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Peer-reviewedCC BYIJID regions

Contrasting pandemic era trajectories of dengue; chikungunya; and hand, foot, and mouth disease in Thailand using national surveillance findings, 2016–2025

  • Wannarat Pongpirul1
  • Mohamed Mustaf Ahmed2
  • Krit Pongpirul3
  1. 1Department of Disease Control, Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi, Thailand
  2. 2Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
  3. 3Faculty of Medicine, School of Global Health, Chulalongkorn University, Bangkok, Thailand
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Abstract

Objectives: To compare the pandemic era trajectories of dengue; chikungunya; and hand, foot, and mouth disease (HFMD) in Thailand

Methods: We conducted a national ecological interrupted time series analysis using weekly surveillance data from all 77 Thai provinces from 2016 to 2025. Segmented quasi-Poisson regression with Fourier terms for annual seasonality estimated the level and slope changes at a calendar-based 2020 break point; sensitivity analyses used later break points.

Results: The analysis included 40579 province-week observations including 790263 dengue, 32265 chikungunya, and 713822 HFMD cases. The estimated level incidence rate ratios at week 1 of the 2020 break point were 0.39 for dengue (95% confidence interval [CI] 0.32-0.48), 0.54 for chikungunya (95% CI 0.41-0.71), and 0.51 for HFMD (95% CI 0.38-0.69). Dengue rebounded above pre-pandemic levels by 2023, chikungunya declined after the 2018-2020 outbreak, and HFMD’s mean annual incidence in 2023–2025 exceeded the pre-pandemic baseline by approximately 26%.

Conclusions: These contrasting trajectories support the need for comparative multi-disease surveillance. Ecological designs cannot separate the contribution of transmission ecology from epidemic history or other time-varying factors.

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Cite

BibTeXRIS
BibTeX
@article{pongpirul2026contrasting,
  title = {{Contrasting pandemic era trajectories of dengue; chikungunya; and hand, foot, and mouth disease in Thailand using national surveillance findings, 2016–2025}},
  author = {Wannarat Pongpirul and Mohamed Mustaf Ahmed and Krit Pongpirul},
  journal = {IJID regions},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ijregi.2026.101037},
  url = {https://europepmc.org/article/PMC/PMC13722057},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Contrasting pandemic era trajectories of dengue; chikungunya; and hand, foot, and mouth disease in Thailand using national surveillance findings, 2016–2025
AU  - Wannarat Pongpirul
AU  - Mohamed Mustaf Ahmed
AU  - Krit Pongpirul
PY  - 2026
DA  - 2026/10/07
JO  - IJID regions
DO  - 10.1016/j.ijregi.2026.101037
UR  - https://europepmc.org/article/PMC/PMC13722057
AB  - Objectives: To compare the pandemic era trajectories of dengue; chikungunya; and hand, foot, and mouth disease (HFMD) in Thailand  Methods: We conducted a national ecological interrupted time series analysis using weekly surveillance data from all 77 Thai provinces from 2016 to 2025. Segmented quasi-Poisson regression with Fourier terms for annual seasonality estimated the level and slope changes at a calendar-based 2020 break point; sensitivity analyses used later break points.  Results: The analysis included 40579 province-week observations including 790263 dengue, 32265 chikungunya, and 713822 HFMD cases. The estimated level incidence rate ratios at week 1 of the 2020 break point were 0.39 for dengue (95% confidence interval [CI] 0.32-0.48), 0.54 for chikungunya (95% CI 0.41-0.71), and 0.51 for HFMD (95% CI 0.38-0.69). Dengue rebounded above pre-pandemic levels by 2023, chikungunya declined after the 2018-2020 outbreak, and HFMD’s mean annual incidence in 2023–2025 exceeded the pre-pandemic baseline by approximately 26%.  Conclusions: These contrasting trajectories support the need for comparative multi-disease surveillance. Ecological designs cannot separate the contribution of transmission ecology from epidemic history or other time-varying factors.
SN  - 2772-7076
ER  -