# Spatial–temporal evolution patterns of influenza incidence in plateau regions from 2009 to 2023

## TL;DR

This study analyzed how influenza spread changed over time and space in Qinghai Province from 2009 to 2023, showing patterns of outbreaks and shifts in high-risk areas.

## Contribution

The study introduces a detailed spatiotemporal analysis of influenza incidence in plateau regions using GIS methods to identify evolving patterns and hotspots.

## Key findings

- Influenza incidence showed significant fluctuations, with notable spikes in 2019 and 2023.
- High influenza incidence was clustered in eastern Qinghai, while low incidence was observed in the west.
- The gravity center of influenza spread shifted southeastward from 2018 to 2023.

## Abstract

This study used (Geographic Information System) GIS technology to analyze the spatiotemporal distribution of influenza incidence in Qinghai from 2009 to 2023, based on influenza surveillance data.

This study first accessed the influenza data sets of Qinghai Province from 2009 to 2023 through the Chinese Infectious Disease Surveillance System. Subsequently, trend charts of influenza incidence in each city and prefecture were employed to illustrate the trends of influenza incidence during the period from 2009 to 2023. To explore the risks of influenza incidence in different counties and districts, methods including spatial autocorrelation, cluster analysis, hotspot analysis, Gravity center shift model, and standard deviation ellipse were utilized.

The study showed that the incidence of influenza showed significant fluctuations, with marked spikes in 2019 and 2023. Spatial autocorrelation analysis revealed significant positive autocorrelation in 2015, 2017–2019, and 2022–2023 (Moran’s I > 0 and p < 0.05). Local spatial autocorrelation analysis identified clustering patterns in different regions, with high - high clustering in eastern Qinghai and low - low clustering in the west. Hot - spot analysis indicated that the counties with a high incidence of influenza in Qinghai were mainly located in the lower - altitude east. Standard deviation ellipse analysis showed that in 2021, the spread of influenza was the most extensive, almost covering eastern and parts of western Qinghai. From 2021 to 2022, the spread range shrank and expanded again in 2023. The gravity center of influenza moved southeastward year by year from Gangcha County in 2018 to Gonghe County in 2023. The spread of influenza was found to be expanding eastward, with the epidemic center shifted over time.

The prominent spatiotemporal heterogeneity of influenza incidence in Qinghai Province indicates the need to develop differentiated and precise influenza prevention and control strategies in different regions to address the changing trends of influenza epidemics.