Behaviors and Perceptions of Japanese Tourists Affecting Diarrheal Illness and Health Care Need Assessment: A Questionnaire Study

Abstract

Objectives: To measure the prevalence rate of, and determine the association between food and drink related behaviors and diarrheal illness among Japanese tourists, and assess their health care needs.Methods: Eligible Japanese tourists (1,480) aged ≥15 years traveling in Chiangmai Province in the north, Ayutthaya Province in the center, Kanchanaburi Province in the west, Pattaya City in the east, and Krabi Province in the south of Thailand were enrolled in the study. Of these tourists, 1,318 consented to participate in this study and completed questionnaires in Japanese, giving a response rate of 89.1%.Results: Among these Japanese tourists 21.3% had diarrheal illness, and of these tourists, 5.0% had classical travelers' diarrhea (TD), 11.8% had mild TD, 3.3% had good food and drink related behaviors, and 75.4% had moderate level of perception of diarrhea related to drinking and eating. Multiple logistic regression analysis indicated three significant diarrheal illness predictors: large number of previous visits to Thailand, longer stay in Thailand, and the experience of visiting other countries. Furthermore, 56.9% suggested providing an adequate number of toilets at tourist destinations; 53.9% suggested providing a 24-hour emergency call facility for a public ambulance; and 51.9% suggested providing garbage bins and garbage disposal facilities at tourist destinations.Conclusions: TD still affects experienced Japanese tourists who visit Thailand. Although the proportions of the good levels of food and drink related behaviors were low, there were indications that Japanese tourists perceived the risk of contracting TD.

Risk Factors Associated with Traveler’s Diarrhea Among Foreign Travelers in Yogyakarta, Indonesia

“…This finding was higher than that from the previous study which was 13.8% [8]. However, it was lower than the findings in some studies among foreign travelers visiting Thailand (21.3%) [9] and Bali (25.5%) [10].…”

“…Length of stay is one the risk factor of TD [14]. The longer the duration of stay, the greater the risk of developing TD compared to shorter duration because long period of stay in a high risk destination can increase the risk of consuming contaminated food and beverages which caused TD [9,15]. On the other hand, this study found that the longer travelers stay at a destination, the greater the likelihood that they acquire natural immunity against enteropathogen [22].…”