Vaccination and Travel Information for Tajikistan

TAJIKISTAN

 Information current as at:  February 2009 by The D2 Medical Centre No1 Fitzwilliam Street Upper Dublin 2 ph 6314500. The experts in travel vaccines Dublin 2.


Climate: In Dushanbe temperatures vary between a minimum -13°C in December/January to a maximum 33°C in July/August. Humidity is generally low. In the mountains it can reach -45°C when the wind chill factor is taken into consideration, and rises to 20°C in summer. In the Pamir Mountains, the climate is semi-arid to polar.
Capital City: Dushanbe
Altitude: 1030 metres above sea level
Main Cities: Khorog, Khugzand, Murgab, Novabad
Population: 6,440,732
Land Area (sq km): 143,100
Currency: Tajikistani ruble (TJR) = 100 tanga
Languages: Tajik (official), Russian widely used in government and business
Religions: Sunni Muslim 80%, Shi'a Muslim 5%
Economy: aluminum, electricity, cotton, fruits, vegetable oil, textiles


The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

HEPATITIS 'A' Immunisation is strongly recommended but not compulsory.


HEPATITIS ‘B’ Immunisation is strongly recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.


POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.


RABIES Immunisation is recommended for travellers who will be staying in rural areas for 1 month or more.

TUBERCULOSIS (TB) Immunisation is not compulsory, and is not routinely recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt, and this is recommended pre- and post- travel for those going to ‘at risk’ regions.


TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

TYPHOID FEVER Immunisation is recommended for travellers who will be living in rural areas for 1 month or more.


YELLOW FEVER No vaccination requirements for any international traveller.




Malaria risk, predominantly due to P. vivax, exists from June through until October, particularly in southern border areas (Khatlon Region), and in some central (Dushanbe), western (Gorno-Badakhshan), and northern (Leninabad Region) areas. Chloroquine-resistant P. falciparum suspected in some areas.
Recommended prophylaxis in risk areas: chloroquine.

Limited foci of vivax malaria exist in Kazakhstan and Uzbekstan. Tajikstan has reported an increase in malaria following the civil war (1992–1996), with P. vivax identified in 84% of cases, P. falciparum in 16%.

There are five common medications for malaria prevention available in Ireland. They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a D2 medical Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.




GENERAL
Medical care in Tajikistan is limited and well below established  European standards. The medical infrastructure of Tajikistan is significantly below Western standards, with severe shortages of basic medical supplies, including disposable needles, anaesthetics, and antibiotics. Many trained medical personnel left the country. Elderly travellers and those with pre-existing health problems may be at particular risk due to inadequate medical facilities. Most resident ex-pats travel to Western Europe for serious medical treatment. Travellers requiring prescription medications or specific brand-name medicines should bring sufficient supplies of medications and not rely on local availability. Hospitals usually require payment in cash for all services. Some medicines are in short supply in public hospitals and clinics.

Visitors intending to remain for more than 90 days must present a medical certificate that they are HIV-free, or submit to a test. Taking the test in Tajikistan is not advised, due to the poor quality of medical facilities.

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 medical recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.
                                                                                                                                                             DR JOHN J RYAN MEDICAL DIRECTOR

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