Publication: Incidence of travelers' diarrhea among adult foreign travelers in Thailand: A prospective study
Issued Date
2020-01-01
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ISSN
14761645
00029637
00029637
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2-s2.0-85085316621
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.102, No.5 (2020), 1009-1015
Suggested Citation
Chollasap Sharma, Kittiyod Poovorawan, Watcharapong Piyaphanee, Ngamphol Soonthornworasiri, Piyada Angsuwatcharakon, Weerapong Phumratanaprapin, Wattana Leowattana, Polrat Wilairatana Incidence of travelers' diarrhea among adult foreign travelers in Thailand: A prospective study. American Journal of Tropical Medicine and Hygiene. Vol.102, No.5 (2020), 1009-1015. doi:10.4269/AJTMH.19-0672 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/56216
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Title
Incidence of travelers' diarrhea among adult foreign travelers in Thailand: A prospective study
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Abstract
© 2020 by The American Society of Tropical Medicine and Hygiene Travelers' diarrhea (TD) is common among foreign travelers to Thailand. We performed a prospective cohort study to determine the TD incidence among foreign adult travelers to Thailand. We retrieved baseline demographic data, travel plans, and health history on enrolling individuals and collected follow-up questionnaires on days 7, 14, and 28 from the day of arrival. We analyzed data from 349 eligible participants. The mean participants' age was 32.3 years; 55.4% were men. Most of the participants had visited a travel clinic for vaccinations and counseling after arrival in Thailand. The cumulative incidences of the participants developing TD were 14.0% (49/349), 23.5% (82/349), and 33.0% (115/349) at 7, 14, and 28 days, respectively. The median time to develop TD was 9 days (interquartile range 5-18 days) post-arrival. Of 115 participants with TD, 64.3% (74/115) consulted a physician, 1.7% (2/115) were hospitalized, and 11.3% (13/115) had to change their travel plans. We identified young age, eating street food, and not routinely washing hands after using a toilet as risk factors significantly associated with the incidence of TD using the log-rank test in our survival analysis. Up to one-third of foreign travelers developed diarrhea during the first month, and some cases were severe. Although no highly effective TD prevention method exists, the practice of good personal hygiene and avoidance of food and drinks derived from unsanitary sources are still recommended to reduce the risk of travelers' TD.