Definition and Overview
Tropical medicine follow-up is an appointment with a tropical medicine specialist after a patient has been provided with treatment. It may last for a couple of weeks to years, depending on the illness.
Although there is no standard definition for tropical medicine especially in the UK, the term refers to a branch of medicine that deals with infectious diseases that are common in tropical regions.
A paper published in the Journal of Tropical Diseases and Public Health said that many diseases are unique and prevalent in the tropics for a number of reasons. One, many countries that belong to this region are described as developing or poor, which means they do not have the adequate necessary health care infrastructure to support the prevention, detection, treatment, and management of these diseases. This makes it easier for the disease, which may be caused by pathogens like viruses, to spread easily. Further, the countries are also known for their high population number and density. The more people there are in defined space, the quicker it is for the disease to spread.
The research further said that many infections occur only in the tropics because the climate creates an environment that is ideal for their growth and development. If these pathogens or parasites are placed in another climate where the temperature is much lower, they would not likely survive.
Tropical medicine is a major concern since infection is one of the leading causes of morbidity or death around the world. As international trade and travel become more popular and convenient, these infectious diseases, which used to exist only in tropical regions, can find their way to other non-tropical nations.
Who Should Undergo and Expected Results
A tropical medicine follow-up care is recommended for:
Patients who have been treated for an infectious disease – Infection can occur for a number of reasons. However, tropical medicine focuses on patients who have traveled to tropical countries or have been exposed to other people who have done so prior to the appearance of the symptoms and the diagnosis of the illness.
Patients who have been monitored for their symptoms – Tropical infectious diseases can have signs and symptoms that are similar to more universal conditions such as flu. These include muscle pains, fever, and fatigue. Follow-up care is performed normally after medications are given to reduce the symptoms or to monitor whether the medications are working or the condition has improved.
People who are exposed to an outbreak – Not all infectious diseases result to an outbreak, but doctors may be more alert during such health crisis.
People who have traveled abroad – Although it is not mandatory, people who travel in tropical countries where a certain infection is prevalent may be asked to undergo a health check-up upon arrival back home. The doctor may request for a follow-up when necessary.
Those who have a genetic predisposition – Certain types of genetic profiles can make some people more susceptible to infection and other tropical-related diseases. Follow-up can be used to treat, manage, detect, screen, and prevent them.
With follow-up, it is expected that:
- The disease will be managed more efficiently and effectively.
- The disease’s spread will be curtailed.
- The patient will fully recover from the illness.
- The patient will be able to manage the long-term effects of the disease.
How Does the Procedure Work?
The attending physician, who has an extensive training and specialization in tropical medicine, will inform the patient about the details of the follow-up care including the schedule. Usually, right after treatment, the patient has to see the doctor more often. As time goes on, the frequency of the visits will be reduced as the patient’s condition improves. Depending on the illness and how well the patient’s body is responding to treatment, the follow-up care may be carried out only for a few weeks or months until the patient has fully recovered.
Follow-up care may be performed in an inpatient or outpatient basis. Being an outpatient, however, does not mean that treatments are already completed. For example, TB (tuberculosis) patients may continue taking their antibiotics even after they were discharged.
During the follow-up visit, the doctor will review the patient’s medical history and update the records if necessary. The updates may cover drugs being taken or no longer taken, new signs and symptoms, any improvement or worsening feeling of the patient, and recent test results and their interpretation. The doctor may also ask about any changes in the family history, such as the presence of new infection or diseases.
When necessary, the doctor may request for specific tests to monitor the progress of the recovery, screen for other possible diseases, or detect diseases that may have been overlooked or not diagnosed early on.
Since the infectious disease can affect not only the physical but also the patient’s mental condition, the follow-up care may also include screening for mental health disorders like depression.
Possible Risks and Complications
One of the biggest challenges of a tropical medicine follow-up is ensuring that the patient commits to it. Follow-up visits require time and even money even if they are covered by insurance. These are challenges that may prevent the patient to proceed with these visits.
This is a huge problem as certain diseases can get worse or introduce new health problems in the absence of follow-up care. For instance, TB patients, who fail to follow-up with their doctor, run the risk of developing antimicrobial drug resistance, which can be a life-threatening condition. They may also spread the disease to others unknowingly or cope less effectively with the long-term effects of the illness.
A practical and simple way to avoid these issues is to establish an excellent communication between the doctor and the patient. The doctor should be able to stress the importance of follow-up and establish the fact that despite the inconveniences, the benefits outweigh them.
Fairley JK, John CC. Health advice for children traveling internationally. In: Kliegman RM, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 168.
World Health Organization. Country list: Yellow fever vaccination requirements and recommendations. Accessed February 9, 2014.