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Spatiotemporal clustering, socioeconomic drivers and policy evaluation of mumps in Hunan Province, China, 2015-2024
Linlong Liang1, Xiaoyan Liu1, Fuqiang Liu2
1Department of Pediatrics, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
Objective:
To analyze the spatiotemporal clustering of mumps in Hunan Province from 2015 to 2024 and its influencing factors and to explore the policy effect of adjusting the immunization schedule.
Methods:
Spatial autocorrelation, spatiotemporal clustering, geographically and temporally weighted regression (GTWR), and interrupted time series (ITS) analyses were performed on county-level mumps surveillance data obtained from Hunan Province for 2015-2024 to identify mumps clustering, quantify socioeconomic drivers and assess the two-dose mumps-containing vaccine (MuCV) policy impact.
Results:
In total 157,502 cases were reported, and 89.7% of patients were aged 0-14 years. The global Moran's I increased from 0.20 to 0.67 (P < 0.01), indicating intensified clustering. Despite the decreasing provincial incidence, high-high hotspot geographic coverage expanded because of widening spatial disparities. The primary hotspot was in northeastern Hunan (Nov 2016-Dec 2019). GTWR revealed that per capita gross domestic product (GDP) and population mobility intensity had positive local effects in northeastern counties (adjusted R 2 = 0.45). ITS showed an immediate significant decline after the 2020 policy (β 2 = -2.50, P < 0.01).
Conclusions:
Persistent hotspots in northeastern Hunan may be driven by per capita GDP and intercounty mobility. The two-dose policy reduced overall incidence but exacerbated regional inequalities.
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