Burden and pattern of acute diarrhea in Thai children under 5 years of age: A 5-year descriptive analysis based on Thailand National Health Coverage (NHC) data

Abstract

Background: The incidence of acute diarrhea in Thai children under five years of age has increased over the last three decades. Even though mortality has significantly declined, the burden and cost of medical treatment are still high. Our objectives are to describe the burden and pattern of acute diarrhea cases that required admissions by Thai children under five years of age from 2015 to 2019.Methods: Data regarding the admission of acute diarrhea cases of Thai children with Thailand National Health Coverage (NHC) under five years of age from 2015 to 2019, recorded as International Statistical Classification of Diseases and Related Health Problems, tenth Revision, Thai Modification (ICD-10-TM), were analyzed.Results: The incidence trend of yearly acute diarrhea in children 0-5 years of age slightly decreased over approximately the last decade (124,403 cases in 2010 to 102,941 cases from 2015 to 2019), along with the high cost of performing the medical treatment of approximately three billion baths per year. Diarrhea-related mortality had a low, constant rate of 0.95 per 100,000 population per year (range: 0.81-1.14 per 100,000 population per year). Three-fourths of the mortality rate was observed in children under 2 years of age and a regional distribution of the causative agent was also observed in Cholera, Typhoid, and Amoebiasis cases. Seasonal variations demonstrated consistency with similar patterns during the cold and rainy seasons throughout the 5-year period. A08 and A09 were the two most common causes of diarrheal diseases.Conclusions: The burden, incidence and mortality rate of acute diarrhea in Thai children under five years of age were lower than those in the past decades. A similar seasonal outbreak of acute diarrhea was seen during each examined year. The causative agent was not significant and was mainly unspecific.Trial registration: number TCTR20220117002, date of registration 17/01/2022