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

Abstract

Traveler's diarrhea (TD) is one of the most common health problem encountered by travelers. TD incidence increases annually especially in developing countries with an average incidence around 20-60% every month. This study was conducted in Yogyakarta because this region's tourism has been growing rapidly, and the information related to TD among foreign travelers in Yogyakarta is still limited. The aim of this study was to determine the prevalence of TD and factor associated with TD. This cross-sectional study was conducted among 150 foreign travelers in March 2018. A selfadministrated questionnaire was used to assess characteristics and risk behaviors of participants. The association were determined using chi square test. The result showed that the prevalence of TD among foreign travelers was 20%. The bivariate analysis results were age (OR = 2.45, 95%CI 0.91-6.58, p-value = 0.09), length of stay (OR = 1.44; 95%CI: 0.38-5.42, p-value = 0.737), and risk behaviors consisting of not washing hands before eating food (OR = 1.54; 95%CI: 0.72-3.31, p-value = 0.375), drinking iced beverage (OR = 1.21; 95%CI: 0.64-2.31, p-value = 0.706), and buying food from street vendor (OR = 0.79; 95%CI: 0.40-1.57, p-value = 0.645) respectively. No significant association were noted with any of the variables. The prevalence of TD was slightly high among foreign travelers in Yogyakarta, and despite the evidence from literature, no association between age, length of stay, and risk behavior was found. There is, therefore, a need to provide intervention programs such as health promotion to foreign travelers in order to raise the awareness of TD and to provide hygiene sanitation facilities in tourism place.