Mortality Among Foreign Nationals in Chiang Mai City, Thailand, 2010 to 2011

Authors

  • Vichan Pawun MD, MPH,

    Corresponding author
    1. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health (GSPH), Pittsburgh, PA, USA
    • Department of Disease Control, Bureau of General Communicable Disease, Ministry of Public Health, Nonthaburi, Thailand
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  • Surasing Visrutaratna DDS, DrPH,

    1. Chiang Mai Provincial Public Health Office, Ministry of Public Health, Chiang Mai, Thailand
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  • Kumnuan Ungchusak MD, MPH,

    1. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
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  • Suteerat Mahasing MA,

    1. Chiang Mai Provincial Public Health Office, Ministry of Public Health, Chiang Mai, Thailand
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  • Chosita Khumtalord MS,

    1. Chiang Mai Provincial Public Health Office, Ministry of Public Health, Chiang Mai, Thailand
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  • Siriying Tipsriraj MS,

    1. Department of Disease Control, Office of Disease Prevention and Control, 10th, Chiang Mai Province, Chiang Mai, Thailand
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  • Chalermpol Chenwittaya BA,

    1. Department of Disease Control, Office of Disease Prevention and Control, 10th, Chiang Mai Province, Chiang Mai, Thailand
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  • Thomas E. Guadamuz PhD,

    1. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health (GSPH), Pittsburgh, PA, USA
    2. Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand
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  • Stephen R. Wisniewski PhD

    1. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health (GSPH), Pittsburgh, PA, USA
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Corresponding Author: Vichan Pawun, MD, MPH, Department of Disease Control, Bureau of General Communicable Disease, Ministry of Public Health, Nonthaburi 11000, Thailand.

E-mail: vichpw@health2.moph.go.th

Abstract

Background

Up to 65% of travelers to less developed countries report health problems while traveling. International travel is an increasing concern for health practitioners. To date, there have not been any published analyses of mortality amongst foreign nationals visiting Thailand. Our objectives are to examine the magnitude and characterize the deaths among foreign nationals in Chiang Mai, a popular tourist province in Thailand.

Methods

The study commenced with a review of the Thai death registration. Death certificates were retrieved, reviewed, and classified by the causes of death. Basic statistics and proportionate mortality ratio (PMR) were used to describe the pattern of deaths. Standardized mortality ratio (SMR) was used to assess the excess mortality risk among foreign nationals.

Results

Between January 1, 2010 and May 31, 2011, there were 1,295 registered deaths in Chiang Mai City, of which 102 records (7.9%) were foreign nationals. Median age of decedents was 64 years (range 14–102 y). Female–to–male ratio was 1 : 5.4. The highest mortality was among Europeans (45.1%). Most of the deaths were natural causes (89.2%) including 36 cardiac diseases (PMR = 35.3) and 20 malignancy diseases (PMR = 19.6). Deaths due to external causes were low. The SMRs range between 0.15 and 0.30.

Conclusion

Communicable diseases and injuries were not the leading causes of death among foreign nationals visiting Chiang Mai, Thailand. It is essential that travelers are aware of mortality risk associated with their underlying diseases and that they are properly prepared to handle them while traveling.

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