content/14/7/e083065},
doi = {10.1136/bmjopen-2023-083065},
year = {2024},
date = {2024-07-28},
journal = {BMJ Open},
volume = {14},
abstract = {Introduction Current traveller health surveillance is ‘top-down’. Mobile-based surveillance could capture infection symptoms in real time. We aimed to evaluate the spectrum of illness in travellers using a mobile app-based system.

Methods This study (ClinicalTrials.gov NCT04672577) used an application called Infection Tracking in Travellers (ITIT) that records travel-related illness symptoms with associated geolocation and weather data. The free ITIT app is available in 14 languages. Participants were recruited globally from April 2022 to July 2023. Participants >18 years of age travelled internationally and provided electronic consent. Incentives included the provision of travel health information imported from the WHO website. Symptoms were recorded with daily pop-up questionnaires and symptom severity was assessed using a Likert scale. Two post-travel questionnaires were administered. Logistic mixed models examined factors relating to symptom presence, and a random forest model examined symptom impact.

Results 609 participants were recruited until July 2023. Participants had an average age of 37 years (18–79), and an average travel duration of 26 days (2–281). Most participants were travelling for leisure/tourism (401; 66%), followed by ‘visiting friends and relatives’ (99; 16%) and business travel (80; 13%). All continents were visited by at least one traveller. Of 470 registered trips, symptoms were reported on 163 trips (35%). Gastrointestinal symptoms were reported on 87 trips (19%) and respiratory symptoms on 81 trips (17%). The most important factors in predicting the presence of symptoms were duration of travel, travelling in winter and high humidity. Diarrhoea, headache and nausea were symptoms with most impact on daily activities. Post-travel questionnaires showed that 12% of surveyed participants experienced symptoms with several episodes of self-treatment. Two diagnoses were recorded: Lyme disease and amoebic dysentery.

Conclusion The digital tool ITIT successfully captures the spectrum of travel-related illness. This detailed epidemiology is crucial for outbreak detection and for the formulation of travel medicine guidelines.

Trial registration number NCT04672577.
},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

@article{Hedrich2022,
title = {Infection tracking in travellers using a mobile app (ITIT): The pilot study},
author = {Nadja Hedrich and Thibault Lovey and Esther Kuenzli and Gilles Epéron and Ulf Blank and Patricia Schlagenhauf},
url = {https://www.sciencedirect.com/science/article/pii/S1477893922002721},
doi = {https://doi.org/10.1016/j.tmaid.2022.102526},
isbn = {2022.102526},
year = {2022},
date = {2022-12-20},
journal = {Travel Medicine and Infectious Disease},
volume = {52},
abstract = {Background: Current surveillance of travellers’ health captures only a small proportion of illness events. We
aimed to evaluate the usability and feasibility of using an app to enable travellers to self-report illness.
Method: This pilot study assesses a novel mobile application called Infection Tracking in Travellers (ITIT) that
records travel-related symptoms with associated geolocation and weather data. Participants were recruited in
three Swiss travel clinics between December 2021 and March 2022. A feedback survey was used to examine app
ease of use, and data from the app was used to examine travel and illness patterns as a proof-of-concept for the
larger ITIT study.
Results: Participants were recruited from Zürich, Basel, and Geneva, with 37 individuals completing a total of 394
questionnaires in 116 locations in Asia, Africa, the Americas, and Europe. Illness symptoms were reported by
41% of participants, 67% of which were respiratory. The post travel questionnaire showed that all participants
found the app easy to use and 63% said they would recommend it to others. Several users provided suggestions
for improved usability.
Conclusion: The app fulfilled its function as a research tool linking infection symptoms with geolocation and
climate data.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

@article{Ferretti2021,
title = {Mobile apps for travel medicine and ethical considerations: A systematic review},
author = {Agata Ferretti and Nadja Hedrich and Thibault Lovey and Effy Vayena and Patricia Schlagenhauf},
doi = {https://doi.org/10.1016/j.tmaid.2021.102143},
year = {2021},
date = {2021-07-13},
journal = {Travel Medicine and Infectious Disease},
volume = {43},
number = {102143},
abstract = {Background
The advent of mobile applications for health and medicine will revolutionize travel medicine. Despite their many benefits, such as access to real-time data, mobile apps for travel medicine are accompanied by many ethical issues, including questions about security and privacy.

Methods
A systematic literature review was conducted following PRISMA guidelines. Database screening yielded 1795 results and seven papers satisfied the criteria for inclusion. Through a mix of inductive and deductive data extraction, this systematic review examined both the benefits and challenges, as well as ethical considerations, of mobile apps for travel medicine.

Results
Ethical considerations were discussed with varying depth across the included articles, with privacy and data protection mentioned most frequently, highlighting concerns over sensitive information and a lack of guidelines in the digital sphere. Additionally, technical concerns about data quality and bias were predominant issues for researchers and developers alike. Some ethical issues were not discussed at all, including equity, and user involvement.

Conclusion
This paper highlights the scarcity of discussion around ethical issues. Both researchers and developers need to better integrate ethical reflection at each step of the development and use of health apps. More effective oversight mechanisms and clearer ethical guidance are needed to guide the stakeholders in this endeavour.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}