Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 1453 The Spatio-Temporal Pattern of Dengue Haemorrhagic Fever, , During 2008 – 2017

Sumolrat Nimkingrat1, Kannitha Krongthamchat2, Sasithorn Tangsawad3, Anun Chaikoolvatana4, Kunthida Kingsawad5 1Student of Doctoral Program of Public Health, 2Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand; 3Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand; 4College of Medicine and Public Health, Ubon Ratchathani University, 5Sirindhorn College of Public Health, Suphanburi

Abstract Background: Dengue haemorrhagic fever (DHF) is a major problem in public health of the world and in tropical area especially Africa and South-East Asia. An endemic area of DHF in Thailand has begun since 1949. DHF in Khon Kaen province increased and transmitted into all areas. This study examined the spatio- temporal pattern of DHF incidence in Khon Kaen during 2008-2017.

Method: DHF data were obtained from Bereau of Vector Borne Disease, Khon Kaen province during 2008 – 2017 were geo-code at sub-district level. The data were acquired a space-time with elevated proportions of DHF incidence rate. The spatio-temporal technique analysis were conducted for a DHF transmission.

Result: The DHF outbreak in Khon Kaen province, Thailand were decrease in every year but DHF was shifted from urban areas to rural areas. The spatial clustering analysis were identified the risk areas in the district that closed Nakhon Ratchasima province and shifted to Udon Thani province in 2015.

Conclusion: The DHF clustered map is one of the best measurement for identified a risk area for surveillance. It has been an effectiveness prevention and controlling plan and allocated a resources of DHF.

Keywords: dengue haemorrhagic fever, spatio-temporal pattern, Thailand.

Introduction virus. Then virus travel to the salivary glands and readily Dengue haemorrhagic fever (DHF) is a major public enter to host who is being next bitten. When an infected health problem in many countries around the world. It mosquito bites to any person, it can be transmitted to that (2) has spread widely and a number of patients has increased person and causes the person to become ill. in 30 years. DHF is endemic areas especially tropical/ DHF in Thailand has begun transmission throughout (1) sub-tropical region. DHF is caused by dengue virus the country since 1949. The outbreaks was found including Aedes aegypti and Aedes albopictus which are in Bangkok in 1958. There were 2,158 DHF cases. the important disease carrier. The Aedes albopictus is a The incidence rate of 8.8 per 100,000 population and common mosquito and house mosquito. A virus is in a mortality rate of 13.90%. DHF was spread to various blood that from a mosquito biting and a lot of virus access provinces especially an urban area with hard density to the mosquito’s stomach and replicate to grow more and convenient transportation and found cases in every province of Thailand since 1958-2002. The situation of Corresponding author: (2) Asst Prof Dr.Kannitha Krongthamchat, Faculty of DHF in Thailand was increase continuously. Public Health, Khon Kaen University, Khon Kaen, The DHF pandemic in Khon Kaen province found 40002, Thailand. Tel.: +66 89 761 4116 Fax: +66 every years. DHF incidence rate from 2008 to 2015 43347058 E-mail: [email protected] were 50.05, 59.78, 66.07, 170.38, 24.70, 127.22, 44.79 ORCID; 0000-0002-5822-3202 1454 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 and 24.51 by sequence. However, DHF in Khon Kaen Kaen province, Thailand was obtained in the boundary province increased in the past and decrease from 2014, a of shapefile for DHF incidence rate from DIVA-GIS. researcher will be used a lot of measurements to explain (4) Quantum GIS version 2.8.5 and custom encode a pandemic disease.(3) were used as tool to generate a polygon shapefile from a map of district boundaries were generated. The DHF One of measurement methods to explain and incidence rate was described a temporal distribution in determine a risk area is Geographic Information System each district were used as characterize outbreak pattern (GIS). This study was aimed to explain a DHF incidence of DHF from secondary data from 2008 – 2017. (5) rate of Khon Kaen Province from 2008 – 2017, by analysing DHF incidence data spatial and temporal. Spatial Cluster Analysis Method The Local Indicators of Spatial Association (LISA) was used for a spatial cluster of DHF incidence rate Study area at the district level in Khon Kaen province, Thailand (6) Khon Kaen is one of the province in Thailand. It during 2008 – 2017 using Geoda software. The cluster located between 16° 25’ 50» north latitude and 102° analysis including time measure of incidence rate were 37’ 0» east longitude and exist of 10,885.991 square performed to detect the DHF cluster under area study. kilometers. The province consisted of 25 districts, an The frame of a study area were included a different sets area was subdivide using its political-administrative of neighbouring districts. The cluster were identified a division. comparison of the expected and observe incidence rate. (7) Data Collection Result DHF incidence rate in Khon Kaen province for the year from 2008-2017 were obtained from Bereau of The total number of 12,263 DHF cases in Khon Vector Borne Disease, Khon Kaen province, Thailand. Kaen province were reported during 2008 – 2017. The There were comply for spatial analysis. This study DHF incidence rate had increased since 2008 to 2013 and was approved by the ethical committee in Khon Kaen were slightly decrease since 2014 to 2017. The highest University IRB. DHF incidence rate (169.10 per 100,000 populations) appeared in the year 2013 as shown in Figure.I. Mueng Implementation of GIS and Spatial Analysis district and Manjakiri district of Khon Kaen had the high incident rate at that time. The spatio-temporal of DHF incidence rate in Khon

Figure I. Dengue Haemorrhagic Fever incidence rate in Khon Kaen province, Thailand during year 2008 - 2017 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 1455 Spatial Distribution of DHF in Khon Kaen province, in Khon Kaen province was a lot of migrant workers Thailand. from Loas and Cambodia.(15) Hence, the DHF incidence rate were still high in urban area and distributed to rural The spatial distribution of DHF incidence rate in area. Thai governmental organization should consider to Khon Kaen province were reported by Bureau of Vector apply the spatial map and the clustered map as a tool to Borne Disease, Khon Kaen province, Thailand where determine a policy to control a DHF transmission on the had 25 districts. The area was devided by quartiles from risk areas. year to year. DHF incidence rate was highest at Mueng and Manjakiri district during 2008 – 2017. DHF was Conclusion transmitted into during 2010 – 2011 Dengue Hemorrhagic Fever (DHF) in Khon Kaen and Waeng Noi district during 2009 – 2013. from 2008-2017 had a potential to decrease. The spatio- Spatial Clustering of Dengue Haemorrhagic temporal analysis was shown a spatial relationship of Fever (DHF) in Khon Kaen province, Thailand DHF. The DHF clustered map will be an important during 2008 - 2017 tool to identify the surveillance areas. It will make an effectiveness prevention plan and to allocating resources Statistically significant spatial clusters of districts for DHF controlling and prevention. with DHF incidence rate during 2008 – 2017were identified in Khon Kaen province. This study was Ethical Clearance: Taken from Khon Kaen identified cluster in Wang Noi district during 2008 – University IRB. 2011. The cluster in Wang Noi district shifted to Ban Source of Funding: This study was supported by Phai district in the year 2014 and also shifted to Nong self. Song Hong district in the year 2017. Therefore, DHF incidence rate were decreased but an observed cluster Conflict of Interests: the authors declare no was changed to border area. potential conflict of interests.

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