Burden of diarrhoeal diseases among hospitalised patients in Thailand: a retrospective national database analysis (2014–2022)

Background: Acute diarrhoea remains one of the leading causes of morbidity and mortality worldwide. Most existing research has focused on children younger than 5 years of age, while data from Thailand are limited. In this study we characterised trend of diarrhoeal admissions, associated Disability-adjusted life years (DALYs) and determined predictors of mortality and high-cost admissions in Thailand. Methods: We analysed Thailand's National Health Security Office inpatient claims database for 2014-2022. We estimated admission rates (ASRs), costs of admission ($PPP), and DALYs for pre-pandemic (2014-2019) and pandemic (2020-2022) periods. Predictors of mortality and high-cost admission were assessed using logistic regression. Rotavirus vaccine impact was evaluated among children younger than 5 years of age. Findings: infection was associated with mortality or high-cost admission. Each 1% increase in rotavirus vaccine coverage was associated with 2·0% reduced rotavirus admissions. Interpretation: . Improved water, sanitation, rotavirus vaccination, and hospital preparedness are essential to tackle the diarrhoeal disease burden. Funding: This research was funded by Wellcome (grant number 315982/Z/24/1). For the purposes of open access, the authors have applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.