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Int. J. Environ. Res. Public Health 2014, 11(1), 312-336; doi:10.3390/ijerph110100312
Article

Spatio-Temporal Distribution and Hotspots of Hand, Foot and Mouth Disease (HFMD) in Northern Thailand

1,* , 1
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 and 2
Received: 18 October 2013; in revised form: 15 December 2013 / Accepted: 17 December 2013 / Published: 23 December 2013
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Abstract: Hand, Foot and Mouth Disease (HFMD) is an emerging viral disease, and at present, there are no antiviral drugs or vaccines available to control it. Outbreaks have persisted for the past 10 years, particularly in northern Thailand. This study aimed to elucidate the phenomenon of HFMD outbreaks from 2003 to 2012 using general statistics and spatial-temporal analysis employing a GIS-based method. The spatial analysis examined data at the village level to create a map representing the distribution pattern, mean center, standard deviation ellipse and hotspots for each outbreak. A temporal analysis was used to analyze the correlation between monthly case data and meteorological factors. The results indicate that the disease can occur at any time of the year, but appears to peak in the rainy and cold seasons. The distribution of outbreaks exhibited a clustered pattern. Most mean centers and standard deviation ellipses occurred in similar areas. The linear directional mean values of the outbreaks were oriented toward the south. When separated by season, it was found that there was a significant correlation with the direction of the southwest monsoon at the same time. An autocorrelation analysis revealed that hotspots tended to increase even when patient cases subsided. In particular, a new hotspot was found in the recent year in Mae Hong Son province.
Keywords: Hand, Foot and Mouth Disease (HFMD); spatial statistics; spatial distribution pattern; temporal distribution pattern; hotspot detection; Geographic Information Systems (GIS); hybrid ring mapping Hand, Foot and Mouth Disease (HFMD); spatial statistics; spatial distribution pattern; temporal distribution pattern; hotspot detection; Geographic Information Systems (GIS); hybrid ring mapping
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Samphutthanon, R.; Tripathi, N.K.; Ninsawat, S.; Duboz, R. Spatio-Temporal Distribution and Hotspots of Hand, Foot and Mouth Disease (HFMD) in Northern Thailand. Int. J. Environ. Res. Public Health 2014, 11, 312-336.

AMA Style

Samphutthanon R, Tripathi NK, Ninsawat S, Duboz R. Spatio-Temporal Distribution and Hotspots of Hand, Foot and Mouth Disease (HFMD) in Northern Thailand. International Journal of Environmental Research and Public Health. 2014; 11(1):312-336.

Chicago/Turabian Style

Samphutthanon, Ratchaphon; Tripathi, Nitin K.; Ninsawat, Sarawut; Duboz, Raphael. 2014. "Spatio-Temporal Distribution and Hotspots of Hand, Foot and Mouth Disease (HFMD) in Northern Thailand." Int. J. Environ. Res. Public Health 11, no. 1: 312-336.


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