Spatiotemporal epidemiology of hepatitis B in Central China: urbanization drivers and implications for adult-targeted control strategies.

Authors

Yanquan Mo, Shanhui Li, Ziqian Zhao, Huiqun Jia, Jingya Zhao, Feng Liu, Caixia Dang, Liyang Guo, Yuanyong Xu, Yeqing Tong, Hui Chen

Published in

BMC public health. Jul 15, 2026. Epub Jul 15, 2026.

Abstract

Hepatitis B virus (HBV) infection remains a significant global public health challenge. Hubei Province, a historically high-prevalence area in central China, continues to face persistently high rates of adult HBsAg carriers despite effective reduction of childhood transmission through universal vaccination, hindering progress toward HBV elimination goals. This study aims to identify key drivers behind the rising hepatitis B incidence in the region, forecast future trends, and inform targeted control strategies.
This population-based spatiotemporal epidemiological study analyzed hepatitis B surveillance data from Hubei Province between January 2015 and December 2024, covering 631,361 reported cases across 17 prefecture-level divisions. Spatial clustering was assessed using Global Moran's I statistics. Urbanization-related spatial drivers were identified via geographically weighted random forest modeling with SHAP value interpretation, and future incidence trends were predicted using Holt-Winters time series forecasting.
The average annual incidence was 106.19 per 100,000 population, showing a U-shaped temporal trend: declining from 111.75 per 100,000 in 2015 to 83.58 in 2020, then rising to 125.86 in 2024. Adults aged 30-50 years consistently accounted for 40-50% of total cases. Significant spatial clustering was detected (Global Moran's I: 0.124-0.307, P < 0.05), with persistent high-risk zones concentrated in the Wuhan metropolitan area. The geographically weighted random forest model identified urbanization rate as the primary spatial driver (SHAP value ≈2.0), followed by higher education enrollment rate (≈1.0) and passenger traffic volume (≈0.8). Time series forecasting projected monthly incidence rates of 8.98-10.41 per 100,000 over the subsequent 18 months (R² = 0.892, MAPE = 1.74%).
In Hubei Province, the hepatitis B burden has concentrated in adults born before the vaccine era, underscoring horizontal transmission risks in this susceptible cohort. Urbanization significantly impacts the spatial distribution of hepatitis B, with high-risk areas mainly concentrated in the Wuhan metropolitan region. It is crucial to address urbanization-related factors affecting HBV transmission and to implement targeted screening and revaccination for adults aged 30-50, particularly among high-risk individuals, mobile populations, and rural residents, to reduce incidence and alleviate the regional disease burden.

PMID:
42458322
Bibliographic data and abstract were imported from PubMed on 16 Jul 2026.

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