Effects of ambient temperature on hospitalizations for intestinal infectious diseases in Northeastern Thailand: Evidence from Health Region 10

Abstract

The influence of ambient temperature on the transmission of intestinal infectious diseases is well established, but evidence from Thailand remains limited. This study aimed to examine the association between ambient temperature and hospitalizations for intestinal infectious diseases in Health Region 10, and to explore differences across age and sex groups. A time-stratified case-crossover design, with distributed lag non-linear model and conditional quasi-Poisson regression was used to estimate province-specific associations between temperature and hospitalizations for intestinal infectious diseases. We then applied a multivariate meta-regression model to pool the province-specific estimates and quantified the burden of hospital admissions for intestinal infectious diseases attributable to temperature. We observed a linear-like exposure–response relationship between ambient temperature and hospital admissions for intestinal infectious diseases at both the current-day exposure (lag 0) and the cumulative 0–7-day lag. Over lag 0–7 days, temperature contributed to 28.95% (95% eCI: 17.02, 47.45) of all intestinal infectious disease hospitalizations. Sex-stratified analyses showed comparable patterns, although the attributable fraction was slightly higher among females (32.80%) than males (24.74%). Age-specific analyses revealed that children had the most immediate temperature response at lag 0, whereas adults and the elderly experienced substantially greater cumulative burdens, with AFs of 42.71% and 41.65%, respectively, over lag 0–7 days. These findings highlight the substantial impact of temperatures on intestinal infectious disease burden in Northeastern Thailand. As climate change continues to intensify temperature extremes, strengthening disease surveillance and early warning systems in Thailand will be essential to mitigate temperature-related health risks in vulnerable populations.