International Journal of Travel Medicine and Global Health

International Journal of Travel Medicine and Global Health

Diarrhea Among International Travelers in Bali-Indonesia: Clinical and Microbiological Finding

Document Type : Original Article

Authors
Sri Masyeni 1
Hegard Sukmawati 1
Lila Paramasatiari 1
Sri Agung Aryastuti 1
Ketut Agus Somia 2
Gede Kambayana 2
Nyoman Astika 2
Renny Duarsa 3
Tuti Parwati Merati 2
1 Departement of Internal Medicine, Faculty of Medicine and Health Science, Warmadewa University, Bali, Indonesia
2 Faculty of Medicine, Udayana University, Bali, Indonesia
3 Kasih Ibu Hospital Denpasar, Bali, Indonesia
10.15171/ijtmgh.2017.18
Abstract
Introduction: Diarrhea is a common illness among travelers to developing countries. Located in a tropical region, Bali has a potentially high prevalence of travelers diarrhea. This hospital-based cross-sectional study was carried out to assess the clinical and microbiological profiles of diarrhea among travelers admitted to Kasih Ibu hospital, Denpasar-Bali.
Methods: This study enrolled a total of 71 patients at Kasih Ibu hospital between April 2015 and August 2016. All patients completed an epidemiologic questionnaire; their clinical histories were taken, and physical examinations were performed. Stool samples were collected for bacterial and parasitologic studies and susceptibility testing.
Results: Most patients were female (70.4%), and the nationality of most patients was Dutch (15.5%). Secretory diarrhea was the most frequently found diarrheal type (88.7%), with only 5.6% of cases having severe dehydration which developed into acute kidney injury. A high percentage of Entamoeba spp. was also seen in this study (54.9%). Of the 37 stool samples available for microbiological testing, 62.2% showed growth; Escherichia coli was the most commonly isolated bacteria (54.1%). Patients not infected by Entamoeba spp. were found more likely to experience nausea and vomiting (P<0.005).
Conclusion: Secretory diarrhea was the most prevalent type of diarrhea among travelers admitted to Kasih Ibu hospital, Bali. The most frequently found pathogens were Entamoeba spp. and E. coli. Although most patients had only mild dehydration as a complication, acute kidney injury did occur in some cases.
Keywords
Diarrhea
Entamoeba
Escherichia coli
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  • Receive Date 22 June 2017
  • Revise Date 03 August 2017
  • Accept Date 03 August 2017