Summary of deaths among thais travelling abroad

Each year some Thai citizens travelling abroad die during travel. In this study we aimed to determine the causes of death among Thais travelling abroad in order to establish evidence-based country advisories for Thai travellers in an effort to reduce this mortality. We retrospectively reviewed a summary of the death certificates of Thai nationals who died while travelling abroad during 2015-2018. The summary was obtained from the Department of Consular Affairs, Ministry of Foreign Affairs, Thailand. During the study period records were available for 2324 people; 57.4% male. The mean (+standard deviation; range) age of study subjects was 52 (±17; 1-103) years. Most subjects died from ill-defined causes (48.6%), followed by neoplasms (15.7%), diseases of the circulatory system (13.6%), injuries (13.6%), infections (7.6%) and gastrointestinal bleeding/perforations (0.9%) respectively. Of the subjects who died from injuries, the leading causes of injury deaths were vehicular accidents (19.4%), falls (11.7%) and suicides (8.3%). Among younger subjects, defined as being aged 18-44 years, injuries were the leading cause of death, accounting for 26.4% of deaths. Among older subjects, defined as being aged >45 years, neoplasms (22.3%) and diseases of circulatory system (15.4%) were the leading causes of death. Thai deaths occurring in low-/middle-income countries (LMIC) were significantly more likely to be caused by infections (p<0.001), falls (p<0.001) and other injuries (p<0.001). Thai deaths occurring in high-income countries (HIC) were significantly more likely to be caused by cardiovascular disease (p<0.001) and neoplasms (p<0.001). In summary, there is a lack of data regarding causes of death for many Thai deaths occurring overseas. These deaths differ by age and destination. In conclusion, pre-travel advice should be tailored to the traveller adjusting for age and destination. Further studies are needed to determine if adjusting for these factors can significantly reduce the incidence of deaths among Thais travelling abroad.