Comparison of geological clusters between influenza and COVID-19 in Thailand with unsupervised clustering analysis

PLoS One. 2024 Jan 22;19(1):e0296888. doi: 10.1371/journal.pone.0296888. eCollection 2024.

Abstract

The coronavirus disease (COVID-19) pandemic has considerably impacted public health, including the transmission patterns of other respiratory pathogens, such as the 2009 pandemic influenza (H1N1). COVID-19 and influenza are both respiratory infections that started with a lack of vaccination-based immunity in the population. However, vaccinations have been administered over time, resulting in a transition of the status of both diseases from a pandemic to an endemic. In this study, unsupervised clustering techniques were used to identify clusters of disease trends in Thailand. The analysis incorporated three distinct surveillance datasets: the pandemic influenza outbreak, influenza in the endemic stage, and the early stages of COVID-19. The analysis demonstrated a significant difference in the distribution of provinces between Cluster -1, representing those with unique transmission patterns, and the other clusters, indicating provinces with similar transmission patterns among their members. Specifically, for Pandemic Influenza, the ratio was 61:16, while for Pandemic COVID-19, it was 65:12. In contrast, Endemic Influenza exhibited a ratio of 46:31, with a notable emergence of more clustered provinces in the southern, western, and central regions. Furthermore, a pair of provinces with highly similar spreading patterns were identified during the pandemic stages of both influenza and COVID-19. Although the similarity decreased slightly for endemic influenza, they still belonged to the same cluster. Our objective was to identify the transmission patterns of influenza and COVID-19, with the aim of providing quantitative and spatial information to aid public health management in preparing for future pandemics or transitioning into an endemic phase.

MeSH terms

  • COVID-19* / epidemiology
  • Cluster Analysis
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human* / epidemiology
  • Thailand / epidemiology

Grants and funding

This research was financially supported by the Ministry of Science and ICT, Republic of Korea in the form of a grant (K-23-L04-C06-S01) received by IA and TM. This research was also financially supported by the Government-wide R&D Fund project for infectious disease research (GFID), Republic of Korea in the form of a grant (HG23C1624) received by IA and TM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.