Effects of sanitation and hygiene perceptions on international travelers' health, travel plans and trip experiences in India

Rishita Chandra; Sakshi Supehia; Bhola Nath; Charu Chhetri; Ranjeeta Kumari; Kumari Damayanti Joshi; Roshan Sharma; Jatin Chaudary; Kishor Joshi; Ramesh Bhatta; Chhavi R Bhatt

doi:10.3389/fpubh.2022.1042880

Effects of sanitation and hygiene perceptions on international travelers' health, travel plans and trip experiences in India

Front Public Health. 2022 Nov 30:10:1042880. doi: 10.3389/fpubh.2022.1042880. eCollection 2022.

Authors

Rishita Chandra¹, Sakshi Supehia^{1

2}, Bhola Nath³, Charu Chhetri⁴, Ranjeeta Kumari¹, Kumari Damayanti Joshi^{5

6}, Roshan Sharma⁷, Jatin Chaudary^{1

8}, Kishor Joshi⁹, Ramesh Bhatta^{10

11}, Chhavi R Bhatt^{5

12}

Affiliations

¹ Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India.
² Department of Community Medicine, Dr RP Government Medical College, Kangra, Himachal Pradesh, India.
³ Department of Community and Family Medicine, AIIMS Raebareli, Uttar Pradesh, India.
⁴ Department of Community Medicine, Doon Medical College, Dehradun, Uttarakhand, India.
⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁶ School of Education, Deakin University, Melbourne, VIC, Australia.
⁷ Center for Urban Research, RMIT University, Melbourne, VIC, Australia.
⁸ Humsafar Trust, Mumbai, Maharashtra, India.
⁹ School of Physiotherapy and Allied Health, Sardar Bhagwan Singh Post Graduate Institute of Biomedical Sciences and Research, Dehradun, India.
¹⁰ Yeti Health Science Academy, Kathmandu, Nepal.
¹¹ Purbanchal University, Biratnagar, Nepal.
¹² School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.

Abstract

Background: International travelers often experience travelers' diarrhea. However, there is paucity of data on whether self-reported gastrointestinal symptoms influence travelers' perceptions of adequacy of sanitation and hygiene services encountered during travel, and to what degree their travel plans, and overall trip experience are impacted.

Methods: A cross-sectional face-to-face survey was conducted amongst international travelers in India. Data collected included socio-demographics, travel characteristics, self-reported occurrence and frequency/severity of gastrointestinal symptoms, perceptions of sanitation and hygiene encountered, and adverse effects of symptoms on travel plans and trip experiences. Chi-square tests and logistic regression were performed to describe differences and associations between categorical variables.

Results: Of the 300 international travelers surveyed, 46.3% experienced diarrhea. At least two thirds of travelers perceived the quality of sanitation (67.0%) and hygiene (70.0%) encountered to be inadequate. Perceptions of inadequate sanitation (adjusted OR = 3.0; 95% CI 1.7-5.5) and poor hygiene (adjusted OR = 7.7; 95% CI 4.1-15.5) were higher among travelers who experienced diarrhea. Additionally, both higher likelihood of travel plans being affected (adjusted OR = 10.7; 95% CI 5.1-23.6) and adverse impacts on overall trip experience (adjusted OR = 2.8; 95% CI 1.4-5.8) were reported among those who experienced diarrhea.

Conclusions: More than two thirds of travelers surveyed in India experienced inadequate sanitation and hygiene services, with perceptions influenced by occurrence and frequency of diarrhea. Self-reported diarrhea was also associated with adverse effects on travel plans and overall trip experience. While these results may seem intuitive, they have important implications and suggest that improving sanitation and hygiene standards in India could potentially enhance tourism.

Keywords: diarrhea; hygiene; sanitation; travel experience; travel health.

MeSH terms

Cross-Sectional Studies
Diarrhea* / prevention & control
Humans
Hygiene
India
Sanitation*
Travel