title: Traveler's Diarrhea in Foreign Travelers in Southeast Asia: A Cross-Sectional Survey Study in Bangkok, Thailand.
abstract: The effect of origin and destination country on traveler's diarrhea incidence rates in Southeast Asia is poorly understood, and research generally only addresses diarrhea in travelers from the developed world. This study evaluated the attack rate and effects of traveler's diarrhea by origin and destination and analyzed key risk factors. A self-administered questionnaire was provided to foreign travelers departing Southeast Asia from Suvarnabhumi Airport, Bangkok, Thailand. It evaluated traveler demographics, relevant knowledge and practices, experiences of diarrhea, and the details and consequences of each diarrheal episode. A total of 7,963 questionnaires were completed between April 2010 and July 2011. Respondents were 56% male (mean age 35) with a mean and median duration of stay of 28 days and 10 days, respectively. Most respondents were from Europe (36.8%) or East Asia (33.4%). The attack rate of traveler's diarrhea was 16.1%, with an incidence rate of 32.05 per 100 person months. Travelers' origin and destination countries significantly related to diarrhea risk. Oceanians had the highest risk (32.9%) and East Asians the lowest (2.6%). Vietnam and Indonesia were the highest risk destinations (19.3%). Other significant factors were youth, trip duration, number of countries visited, and frequently drinking beverages with ice.
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Disease Control, Bureau of General Communicable Diseases, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Chatporn
authors.initials: C
authors.lastname: Kittitrakul
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Disease Control, Bureau of General Communicable Diseases, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Saranath
authors.initials: S
authors.lastname: Lawpoolsri
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Disease Control, Bureau of General Communicable Diseases, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Teera
authors.initials: T
authors.lastname: Kusolsuk
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Disease Control, Bureau of General Communicable Diseases, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Jutarmas
authors.initials: J
authors.lastname: Olanwijitwong
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Disease Control, Bureau of General Communicable Diseases, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Waraluk
authors.initials: W
authors.lastname: Tangkanakul
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Department of Disease Control, Bureau of General Communicable Diseases, Ministry of Public Health, Nonthaburi, Thailand watcharapong.piy@mahidol.ac.th.
authors.forename: Watcharapong
authors.initials: W
authors.lastname: Piyaphanee
mesh_terms: D000328:Adult; D059028:Airports / Q000706:statistics & numerical data; D001210:Asia, Southeastern / Q000453:epidemiology; D001292:Attitude to Computers; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology; D014195:Travel