Spatio-temporal clustering characteristics of hepatitis B in China: an 18-year study

To describe the spatiotemporal characteristics of hepatitis B in China and to identify its possible hotspots and potential high-risk areas. A retrospective, province-level ecological analysis of hepatitis B surveillance data. Global Moran's I and local Moran's I were calculated using GeoDa 1.16 to explore the spatial clustering characteristics from 2004 to 2021, and the results of the spatiotemporal scan analysis were obtained using SaTScan 10.1 to identify cluster areas from 2004 to 2018. From 2004 to 2021, the number of hepatitis B incident cases in China increased from 916,426 in 2004 to 976,233 in 2021 (AAPC = 0.38%, P = 0.613), which is not statistically significant. From 2018 to 2021, High-High cluster areas of hepatitis B incidence rates in China were concentrated in the southeast; from 2004 to 2019, High-Low cluster areas of hepatitis B mortality rates were concentrated in Beijing and Shanghai. During the 18-year study period, the crude mortality rate showed a statistically significant decline with an average annual decline of 4.03%. Hepatitis B high-risk areas were concentrated in northwestern and southeastern coastal regions of China, while death counts were clustered in the northwestern and eastern regions.