Only 23% of backpackers stated that they always washed their hands before eating food. The complete results are shown in I-BET-762 order Table 3. Of the 404 backpackers in our study, 124 (30.7%) had experienced diarrhea during their trip. About 60% of cases had only single episodes of diarrhea, while 25% had two episodes; only 6% had experienced more than three episodes during the

current trip. Approximately half (48.7%) of the diarrheal attacks occurred in the first 5 days after arrival. Only 16% of diarrheal attacks took place more than 15 days after arrival. Approximately half (48.6%) of the diarrheal episodes lasted 1 to 2 days, and 30.6% of episodes lasted 3 to 4 days. Most diarrheal attacks were mild; 61.6% of cases had only 3 to 4 bowel movements per day,

25.8% had 5 to 6 bowel movements per day, while only 6.6% had more than 10 bowel movements per day. Most cases were self-limited, with only 8.8% required a doctor’s visit, and only 3.2% required hospitalization. However, nearly half of the cases (48.4%) had bought some antidiarrheal medication, and 11.3% had to delay or cancel a trip. Diarrheal attacks occurred in all countries being visited by backpackers in varying percentage. Details of the results are shown in Tables 4 and 5. The mean duration of stay of backpackers in the diarrheal group was statistically longer than the nondiarrheal group (94.4 days vs 49.6 days, p < 0.001. There was no statistical difference between the two groups for other factors, including age, sex, nationality,

and purpose of travel. Most Selleckchem LDK378 preventive practices were similar in both groups, except that drinking beverages with ice was more common in the diarrheal group (100% vs 89.8%, p < 0.001). Detailed Cell press analysis is shown in Table 6. In our study, the incidence of travelers’ diarrhea among backpackers in Southeast Asia was 30.7% in an average stay of 60 days. This number was a close match with the estimated risk of travelers’ diarrhea in Asia, which ranged between 20 and 60%.1,4,6 However, with a focus only on Southeast Asia, particularly on Thailand, the incidence in our study was much higher than previous reports. A recent, well-designed study worthy of mention was conducted with foreign travelers in two main cities of Thailand: Chiangmai and Phuket.9 The researchers reported the incidence rate of travelers’ diarrhea in Thailand of between 1.6 and 17.6%, depending on the nationalities of the travelers. When focus on European travelers, which were the majority (80%) of our study also, the risk of diarrhea among them was only 6%, five times lower than our study. Our study, as well as the study of Japanese backpackers,12 might support the general assumption that backpackers as a group are at higher risk of diarrhea than the average traveler. The backpackers in the present study were clearly younger (mean age 26 vs 40.