JMIR Publications

ABSTRACT

Background:

Research assessing the trend in online search activity of monkeypox in China is scarce.

Objective:

We aimed to analyze the trend and differences in online search activity of monkeypox at geographical and economic level in China.

Methods:

We obtained data on the online search activity of monkeypox from Baidu index. Segmented interrupted time-series analysis was used to estimate the changes of online search activity after first imported case reported in China, as well as the announcement of the Public Health Emergency of International Concern (PHEIC), after adjusting for daily cumulative new cases. The influencing factors were analyzed using a general linear regression (GLM) model. We calculated concentration index to measure economic-related inequality on online search activity.

Results:

Online search activity was highest on the day of first imported monkeypox in Chongqing than other three cut-off points. After the first imported case in Taiwan (provinces of China), PHEIC, first imported monkeypox in Hongkong, China, and first imported monkeypox in Chongqing, the national online search activity increased by 0.642%, 1.035%, 1.199% and 2.023%. The eastern regions always had higher changes than central and western regions. Across 31 provinces, the top three provinces with higher changes were Beijing, Shanghai and Tianjin, until first imported monkeypox case was reported in Chongqing, then Chongqing replaced Tianjin provinces. When AIDs incidence rate increased by 1 per 100, 000 people, the changes after the first imported monkeypox in Chongqing increased by 36.22% (95% CI: 3.29%, 69.15%; P=0.0448) after controlled other covariates. Online search activity (concentration index=0.177; P<0.0001) were more concentrated among population with higher economic status. Except central area, eastern (concentration index=0.234; P<0.0001) and western areas (concentration index=0.047; P=0.038) had the significant similar economic-related disparities (P for difference<0.0001) on online search activity. The overall concentration index became lower over time on changes in online search activity.

Conclusions:

Regions with higher economic level had more interest behavior in monkeypox, especially in Beijing and Shanghai. After first imported monkeypox in Chongqing, changes in online search activity were affected by AIDs incidence rate, and economic-related disparities became lower over time. It is desirable to construct a reliable information source in regions with higher economic level and higher AIDs incidence rate, and promote public knowledge in regions with lower economic level in China, especially after important public opinion events.