Correlating hemorrhagic fever with renal syndrome incidence and research publications in China: insights from epidemiological and bibliometric analysis.

Abstract

Background: Hemorrhagic Fever with Renal Syndrome (HFRS) is a zoonotic disease caused by hantaviruses, remains a significant public health challenge in China. Despite a decline in national incidence, persistent regional outbreaks highlight a need to understand how scientific research corresponds to these evolving epidemiological patterns to better inform public health strategies.

Objective: We aimed to identify the spatiotemporal correlations between HFRS incidence and research publication output in China, identifying trends and disparities to inform future research priorities.

Methods: We conducted a bibliometric and spatial analysis of 3,304 Chinese articles from the China National Knowledge Infrastructure (CNKI) and 556 English articles from Web of Science (WOS) from 1981 to 2023. Provincial HFRS incidence data were correlated with publication output using Spearman's correlation and the Geographical Detector model across distinct analytical phases.

Results: HFRS incidence declined nationally but remained concentrated in specific regions. Domestic publications (CNKI) peaked during Phase 2 (1992-2006; 120-226/year), while international publications (WOS) surged in Phase 3 (2007-2023). A strong and consistent spatial correlation was found between HFRS incidence and CNKI publication output (q > 0.49). In contrast, the correlation with WOS publications only became significance in Phase 3 (q = 0.271). Thematic analyses revealed differing research priorities: CNKI publications emphasized clinical and epidemiological research, while WOS focused more on epidemiological and mechanistic research. Collaboration networks became increasingly international in Phase 3, with Beijing and Shaanxi emerging as central hubs.

Conclusion: This study reveals a strong spatial correspondence between research output and disease incidence in high-incidence province. However, it also underscores significant research gaps in some highly affected yet under-resourced regions. The diverging thematic focus and collaboration patterns between domestic and international publications reflect the evolution of China's research ecosystem. Integrating bibliometric with epidemiological analysis provides a robust, evidence-based framework to help guide equitable resource allocation and foster collaborations that address the persistent challenges of HFRS.