Abstract

Research assessing trends in online search activity related to mpox in China is scarce. We aimed to provide evidence for an overview of online information searching during an infectious disease outbreak by analyzing trends in online search activity related to mpox at geographical and economic levels in China and explore influencing factors. We used the Baidu index to present online search activity related to mpox from May 19 to September 19, 2022. Segmented interrupted time-series analysis was used to estimate trends in online search activity. Factors influencing these trends were analyzed using a general linear regression (GLM) model. We calculated the concentration index to measure economic-related inequality in online search activity and related trends. Online search activity was highest on the day the first imported case of mpox appeared in Chongqing compared to 3 other cutoff time points. After the day of the first imported mpox case in Taiwan, the declaration of a public health emergency of international concern, the first imported mpox case in Hong Kong, and the first imported mpox case in Chongqing, national online search activity increased by 0.642%, 1.035%, 1.199%, and 2.023%, respectively. The eastern regions had higher increases than the central and western regions. Across 31 provinces, municipalities, and autonomous regions, the top 3 areas with higher increases were Beijing, Shanghai, and Tianjin at 3 time points, with the exception of the day of the first imported mpox case in Chongqing (Chongqing replaced Tianjin on that day). When AIDS incidence increased by 1 per 100,000 people, there was an increase after the day of the first imported mpox case in Chongqing of 36.22% (95% CI 3.29%-69.15%; P=.04) after controlling for other covariates. Online search activity (concentration index=0.18; P<.001) was more concentrated among populations with a higher economic status. Unlike the central area, the eastern (concentration index=0.234; P<.001) and western areas (concentration index=0.047; P=.04) had significant economic-related disparities (P for difference <.001) in online search activity. The overall concentration index of changes in online search activity became lower over time. Regions with a higher economic level showed more interest in mpox, especially Beijing and Shanghai. After the day of the first imported mpox case in Chongqing, changes in online search activity were affected by AIDS incidence rate. Economic-related disparities in changes in online search activity became lower over time. It would be desirable to construct a reliable information source in regions with a higher economic level and higher AIDS incidence rate and promote public knowledge in regions with a lower economic level in China, especially after important public events.

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