Incidence of Travelers' Diarrhea Among Japanese Visiting Thailand

Abstract

Abstract:A cross-sectional survey of 327 Japanese short-term travelers (!3 weeks) arriving in Bangkok, Thailand was conducted to assess the incidence of travelers' diarrhea (TD) as well as their symptoms and treatment-seeking behaviors. The incidence of the first episode of TD (FTD) was ascertained retrospectively by questionnaire. Reported by 69 travelers, FTD clustered within the first 8 days of arrival in Thailand, and the incidence rate varied from 2% to 8% with the highest incidence on the third day.Cumulative probability of FTD was 19% for those arriving in Thai directly from Japan, 42 % for those arriving via Southeast Asia, and 25% for those arriving via other regions at Day 7 by the Kaplan-Meier survival analysis. Log rank test revealed a higher FTD risk for travelers arriving via other Southeast Asian countries than for those arriving directly from Japan (P < 0.005). Of all the 69 FTD episodes, 33% had classic TD defined as "3 unformed stools per 24 hours with at least one accompanying symptom, 49% had moderate TD defined as !2 unformed stools with at least one additional symptom or more unformed stools without additional symptoms, and 17% had mild TD defined as with !2 unformed stools without additional symptoms. Cumulative probability of FTD at Day 7 was 12% for classic TD, 25% for classic plus moderate TD and 30% for all the TD. More than 38% of travelers with diarrhea took medicine brought from Japan. Among travelers with classic TD, 35% bought medicine in Thailand, whereas 47-50% of travelers with moderate and mild TD took only rest without any treatment.

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

“…TD was classified into three categories according to the classification of Steffen (13); 5.0% of the Japanese tourists had classical TD, 4.5% had moderate TD and 11.8% had mild TD. The overall TD prevalence rate was almost the same as the finding of 21.1% (69/327) by Mitsui et al (10). However, it was considerably lower than that in the study of Howteerakul et al (11) (21.3% vs 36.3%).…”

“…Information on these factors is essential to assist health providers and organizations who are responsible for health and tourism to develop and prioritize health services for Japanese tourists. So far, only one domestic study has been conducted to assess the incidence of TD among Japanese visiting Bangkok, Thailand (10). Therefore, in this survey, we aimed to measure the prevalence rate of, and determine the associations between general characteristics, behaviors and perceptions related to food and drink consumption and diarrheal illness of Japanese tourists, and assess their health care needs.…”

Traveler's Diarrhea in Foreign Travelers in Southeast Asia: A Cross-Sectional Survey Study in Bangkok, Thailand

“…This number is comparable with several previous studies done in Southeast Asia that report the rate being between 1.6% and 30.7%. 3,4,7,8 It was impossible to compare this attack rate directly with previous studies because there were substantial differences in our sample, including population characteristics, destination, duration of stay, and travel style. However, several important points should be noted.…”