title: Risk factors associated with diarrhea among international visitors to Cuzco, Peru.
abstract: The objective of this study was to determine the risk factors for travelers' diarrhea (TD) reported by visitors to Cuzco, Peru. In this cross-sectional study, self-administered questionnaires looking at perceived occurrence of health problems and pre-travel health advice were obtained from departing travelers at Cuzco's International Airport between August and November 2002. A total of 5,988 travelers participated in the study. The mean age was 35 years, and 51% were women. The prevalence of TD was 24%. Factors associated with TD in the multivariable analysis were use of antibiotic prophylaxis (OR: 3.20), vaccination against cholera (OR: 1.44), history of advice for safe food and water consumption (OR: 1.46), being younger than 35 years of age (OR: 1.37), being a resident of the United States (OR: 1.28), not staying in hotels in Cuzco (OR: 1.13), and number of unsafe food or beverages consumed (OR: 1.04). Remaining in Cuzco < 1 week was a protective factor (OR: 0.58). TD is common among travelers to Cuzco. This study suggests that conventional recommendations are not invariably effective at decreasing TD.
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru. 03517@upch.edu.pe
authors.forename: Miguel M
authors.initials: MM
authors.lastname: Cabada
authors.forename: Fernando
authors.initials: F
authors.lastname: Maldonado
authors.forename: Wanda
authors.initials: W
authors.lastname: Quispe
authors.forename: Karen
authors.initials: K
authors.lastname: Mozo
authors.forename: Edson
authors.initials: E
authors.lastname: Serrano
authors.forename: Elsa
authors.initials: E
authors.lastname: González
authors.forename: Carlos
authors.initials: C
authors.lastname: Seas
authors.forename: Kristien
authors.initials: K
authors.lastname: Verdonck
authors.forename: Juan I
authors.initials: JI
authors.lastname: Echevarria
authors.forename: Herbert L
authors.initials: HL
authors.lastname: Dupont
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006266:Health Education; D006801:Humans; D007255:Information Services / Q000706:statistics & numerical data; D008297:Male; D010349:Patient Compliance; D010568:Peru / Q000453:epidemiology; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014195:Travel