Tourists in Leishmaniasis endemic areas and their knowledge of the disease

Objectives: Tourists have been infected by Leishmania braziliensis, and the lack of appropriate travel information on the disease has been documented. The purpose of this study was to 1) ascertain tourists' knowledge on leishmaniasis and the source and type of travel health advice received before their trip, 2) to assess the usefulness of an information leaflet on the disease and its prevention, and 3) to examine if tourists preventive behaviour had been influenced by the leaflet. Method: The clients of two separate tour operators in Cusco/Peru represented the experimental and control group. The experimental group completed a questionnaire after the tour briefing the night before the trip and received the information leaflet. A second questionnaire was completed just before returning from the jungle. The clients in the control group did not receive the leaflet. Results: 95% of all participants never heard of leishmaniasis. Of the 94% who read the leaflet, all found it informative although 40% wished more information. It was suggested that the leaflet should be distributed by travel agents (55%), tour operators (52%) and family doctors (48%). There was a slight difference in the use of preventative measures (experiment 100% repellent, 95% protective clothing; control: 97% repellent, 93% protective clothing). One third of the experimental group paid more attention to protection due to the leaflet. Conclusion: There is generally a lack of knowledge on leishmaniasis with a great felt need for more and detailed information. It must be assumed that the implementation of preventative measures is generally due to the discomfort through biting insects rather the aspect of disease prevention. However, despite all measures, many were badly bitten which suggests that the current practice of prevention is not adequate