Older age, chronic medical conditions and polypharmacy in Himalayan trekkers in Nepal: an epidemiologic survey and case series

The number of tourists in Nepal doubled between 2003 and 2013 is nearly 800 000. With the increased popularity of trekking, the number of those with pre-existing medical conditions requiring access to healthcare is likely to increase. We therefore sought to characterize the demographics and health s...

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Bibliographic Details
Published in:Journal of travel medicine 2016-06, Vol.23 (6), p.taw052
Main Authors: Keyes, Linda E, Mather, Luke, Duke, Charles, Regmi, Nirajan, Phelan, Benoit, Pant, Sushil, Starling, Jennifer, McElwee, Matthew, Cole, Devlin, McConnell, Theodore, Paudel, Purshotam, Sallade, T Douglas, Sheets, Alison, Twillman, David, Young, David S, Basnyat, Buddha
Format: Article
Language:English
Subjects:
Adult
Altitude Sickness - epidemiology
Female
Humans
Male
Middle Aged
Mountaineering - statistics & numerical data
Nepal
Occupational Diseases - epidemiology
Polypharmacy
Risk Factors
Self Medication
Young Adult
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Summary:The number of tourists in Nepal doubled between 2003 and 2013 is nearly 800 000. With the increased popularity of trekking, the number of those with pre-existing medical conditions requiring access to healthcare is likely to increase. We therefore sought to characterize the demographics and health status of trekkers on the Everest Base Camp route in the Solukhumbu Valley. In addition, we report cases that illustrate the potential complications of an ageing and medicated population of trekkers with underlying diseases. Trekkers over 18 years were enrolled in a larger observational cohort study on blood pressure at high altitude at 2860 m. They answered a questionnaire regarding demographics, medical history and current medications. Acute medical problems relating to medication use that were brought to the attention of investigators were documented and are presented as case reports. We enrolled 670 trekkers, 394 (59%) male, with a mean age of 48 years (range 18-76). Pre-existing medical conditions were reported by 223 participants (33%). The most frequent conditions included hypertension, hypercholesterolemia, migraines and thyroid dysfunction. A total of 276 participants (41%) reported taking one or more medications. The most common medications were acetazolamide (79, 12%), antihypertensives (50, 8%) and NSAIDs (47, 7%), with 30 classes of drugs represented. Excluding acetazolamide, older trekkers (age >50 years) were more likely than younger ones to take medications (OR = 2.17; 95% CI 1.57-3.00; P 
ISSN:1195-1982
1708-8305
DOI:10.1093/jtm/taw052