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.
J Travel Med. 2019 Oct 14;26(7). doi: 10.1093/jtm/taz045.
There are few studies of the incidence of health problems among travelers to Southeast Asia. The current study sought to determine the incidence of self-reported health problems among travelers visiting the region.
A prospective questionnaire-based study was conducted among travelers from high-income countries who visited Southeast Asia. Participants were enrolled at time of their pre-travel visit at Mahidol University, Bangkok, Thailand. Travelers were prospectively followed by self-administered questionnaires 2 weeks after arrival, upon return to their home country and 2 weeks after return.
During January 2018-February 2019, 359 travelers were enrolled in Bangkok, Thailand, and the first questionnaire was administered. Follow-up questionnaires were returned by 191, 96 and 64 participants 2 weeks later, at the end of the trip and 2 weeks after return, respectively. A total of 6094 travel days were included in the final analysis. The incidence of acute diarrhea per month per 1000 travelers was 217 [95% confidence interval (CI), 189-248] episodes; skin problems, 197 (95% CI, 170-227); respiratory symptoms, 133 (95% CI, 111-158); fever, 49 (95% CI, 36-65); and potential rabies exposure, 34 (95% CI, 24-48). The incidence of acute diarrhea episodes per month per 1000 travelers was significantly higher during the first 2 weeks of travel compared with subsequent weeks of travel: 325 (95% CI, 291-362) vs 132 (95% CI, 110-1157) (P < 0.05). The incidence of outpatient visits and hospitalizations per month per 1000 travelers was 49 (95% CI, 36-65) and 5 (95% CI, 2-10), respectively.
In this prospective cohort study we observed substantial burden of acute diarrhea and skin and respiratory symptoms among travelers to Southeast Asia. The higher incidence of diarrhea in the first 2 weeks of travel should be further investigated.
有关东南亚旅行者健康问题发生率的研究较少。本研究旨在确定该地区旅行者报告的健康问题发生率。
对来自高收入国家的东南亚旅行者进行了前瞻性基于问卷的研究。参与者在泰国曼谷玛希隆大学进行旅行前就诊时入组。旅行者在抵达后 2 周、旅行结束时和返回后 2 周通过自我管理问卷进行前瞻性随访。
2018 年 1 月至 2 月期间，359 名旅行者在泰国曼谷入组，进行了第一次问卷调查。2 周后，191、96 和 64 名参与者分别返回了后续问卷，旅行结束时和返回后 2 周。最终分析共纳入 6094 个旅行日。每月每 1000 名旅行者中急性腹泻的发生率为 217 例（95%置信区间[CI]，189-248）；皮肤问题发生率为 197 例（95%CI，170-227）；呼吸道症状发生率为 133 例（95%CI，111-158）；发热发生率为 49 例（95%CI，36-65）；潜在狂犬病暴露发生率为 34 例（95%CI，24-48）。旅行者旅行前 2 周内每月每 1000 名旅行者中急性腹泻发作的发生率明显高于旅行后几周：325 例（95%CI，291-362）与 132 例（95%CI，110-1157）（P<0.05）。每月每 1000 名旅行者中门诊就诊和住院治疗的发生率分别为 49 例（95%CI，36-65）和 5 例（95%CI，2-10）。
在这项前瞻性队列研究中，我们观察到东南亚旅行者中急性腹泻以及皮肤和呼吸道症状负担较大。旅行前 2 周腹泻发生率较高，应进一步调查。
