Abstract
BackgroundDiarrhea is a major public health problem in Thailand. The Ministry of Public Health, Thailand, has been trying to monitor and control this disease for many years. The methodology and the results from this study could be useful for public health officers to develop a system to monitor and prevent diarrhea outbreaks.MethodsThe objective of this study was to analyse the epidemic outbreak patterns of diarrhea in Chiang Mai province, Northern Thailand, in terms of their geographical distributions and hotspot identification. The data of patients with diarrhea at village level and the 2001–2006 population censuses were collected to achieve the objective. Spatial analysis, using geographic information systems (GIS) and other methods, was used to uncover the hidden phenomena from the data. In the data analysis section, spatial statistics such as quadrant analysis (QA), nearest neighbour analysis (NNA), and spatial autocorrelation analysis (SAA), were used to identify the spatial patterns of diarrhea in Chiang Mai province. In addition, local indicators of spatial association (LISA) and kernel density (KD) estimation were used to detect diarrhea hotspots using data at village level.ResultsThe hotspot maps produced by the LISA and KD techniques showed spatial trend patterns of diarrhea diffusion. Villages in the middle and northern regions revealed higher incidences. Also, the spatial patterns of diarrhea during the years 2001 and 2006 were found to represent spatially clustered patterns, both at global and local scales.ConclusionSpatial analysis methods in GIS revealed the spatial patterns and hotspots of diarrhea in Chiang Mai province from the year 2001 to 2006. To implement specific and geographically appropriate public health risk-reduction programs, the use of such spatial analysis tools may become an integral component in the epidemiologic description, analysis, and risk assessment of diarrhea.
Highlights
Diarrhea is a major public health problem in Thailand
The results show that the spatial distribution of diarrhea affected villages (DAV) from the years 2001–2006 were clustered (47.29–94.69) according to the variance-to-mean ratio (VTMR), and clustered (0.32–0.52) for the nearest neighbour index (NNI)
Using spatial analysis methods in geographic information systems (GIS), we explored the spatial patterns of diarrhea in Chiang Mai from 2001 to 2006
Summary
Diarrhea is a major public health problem in Thailand. The Ministry of Public Health, Thailand, has been trying to monitor and control this disease for many years. The methodology and the results from this study could be useful for public health officers to develop a system to monitor and prevent diarrhea outbreaks. Diarrhea is a major public health problem in Thailand. International Journal of Health Geographics 2009, 8:36 http://www.ij-healthgeographics.com/content/8/1/36 results could be useful for public health officers to develop a system to monitor and prevent diarrhea outbreaks. Diarrhea is the passage of three or more loose or liquid stools per day, or more frequently than is normal for the individual. It is most commonly caused by gastrointestinal infections (bacterial, viral and parasitic organisms). It is widespread all over the world, and especially in developing regions such as Africa, South East Asia and the Eastern Mediterranean, where there is rapid population growth, increased urbanization, and limited safe water, infrastructure, and health systems [1]
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