Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review

Abstract Background Thailand, a major tourist destination, exhibits variations in sanitation and food safety practices that can lead to cases of travelers’ diarrhea (TD) caused by a plethora of pathogens. This systematic review synthesizes data on the pathogens associated with TD in Thailand, provid...

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Main Authors: Wanida Mala, Kwuntida Uthaisar Kotepui, Frederick Ramirez Masangkay, Kinley Wangdi, Polrat Wilairatana, Manas Kotepui
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Tropical Diseases, Travel Medicine and Vaccines
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Online Access:https://doi.org/10.1186/s40794-024-00243-y
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author Wanida Mala
Kwuntida Uthaisar Kotepui
Frederick Ramirez Masangkay
Kinley Wangdi
Polrat Wilairatana
Manas Kotepui
author_facet Wanida Mala
Kwuntida Uthaisar Kotepui
Frederick Ramirez Masangkay
Kinley Wangdi
Polrat Wilairatana
Manas Kotepui
author_sort Wanida Mala
collection DOAJ
description Abstract Background Thailand, a major tourist destination, exhibits variations in sanitation and food safety practices that can lead to cases of travelers’ diarrhea (TD) caused by a plethora of pathogens. This systematic review synthesizes data on the pathogens associated with TD in Thailand, providing valuable insights into pathogen diversity and distribution, traveler profiles, and geographical regions of concern. Methods This systematic review followed the PRISMA guidelines and was registered in PROSPERO (CRD42022346014). A comprehensive search was conducted across PubMed, Embase, Scopus, MEDLINE, and Journals@Ovid databases. The search included terms related to “diarrhea,” “travelers,” and “Thailand,” without restrictions on publication date. Eligible studies focused on travelers to Thailand who developed diarrhea with identified specific pathogens. Data was extracted and synthesized using a narrative approach. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results A total of 15 studies met the eligibility criteria, identifying that pathogens related to TD in Thailand were bacteria, particularly enterotoxigenic Escherichia coli (ETEC) (80%), followed by Campylobacter jejuni (33.3%) and Salmonella spp. (40%). Viral pathogens such as rotavirus and norovirus were also notable, with Giardia spp. being the most identified parasite. Pathogen distribution varied across different regions of Thailand, with tourism hubs such as Bangkok, Chiang Mai, Phuket, and Krabi reporting a broader range of infections. Conclusions This systematic review highlights the diverse range of pathogens associated with TD in Thailand, with bacterial pathogens, specifically ETEC, being the predominant cause in most studies. The findings underscore the importance of preventive measures, such as improved hygiene practices and food safety awareness, especially in high-risk tourist areas. Further research is needed to understand better the risk factors contributing to TD and to develop targeted interventions for prevention.
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spelling doaj-art-71c4071472af41ec81ceab79bb2a3ea32025-08-20T02:55:28ZengBMCTropical Diseases, Travel Medicine and Vaccines2055-09362025-04-0111111210.1186/s40794-024-00243-yEvidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic reviewWanida Mala0Kwuntida Uthaisar Kotepui1Frederick Ramirez Masangkay2Kinley Wangdi3Polrat Wilairatana4Manas Kotepui5Medical Technology, Faculty of Science, Nakhon Phanom UniversityMedical Technology, Faculty of Science, Nakhon Phanom UniversityDepartment of Medical Technology, Faculty of Pharmacy, University of Santo TomasHEAL Global Research Centre, Health Research Institute, Faculty of Health, University of CanberraDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol UniversityMedical Technology, Faculty of Science, Nakhon Phanom UniversityAbstract Background Thailand, a major tourist destination, exhibits variations in sanitation and food safety practices that can lead to cases of travelers’ diarrhea (TD) caused by a plethora of pathogens. This systematic review synthesizes data on the pathogens associated with TD in Thailand, providing valuable insights into pathogen diversity and distribution, traveler profiles, and geographical regions of concern. Methods This systematic review followed the PRISMA guidelines and was registered in PROSPERO (CRD42022346014). A comprehensive search was conducted across PubMed, Embase, Scopus, MEDLINE, and Journals@Ovid databases. The search included terms related to “diarrhea,” “travelers,” and “Thailand,” without restrictions on publication date. Eligible studies focused on travelers to Thailand who developed diarrhea with identified specific pathogens. Data was extracted and synthesized using a narrative approach. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results A total of 15 studies met the eligibility criteria, identifying that pathogens related to TD in Thailand were bacteria, particularly enterotoxigenic Escherichia coli (ETEC) (80%), followed by Campylobacter jejuni (33.3%) and Salmonella spp. (40%). Viral pathogens such as rotavirus and norovirus were also notable, with Giardia spp. being the most identified parasite. Pathogen distribution varied across different regions of Thailand, with tourism hubs such as Bangkok, Chiang Mai, Phuket, and Krabi reporting a broader range of infections. Conclusions This systematic review highlights the diverse range of pathogens associated with TD in Thailand, with bacterial pathogens, specifically ETEC, being the predominant cause in most studies. The findings underscore the importance of preventive measures, such as improved hygiene practices and food safety awareness, especially in high-risk tourist areas. Further research is needed to understand better the risk factors contributing to TD and to develop targeted interventions for prevention.https://doi.org/10.1186/s40794-024-00243-yTravelers’ diarrheaSystematic reviewThailandEnterotoxigenic Escherichia coliETEC
spellingShingle Wanida Mala
Kwuntida Uthaisar Kotepui
Frederick Ramirez Masangkay
Kinley Wangdi
Polrat Wilairatana
Manas Kotepui
Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review
Tropical Diseases, Travel Medicine and Vaccines
Travelers’ diarrhea
Systematic review
Thailand
Enterotoxigenic Escherichia coli
ETEC
title Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review
title_full Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review
title_fullStr Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review
title_full_unstemmed Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review
title_short Evidence of pathogens associated with travelers’ diarrhea in Thailand: a systematic review
title_sort evidence of pathogens associated with travelers diarrhea in thailand a systematic review
topic Travelers’ diarrhea
Systematic review
Thailand
Enterotoxigenic Escherichia coli
ETEC
url https://doi.org/10.1186/s40794-024-00243-y
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