ARTICLE
31 August 2026

Multi-Factor-Driven Inter-City Forecasting of Viral and Bacterial Epidemics: A Comparative Modeling Study

Yunhui Xiang1 Guokang Sun2 Lvbo Tian1 Jiangtao Hu1 Jianfeng Li3* Qin Zhang1 Junxian Wang1 Pinpin Xiang4 Ping Chen1 Chunbao Xie5*
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1 Department of Laboratory Medicine and Port Epidemic Disease Monitoring Key Laboratory of Sichuan Province, Sichuan International Travel Hea lthcare Cen ter (Por t Clinic of Chengdu Customs), Che ngdu 610 042, Sich uan, China
2 Department of Laboratory Medicine, West China School of Public Health and West China Fourth Hospital of Sichuan University, Chengdu 610041, Sichuan, China
3 Faculty of Resources and Environment, Chengdu University of Information Technology, Chengdu 610225, Sichuan, China
4 Department of Laboratory Medicine, Xiping Community Healthcare Center of Longquanyi District, Chengdu 610107, Sichuan, China
5 Department of Laboratory Medicine and Genetic Diseases Key Laboratory of Sichuan Province, Sichuan Provincial People’s Hospital & University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
JCNR 2026 , 10(8), 310–324; https://doi.org/10.26689/JCNR.v10i8.15439
© 2026 by the Author. Licensee: Bio-Byword Scientific Publishing Pty Ltd, Australia. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Objective: To compare the performance of prediction models incorporating multidimensional urban environmental factors in cross-city forecasting of viral and bacterial infectious diseases, and to explore how these multidimensional factors jointly shape epidemic dynamics, thereby providing a reference for optimizing urban epidemic forecasting strategies. Methods: Three representative cities in China were selected to characterize the correlation networks between multi-factor urban characteristics, including climate, air pollutants, economic activities, and control measures, and the incidence of viral infections (represented by hand, foot, and mouth disease and influenza) as well as bacterial infections (represented by pertussis and scarlatina). Using the seasonal auto-regressive integrated moving average (SARIMA) model as a benchmark, we systematically compared a long short-term memory (LSTM) model driven by these multidimensional factors with a SARIMAX model incorporating the same covariates. Through multi-disease forecasting experiments, the models were comprehensively evaluated across multiple dimensions, including predictive accuracy, robustness, and peak event forecasting capability. Results: The associations between multiple urban factors and infectious diseases exhibited marked spatial heterogeneity, and close statistical correlations were observed between climate variables and air pollutants, suggesting potential interactions among environmental covariates. Overall, both the multi-factor-driven LSTM and SARIMAX models significantly outperformed the traditional SARIMA model, with each demonstrating distinct advantages in predictive accuracy and peak event forecasting. For viral infections characterized by high incidence and rapid spread, the LSTM model showed the best performance, achieving the highest correlation between predicted and observed values, the smallest error metrics, and greater consistency across cross-validation folds. For bacterial infections with relatively lower incidence, the SARIMAX model performed better. Conclusions: Multidimensional urban factors may exert synergistic effects on infectious disease transmission. Multi-factor-driven forecasting strategies considerably outperformed traditional time-series models, and the respective strengths of specific models were closely associated with the epidemiological characteristics of the diseases. These findings may offer practical insights into methodological selection for constructing multi-category epidemic forecasting models adapted to heterogeneous urban environments.

Keywords
Infectious disease
Prediction model
Long short-term memory network
SARIMA
Funding
General Administration of Customs of the People’s Republic of China Science and Technology Program (Project No.: 2024HK161)
Chengdu Science and Technology Program (Project No.: 2025-YF08-00230-SN)
Science and Technology Research and Development Program of China Railway Chengdu Group Co., Ltd (Project No.: CX25014)
Sichuan Science and Technology Program (Project No.: 2024JDRC0032)
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