Comparison of Climatic Factors Contributing to Hand-Foot-and-Mouth Disease Outbreak in the Northern and the Central Regions of Thailand

Background- Hand-foot-and-mouth disease (HFMD) has been noted as one of the most common contagious diseases in Thailand. Each year the highest reported cases have been mostly found in the Northern and the Central regions. These regions are quite different in terms of topography and climate. Therefore, the interest of this research was to compare the climatic factors that affect the incidence of HFMD outbreak. Objective- The research objective was to identify the climatic factors influencing HFMD in the two regions. Methods- The research applied spatial autocorrelation via the stepwise regression analysis to elaborate the influence of climatic factors on HFMD outbreaks during 2006-2016. Results- The HFMD distribution patterns mapping in this study indicated that there were large infectious areas in almost every province in both the Northern and the Central regions during 2012-2016. The stepwise regression analysis evaluated all possible combinations of the explanatory input candidate variables, including average temperature, average rainfall, air pressure, and relative humidity. The study finds found that the major climate factors pertaining to HFMD occurrence in the Northern region were temperature and humidity (R2 = 0.56), whereas humidity and rainfall (R2 = 0.49) played important roles in the Central region. The results confirmed the meteorological factors which were statistically significant in association with HFMD cases in seasonal of Thailand. Conclusion- It was concluded that the use of spatial autocorrelation in GIS and stepwise regression approach should be encouraged in epidemiology in estimating the involvement of meteorological indicators on the spatial distribution of HFMD and health geography in climate change situation.