Oren Hillel1, Israel Potasman. 1. Infectious Diseases and Travel Clinic, Bnai-Zion Medical Centre, Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Abstract
BACKGROUND: Travelers' diarrhea is the most common infectious disease afflicting travelers to developing countries. Most studies investigating the benefits of recommendations regarding the consumption of food and water have focused on short-term travelers. We investigated the benefits of adherence to the precautions from the World Health Organization (WHO) among long-term travelers. METHODS: We asked 140 incidental travelers in India traveling for at least 2 months to complete a questionnaire about their adherence to the WHO precautions and the occurrence of diarrhea. Adherence was graded on a scale of 1 to 6 (least to most). RESULTS: The mean age of the 114 travelers whose questionnaires were eligible was 26.6 +/- 5.7 years, and the median duration of their trip was 5 months. None of them adhered strictly to the entire set of rules. The mean individual adherence was 3.4 (range 1.2-5.8). The vast majority of the travelers (83%) suffered from diarrhea. Most travelers (60%) had diarrhea for up to 3% of their journey time. Diarrhea was accompanied by fever among 18% and necessitated hospitalization in 3%. Forty-five percent indicated that they had lost traveling days due to diarrhea, for an average of 0.7% of the traveling time. We found no correlation between the percentage of traveling time with diarrhea and the following variables: adherence to the WHO recommendations, receipt of advice regarding prevention, duration of the trip, age, sex, and nationality of the travelers. CONCLUSIONS: Dietary self-restraint of travelers as proposed by the WHO is both difficult to comply with and lacks a proven value for the long-term traveler to a developing country.
BACKGROUND: Travelers' diarrhea is the most common infectious disease afflicting travelers to developing countries. Most studies investigating the benefits of recommendations regarding the consumption of food and water have focused on short-term travelers. We investigated the benefits of adherence to the precautions from the World Health Organization (WHO) among long-term travelers. METHODS: We asked 140 incidental travelers in India traveling for at least 2 months to complete a questionnaire about their adherence to the WHO precautions and the occurrence of diarrhea. Adherence was graded on a scale of 1 to 6 (least to most). RESULTS: The mean age of the 114 travelers whose questionnaires were eligible was 26.6 +/- 5.7 years, and the median duration of their trip was 5 months. None of them adhered strictly to the entire set of rules. The mean individual adherence was 3.4 (range 1.2-5.8). The vast majority of the travelers (83%) suffered from diarrhea. Most travelers (60%) had diarrhea for up to 3% of their journey time. Diarrhea was accompanied by fever among 18% and necessitated hospitalization in 3%. Forty-five percent indicated that they had lost traveling days due to diarrhea, for an average of 0.7% of the traveling time. We found no correlation between the percentage of traveling time with diarrhea and the following variables: adherence to the WHO recommendations, receipt of advice regarding prevention, duration of the trip, age, sex, and nationality of the travelers. CONCLUSIONS: Dietary self-restraint of travelers as proposed by the WHO is both difficult to comply with and lacks a proven value for the long-term traveler to a developing country.
Authors: Lin H Chen; Mary E Wilson; Xiaohong Davis; Louis Loutan; Eli Schwartz; Jay Keystone; Devon Hale; Poh Lian Lim; Anne McCarthy; Effrossyni Gkrania-Klotsas; Patricia Schlagenhauf Journal: Emerg Infect Dis Date: 2009-11 Impact factor: 6.883