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Am. J. Trop. Med. Hyg., 75(5), 2006, pp. 968-972
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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RISK FACTORS ASSOCIATED WITH DIARRHEA AMONG INTERNATIONAL VISITORS TO CUZCO, PERU

MIGUEL M. CABADA, FERNANDO MALDONADO, WANDA QUISPE, KAREN MOZO, EDSON SERRANO, ELSA GONZÁLEZ, CARLOS SEAS*, KRISTIEN VERDONCK, JUAN I. ECHEVARRIA, HERBERT L. DUPONT, AND EDUARDO GOTUZZO
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Universidad Nacional San Antonio Abad del Cuzco, Cuzco, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru; Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; University of Texas–Houston School of Public Health; St. Luke’s Episcopal Hospital; and Baylor College of Medicine, Houston, Texas

The objective of this study was to determine the risk factors for travelers’ diarrhea (TD) reported by visitors to Cuzco, Peru. In this cross-sectional study, self-administered questionnaires looking at perceived occurrence of health problems and pre-travel health advice were obtained from departing travelers at Cuzco’s International Airport between August and November 2002. A total of 5,988 travelers participated in the study. The mean age was 35 years, and 51% were women. The prevalence of TD was 24%. Factors associated with TD in the multivariable analysis were use of antibiotic prophylaxis (OR: 3.20), vaccination against cholera (OR: 1.44), history of advice for safe food and water consumption (OR: 1.46), being younger than 35 years of age (OR: 1.37), being a resident of the United States (OR: 1.28), not staying in hotels in Cuzco (OR: 1.13), and number of unsafe food or beverages consumed (OR: 1.04). Remaining in Cuzco < 1 week was a protective factor (OR: 0.58). TD is common among travelers to Cuzco. This study suggests that conventional recommendations are not invariably effective at decreasing TD.

Received February 19, 2005. Accepted for publication April 17, 2006.

Acknowledgment: The authors thank Dr. Clinton White for critically reviewing the manuscript.

Financial support: This study was supported by the Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. The work was partially supported by the US Public Health Service (Grant DK 56338), which funds the Texas Gulf Coast Digestive Diseases Center.

Disclosure: The authors have no conflicts of interest to disclose that would influence interpretation of data or the conduct of the study.

* Address correspondence to Carlos Seas, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru. E-mail: cseas{at}upch.edu.pe

Authors’ addresses: Miguel M. Cabada, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru, Telephone: 511-9791-5563, Fax: 511-482-3404, E-mail: 03517{at}upch.edu.pe. Fernando Maldonado, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru, Telephone: 511-482-3910, Fax: 511-482-3404, E-mail: fmaldonado66{at}yahoo.com. Wanda Quispe, Universidad Nacional San Antonio Abad del Cuzco, Av. La Cultura S/N, Wanchaq, Cuzco, Telephone: 584-261-255, E-mail: thongzhi4{at}yahoo.com. Karen Mozo, Universidad Nacional San Antonio Abad del Cuzco, Av. La Cultura S/N, Wanchaq, Cuzco, Telephone: 584-237-552, E-mail: karenzit{at}hotmail.com. Edson Serrano, Universidad Nacional San Antonio Abad del Cuzco, Av. La Cultura S/N, Wanchaq, Cuzco, Telephone: 584-974-3620, E-mail: edsonserrano{at}yahoo.com. Elsa González, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru, Telephone: 511-482-3910, Fax: 511-482-3404, E-mail: egonzalezlagos{at}yahoo.com. Carlos Seas, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru and Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru, Telephone: 511-482-3910, Fax: 511-482-3404, E-mail: cseas{at}upch.edu.pe. Kristien Verdonck, Prince Leopold Institute of Tropical Medicine. Nationalestraat 155, Antwerp, Belgium and Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, Telephone: 511-482-3910, Fax: 511-482-3404, E-mail: verweven{at}amauta.rcp.net.pe. Juan I. Echevarria, Instituto de Medicina Tropical Alexander von Hum-boldt, Universidad Peruana Cayetano Heredia. Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru and Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru, Telephone: 511-482-3910, Fax: 511-482-3404, E-mail: chito{at}upch.edu.pe. Herbert L. DuPont, University of Texas–Houston School of Public Health, Baylor College of Medicine and St. Luke’s Episcopal Hospital, Houston, TX, Telephone: 832-355-4122, Fax: 932-355-4167, E-mail: hdupont{at}sleh.com. Eduardo Gotuzzo, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia. Av. Honorio Delgado 430, San Martin de Porres, Lima, Peru and Departa-mento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru, Telephone: 511-482-3910, Fax: 511-482-3404, E-mail: egh{at}upch.edu.pe.






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