Knowledge, Attitude, and Practices on Travelers’ Diarrhea among Short-Term Travelers to Kenya, 2023: A Cross-sectional Study

Abstract Introduction: Traveler’s diarrhea (TD) is a common condition resulting in healthcare-related travel costs and disruptions of travel plans. Objective: The objective is to assess the knowledge, attitudes, and practices (KAPs) on TD among short-term travelers to Kenya. Subjects and Methods: An airport-based cross-sectional study was conducted at Jomo Kenyatta International Airport, Nairobi City, Kenya, among 397 respondents using self-administered mobile- or paper-based questionnaires over 26 days. Participants had to be English-speaking travelers with in-country stay of >1 day but <6 months, residency outside of Africa, and aged ≥18 years. Where data was incomplete or missing, we reported the valid percentage instead. Results: Median age was 39 years, 67.9% (267/393) were below 30 years, comprising 61.5% (243/395) males, traveling from Europe (62.3%, 240/385) and the United States (12.2%, 47). Common TD-associated symptoms were stomach ache (19.1%, 76/397), diarrhea (18.9%, 75), and fatigue (12.3%, 49). Common food items implicated with TD were tap water (49.6%, 197/397), fruit salad (26.7%, 106), and fish (25.2%, 100). Only about 22.5% (88/391) of the participants believed that travel-related vaccines were inessential, while 11.3% (43/382) considered them unsafe. The majority 70.7% (280/396) sought travel health advice, mainly from the internet (47.9%, 190/397), general practitioner (28.5%, 113), or family/friends (20.9%, 83). Ninety-four percent (369/383) travelers reported high self-rating handwashing practices. Ten percent (10%, 43/396) of participants reported travel-related diseases, and 17.7% (70/395) carried self-treatment for TD. Conclusion: One in ten travelers reported illness during their trip and identified gaps in KAPs on TD that can be addressed through in-country education programs for travelers.