Incidence and spectrum of health problems among travelers to Laos.

BACKGROUND: The number of travelers visiting Laos has more than doubled in the last 5 years. Little is known about their pre-travel preparations and the incidence of health problems during their trips. METHODS: At three border posts between Laos and Thailand, travelers were invited to complete a study questionnaire. They were asked about their demographic profile, travel characteristics, pre-travel health preparations, and health problems during their stay in Laos. RESULTS: From September 2011 to April 2012, 1,205 questionnaires from Thais and 1,191 from foreigners were collected. Approximately 60% of the travelers were male; the overall median age among the Thais was 43 years, and among the foreigners was 32 years. Most foreign visitors were from Europe (66.8%), followed by other Asian countries (19.0%) and North America (7.1%). Almost half of the foreigners (47.8%) traveled as individual backpackers, whereas the majority of Thais traveled as package tourists. Foreigners were more likely to trek, cycle, and swim during their trips. There were also significant differences in the average length of stay between foreigners (16.1 days) and Thais (3.8 days, p < 0.001). Health problems were reported in 24.9% of foreigners, the most common being diarrhea, cough, animal exposure, and fever. Only 6.1% of Thais reported health problems, the most common being cough and diarrhea. The relative risk adjusted for duration of stay was 1.63 (95% confidence interval: 1.01-2.64). Occurrence of health problems was associated with younger age group, non-Asian nationality, length of stay, and participation in adventurous activities. CONCLUSIONS: Health problems are rather frequent among non-Thai travelers in contrast to Thais during their trips to Lao People's Democratic Republic. There were significant differences in terms of risk profile and prevalence of health problems between these two groups.

Rabies exposure risk among foreign backpackers in Southeast Asia.

Rabies remains a problem in Southeast Asia where large numbers of backpackers visit each year. During May-June 2008, a survey study was conducted of foreign backpackers in Bangkok, Thailand to assess their risk of rabies exposure. Eight hundred seventy (870) questionnaires were collected and analyzed. The median age of the backpackers was 25.5 years. Most of them were European (68.4%), followed by North American (13.2%). Although 80.7% had sought health information before traveling, only 55.6% had received information about rabies. Only 18.1% had completed pre-exposure rabies vaccination (3 shots) before travel, whereas 70.9% had not been vaccinated for rabies at all. In this study, the incidence of being licked was 3.56%, and of being bitten 0.69%, on average stays of 30.06 days in Southeast Asia. More than a half (54%) of exposures occurred in the first 10 days after arrival in Southeast Asia.

Knowledge, attitudes, and practices among foreign backpackers toward malaria risk in southeast Asia.

BACKGROUND: Malaria is still prevalent in Southeast Asia where large numbers of backpackers visit each year. This study aimed to assess the knowledge, attitude, and practices among foreign backpackers toward malaria risk in Southeast Asia. METHODS: Questionnaires were administered to foreign backpackers in Bangkok, Thailand. They were asked about their general background, their attitude to malaria risk, and their preventive measures against malaria. Their knowledge about malaria was assessed by 10 true-false questions in the questionnaires. RESULTS: In total, 434 questionnaires were evaluated. Fifty-five percent of travelers were male and the median age was 28 years. The main reason for travel was tourism (91%). Almost all travelers (94%) were aware of the risk of malaria. Twenty-two percent of them would take antimalarial prophylaxis and 33% would use measures against mosquito bite, but nearly 40% had "no prevention" at all. Mean knowledge score was only 5.52 of 10. Most backpackers (92%) knew that malaria is a serious disease and sometime fatal and 74% knew that some travelers could develop malaria after they return. However, up to 35% believed that eating contaminated food could lead to malaria infection. And 49% believed that malaria could be 100% prevented by chemoprophylaxis. In backpackers, who had traveled in the forest (n = 65), only 54% used insect repellent regularly. Among those who had taken antimalarial prophylaxis, nearly 30% had stopped the medication prematurely. CONCLUSIONS: Although most backpackers perceive the risk of malaria in Southeast Asia, they have some misunderstandings about malaria and tend to comply poorly with mosquito bite prevention and chemoprophylactic strategies.