Mapping paediatric acute gastroenteritis in Talavera, Nueva Ecija, Philippines: a cross-sectional study on prevalence and community risk factors

菲律宾新怡诗夏省塔拉韦拉市儿童急性肠胃炎患病率及社区危险因素横断面研究

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Abstract

AIM: To map the prevalence of paediatric acute gastroenteritis (AGE) in Talavera, Nueva Ecija, Philippines and to examine how community-level risk factors shape its spatial distribution. METHODS: We conducted a single-centre cross-sectional study with spatial analysis at Talavera General Hospital in 2023. Children aged 0-17 years diagnosed with AGE were included. Barangay-level prevalence was mapped, and spatial autocorrelation was assessed using Moran's I and Local Indicators of Spatial Association. Ordinary least squares (OLS) and geographically weighted regression (GWR) were used to evaluate associations between community risk factors and AGE prevalence. RESULTS: A total of 398 paediatric AGE cases were included, mainly among male children under 5 years of age. Paediatric AGE prevalence ranged from 1.74 to 22.34 cases per 1000 children, with clear geographic variability. Significant spatial clustering was observed (Moran's I=0.268, p=0.001), with high-risk clusters in southwestern barangays and low-risk clusters in the north. GWR outperformed OLS and revealed localised associations: household income below the poverty line (25 barangays) and population density (13 barangays) showed positive effects, while distance to the hospital showed a negative association across the municipality (t-values: -2.11 to -3.35). CONCLUSION: This study demonstrates significant spatial heterogeneity in the paediatric AGE burden in Talavera, with distinct high-risk clusters and spatially varying associations. The findings support geographically targeted interventions addressing local poverty and population density as well as strengthening access to healthcare in remote areas to improve case detection and reduce under-reporting.

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