Preventing Infectious Diseases in Long-Term Travelers to Rural Africa

[Extract] The traveler to, or expatriate residing in, rural areas of developing countries for prolonged periods is at greater risk of illness than the short-term traveler.1 This is a result of increased and more intense exposure to pathogens and their vectors or reservoirs, poorly developed infrastructure for water supply and sewerage disposal, limited environmental hygiene, extreme climates, potentially greater risk-taking behavior, and limited availability of medical facilities. Risk may be reduced by appropriate counseling, and vaccination and prophylactic medication based on the best available epidemiological data. This paper aims to provide travelers and practitioners with guidelines for reducing the risk of acquiring important infectious diseases associated with long-term travel or placement in rural Africa, a topic that is generally neglected.2 The diseases discussed were chosen on the basis of their frequency or potential severity and include yellow fever, malaria, tick-borne infections, food and waterborne disease, schitosomiasis, rabies, and tuberculosis