title: Mortality among foreign nationals in Chiang Mai City, Thailand, 2010 to 2011.
abstract: BACKGROUND
  Up to 65% of travelers to less developed countries report health problems while traveling. International travel is an increasing concern for health practitioners. To date, there have not been any published analyses of mortality amongst foreign nationals visiting Thailand. Our objectives are to examine the magnitude and characterize the deaths among foreign nationals in Chiang Mai, a popular tourist province in Thailand.
  
  
  METHODS
  The study commenced with a review of the Thai death registration. Death certificates were retrieved, reviewed, and classified by the causes of death. Basic statistics and proportionate mortality ratio (PMR) were used to describe the pattern of deaths. Standardized mortality ratio (SMR) was used to assess the excess mortality risk among foreign nationals.
  
  
  RESULTS
  Between January 1, 2010 and May 31, 2011, there were 1,295 registered deaths in Chiang Mai City, of which 102 records (7.9%) were foreign nationals. Median age of decedents was 64 years (range 14-102 y). Female-to-male ratio was 1 : 5.4. The highest mortality was among Europeans (45.1%). Most of the deaths were natural causes (89.2%) including 36 cardiac diseases (PMR = 35.3) and 20 malignancy diseases (PMR = 19.6). Deaths due to external causes were low. The SMRs range between 0.15 and 0.30.
  
  
  CONCLUSIONS
  Communicable diseases and injuries were not the leading causes of death among foreign nationals visiting Chiang Mai, Thailand. It is essential that travelers are aware of mortality risk associated with their underlying diseases and that they are properly prepared to handle them while traveling.
authors: Department of Disease Control, Bureau of General Communicable Disease, Ministry of Public Health, Nonthaburi, Thailand. vichpw@health2.moph.go.th
authors: Vichan
authors: V
authors: Pawun
authors: Surasing
authors: S
authors: Visrutaratna
authors: Kumnuan
authors: K
authors: Ungchusak
authors: Suteerat
authors: S
authors: Mahasing
authors: Chosita
authors: C
authors: Khumtalord
authors: Siriying
authors: S
authors: Tipsriraj
authors: Chalermpol
authors: C
authors: Chenwittaya
authors: Thomas E
authors: TE
authors: Guadamuz
authors: Stephen R
authors: SR
authors: Wisniewski
mesh_terms: D000293:Adolescent; D000369:Aged, 80 and over; D002423:Cause of Death; D003141:Communicable Diseases / Q000401:mortality*; D005006:Ethnicity / Q000145:classification / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D010358:Patient Participation / Q000379:methods; D011314:Preventive Health Services / Q000379:methods; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment; D013785:Thailand / Q000453:epidemiology; D014195:Travel / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000401:mortality*