[goa-research-net] Epidemiology of travelers' diarrhea: details of a global survey.

[FN]

J Travel Med 2004;11(4)
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Epidemiology of travelers' diarrhea: details of a global survey.

Steffen R, Tornieporth N, Clemens SA, Chatterjee S, Cavalcanti AM, Collard F, 
De Clercq N, DuPont HL, von Sonnenburg F

Division of Epidemiology and Prevention of Communicable Diseases, Institute of 
Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.

BACKGROUND: Recent epidemiologic data on travelers' diarrhea (TD) are essential 
for the evaluation of conventional and future prophylactic and therapeutic 
measures. METHODS: To determine the epidemiology, including risk factors, 
impact and quality-of-life evaluation of TD, a cross-sectional survey was 
conducted over 12 months at the airports of Mombasa (Kenya), Goa (India), 
Montego Bay (Jamaica) and Fortaleza (Brazil) by distributing questionnaires to 
visitors just prior to their flying home. The study period was March 1996 to 
July 1998.

RESULTS: Overall, 73,630 short-term visitors completed a questionnaire. The 
total diarrhea attack rate varied between a high of 54.6% in Mombasa and a low 
of 13.6% in Fortaleza, but only between 31.5% and 5.4% of all travelers had 
classic TD. The 14-day incidence rates varied between 19.5% and 65.7%. Few 
travelers meticulously avoided potentially dangerous food
items, although in India and Kenya most travelers avoided those considered most 
dangerous.

Risk factors were stays exceeding 1 week, age  between 15 and 30 years, and 
residence in the UK. The impact, measured as incapacity or quality-of-life 
scores, was very considerable.

CONCLUSIONS: TD continues to affect vacationers and business travelers as 
frequently as it did some 20 years ago. Compliance with recommendations to 
reduce exposure to pathogens by avoiding dangerous food items is poor among 
travelers from all countries. Implementation of food safety education programs 
may be difficult to achieve.

PMID: 15541226[PM]
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