AUTHOR=Yun Zhi , Li Panpan , Wang Jinzhong , Lin Feng , Li Wenting , Weng Minhua , Zhang Yanru , Wu Huazhi , Li Hui , Cai Xiaofang , Li Xiaobo , Fu Xianxian , Wu Tao , Gao Yi 

TITLE=Spatial-temporal analysis of hepatitis E in Hainan Province, China (2013-2022): insights from four major hospitals

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1381204

DOI=10.3389/fpubh.2024.1381204

ISSN=2296-2565

ABSTRACT=We collected confirmed cases of hepatitis E among Hainan residents admitted to four major tertiary hospitals in Haikou from January 2013 to December 2022.Perform correlation analysis using SPSS software and draw scatter plots using origin software.  Use SAS 9.4 software to conduct descriptive analysis of time trends. The distribution was analyzed using ArcMap 10.8 software (spatial autocorrelation analysis, hotspot identification, concentration, and dispersion trend analysis). SAS software was used to build an autoregressive integrated moving average model (ARIMA) to predict the monthly number of cases in 2023 and 2024. Results: From 2013 to 2022, 1,922 patients with sporadic hepatitis E were treated in Haikou, Hainan Province. The highest proportion of patients (n = 555, 28.88%) were aged 50-59 years. The annual incidence of hepatitis E increased from 2013 to 2019, with a slight decrease in 2020 and 2021 and an increase in 2022. The highest number of cases was reported in Haikou, followed by Dongfang and Danzhou. We found a positive linear correlation between economy, population density, latitude, and number of cases. Global Moran's I, calculated through spatial autocorrelation analysis, showed that each year from 2013 to 2022 all had a Moran's I value > 0, indicating positive spatial autocorrelation (P < 0.01). Local Moran's I analysis revealed that from 2013 to 2022, local hotspots were mainly concentrated in the northern part of Hainan Province, with Haikou, Wenchang, Ding'an, and Chengmai being frequent hotspot regions, whereas Baoting, Qiongzhong, and Ledong were frequent cold-spot regions. Concentration and dispersion analysis indicated a clear directional pattern in the average density distribution, moving from northeast to southwest. Time-series forecast modeling showed that the forecast number of newly reported cases per month remained relatively stable in 2023 and 2024, fluctuating between 17 and 19. The overall incidence of hepatitis E in Hainan Province remains relatively stable. The incidence of hepatitis E in Hainan Province increased from 2013 to 2019, with a higher clustering of cases in the northeast region and a gradual spread toward the southwest over time. The ARIMA model predicted a relatively stable number of new cases each month in 2023 and 2024.