title: An exploration of spatial patterns of seasonal diarrhoeal morbidity in Thailand.
abstract: Studies of temporal and spatial patterns of diarrhoeal disease can suggest putative aetiological agents and environmental or socioeconomic drivers. Here, the seasonal patterns of monthly acute diarrhoeal morbidity in Thailand, where diarrhoeal morbidity is increasing, are explored. Climatic data (2003-2006) and Thai Ministry of Health annual reports (2003-2009) were used to construct a spatially weighted panel regression model. Seasonal patterns of diarrhoeal disease were generally bimodal with aetiological agents peaking at different times of the year. There is a strong association between daily mean temperature and precipitation and the incidence of hospitalization due to acute diarrhoea in Thailand leading to a distinct spatial pattern in the seasonal pattern of diarrhoea. Model performance varied across the country in relation to per capita GDP and population density. While climatic factors are likely to drive the general pattern of diarrhoeal disease in Thailand, the seasonality of diarrhoeal disease is dampened in affluent urban populations.
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA. ben.mccormick@nih.gov
authors.forename: B J J
authors.initials: BJ
authors.lastname: McCormick
authors.forename: W J
authors.initials: WJ
authors.lastname: Alonso
authors.forename: M A
authors.initials: MA
authors.lastname: Miller
mesh_terms: D002980:Climate; D003967:Diarrhea / Q000453:epidemiology*; D006801:Humans; D015233:Models, Statistical; D012621:Seasons; D013785:Thailand / Q000453:epidemiology; D019371:Topography, Medical