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Table 1.

Scrub typhus reporting criteria.

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Fig 1.

Trend in the annual number of reported scrub typhus cases (A) from 1980–2018 and annual incidence rate per 100,000 population (B) from 1985–2018.

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Fig 2.

Scrub typhus cases by month from 2003–2018.

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Fig 3.

Administrative regions of Thailand [National Statistical Office, Ministry of Information and Communication Technology; reprinted from mapchart.net under a CC BY license, with permission from Minas Giannekas original copyright 2019].

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Fig 4.

Seasonality of scrub typhus cases by month per region from 2003–2018.

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Fig 5.

Map of Thailand depicting: (A) the geography with elevation, provincial boundaries and location of Chiangrai province; (B) total scrub typhus cases from 2003–2018 per district; and (C) interpolation of scrub typhus cases at sub-district level by kriging using semi-variogram based on the centroids of geographical coordinates of each sub-district (for clarity, only provincial boundaries are shown) [created using tmap and tmaptools in R software–R Core Team 2018 [3840]].

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Fig 6.

Chiangrai province with: (A) the geography with elevation, main rivers and sub-district boundaries; (B) scrub typhus cases from 2003–2018 per sub-district; and (C) interpolation of scrub typhus cases at sub-district level by kriging using semi-variogram based on the centroids of geographical coordinates of each sub-district [created using tmap and tmaptools in R software–R Core Team 2018 [3840]].

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Fig 7.

Time series analysis of (A) reported monthly scrub typhus cases, (B) total monthly rainfall in mm and (C) average monthly temperature in°C for Chiangrai province.

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Table 2.

Results of the best global GLM with binomial negative link function (p<0.001), with theta = 2.12 (standard deviation = 0.026), explaining the number of scrub typhus cases in Chiangrai province from 2003–2018 by sub-district and by month with explanatory geographical and meteorological variables in the initial model.

Estimate and standard deviation (SD) were given for each selected explanatory variables, with P value and VIF (Variance Inflation Factor). For the best selected model the log likelihood = -8925.35 with degree of freedom (DF) = 12, null deviance = 3497.2, R2 estimated by maximum likelihood (R2ML) = 0.25, wr = 0.36 and Akaike Information Criteria (AIC) = 17875 (see S6 Fig).

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Fig 8.

Results of the best General Additive Modeling (GAM) explaining the number of scrub typhus cases in Chiangrai province over 2003–2018 by sub-district and by month, using a binomial negative link function (theta = 2.12).

The smoothed variables selected in the best GAM were (A) the geographical distribution of sub-district (longitude and latitude of the centroid), (B) total monthly rainfall (mm), (C) temperature (°C), (D) population size, (E) rain-fed land cover, (F) flooded land cover, (G) habitat complexity and (H) mosaic land cover.

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Table 3.

Results of general additive modelling (GAM) explaining the number of cases of scrub typhus per sub-district in Chiangrai province using a negative binomial link (theta = 2.12), with approximate significance of smooth terms.

For the best selected model, the deviance explained = 50.4%, R2 = 0.37, maximum likelihood = 8868.2, AIC = 17689.8 (see Fig 8).

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