Peer-reviewed article

Incidence of acute diarrhoea among children (0-59 months old) in Thailand after introduction of rotavirus vaccine: a retrospective national database analysis (2014-2024).

Thanate Sailuenarm, Wanatpreeya Phongsamart, Wichan Bhunyakitikorn, Pawinee Doungngern, Keswadee Lapphra et al. · 3 Jun 2026

Summary

Written by AI, not yet AICS's view · claude-haiku-4-5-20251001

This study examined the impact of rotavirus vaccination introduced into Thailand's national immunisation programme in February 2020 on diarrhoea rates in children under five. Using national health surveillance data from public facilities covering about 90% of the country, researchers compared diarrhoea incidence and hospitalisation rates before (2014-2019) and after (2021-2024) vaccine introduction. The results show that both all-cause and rotavirus-specific diarrhoea incidence fell by about 50%, with hospitalisation rates dropping by even more. The vaccine did not increase intussusception (a type of bowel obstruction), and seasonal patterns of diarrhoea became less severe.

Key points

All-cause diarrhoea incidence declined by 50.0% after rotavirus vaccine introduction (IRR 0.50; 95% CI 0.39-0.63)
Rotavirus-associated diarrhoea incidence declined by 52.0% (IRR 0.48; 95% CI 0.39-0.59)
Hospitalisation for all-cause diarrhoea decreased by 58.2% and for rotavirus-associated diarrhoea by 49.0% at 1-4 years post-vaccination
Intussusception rates remained stable post-vaccination (IRR 1.03; 95% CI 0.82-1.29), showing no increase in this adverse event
Seasonal peaks of diarrhoea between December and February became less pronounced following vaccine introduction

Limitations

The analysis used aggregated national surveillance data without individual-level demographic characteristics, which limits ability to examine differential impacts by socioeconomic status or other population subgroups. The study excludes 2020 data, potentially missing transition effects during vaccine introduction.

Abstract

BACKGROUND: Rotavirus vaccination has reduced incidence of childhood diarrhoea, but evidence from low- and middle-income countries remains limited. We evaluated diarrhoea incidence and hospitalisation rates among children aged 0-59 months after introduction of rotavirus vaccination in Thailand's national immunisation programme (February 2020-December 2024). METHODS: We analysed aggregated national surveillance data (ICD-10-TM: A00-A09, K56.1) from Thailand's Health Data Centre (covering ≈90% of public health facilities), including inpatient, outpatient, and death records. Diarrhoea incidence and hospitalisation rates were assessed using Poisson regression to estimate incidence rate ratios (IRRs) among children 0-59 months of age with acute diarrhoea and among 0-11 months with intussusception. Vaccine impact was assessed by comparing pre-vaccination (2014-2019) and post-vaccination (2021-2024) periods, excluding the year 2020. Analyses were age-stratified as proxies for differential vaccine exposure across birth cohorts under the immunisation program. FINDINGS: Individual-level demographic characteristics were not available. All-cause and rotavirus-associated diarrhoea incidence declined by 50.0% (IRR 0.50; 95% CI 0.39-0.63) and 52.0% (IRR 0.48; 95%CI 0.39-0.59), respectively, following rotavirus vaccine introduction. Hospitalisation for all-cause and rotavirus-associated diarrhoea decreased by 58.2% (IRR 0.42; 95% CI 0.30-0.58) and 49.0% (IRR 0.51; 95%CI 0.30-0.88), respectively, at 1-4 years post-vaccination. All-cause acute diarrhoea mortality did not differ significantly during pre- and post-vaccination periods (IRR 0.94; 95% CI 0.50-1.77); rotavirus-specific mortalities were too few to analyse. Following vaccine introduction, seasonal peaks between December and February became less pronounced. Intussusception rates remained stable during the post-vaccination period (IRR 1.03; 95% CI 0.82-1.29). INTERPRETATION: This study demonstrated a significant decline in incidence and hospitalisation of all-cause and rotavirus-associated diarrhoea among children (0-59 months). Sustaining high coverage is essential to maximise public health benefits from vaccination. FUNDING: None.

Findings the Hub has extracted

Each claim below is labelled by its type of design and links back to this report.

Survival

Problem

High incidence and hospitalisation rates of rotavirus-associated and all-cause acute diarrhoea among children aged 0-59 months in Thailand

Intervention: Introduction of rotavirus vaccine into Thailand's national immunisation programme
Population: Children aged 0-59 months in Thailand, assessed through national health surveillance data covering approximately 90% of public health facilities

Key finding

All-cause diarrhoea incidence declined by 50.0% (IRR 0.50; 95% CI 0.39-0.63)

Experimental