Spatiotemporal clustering, socioeconomic drivers and policy evaluation of mumps in Hunan Province, China, 2015–2024

Abstract

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 R2 = 0.45). ITS showed an immediate significant decline after the 2020 policy (β2 = −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.