BACKGROUND Early warning systems (EWSs) are of increasing importance in the context of outbreak-prone diseases such as chikungunya, dengue, malaria, yellow fever, and Zika. A scoping review has been undertaken for all 5 diseases to summarize existing evidence of EWS tools in terms of their structural and statistical designs, feasibility of integration and implementation into national surveillance programs, and the users' perspective of their applications. METHODS Data were extracted from Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Latin American and Caribbean Health Sciences Literature (LILACS), PubMed, Web of Science, and WHO Library Database (WHOLIS) databases until August 2019. Included were studies reporting on (a) experiences with existing EWS, including implemented tools; and (b) the development or implementation of EWS in a particular setting. No restrictions were applied regarding year of publication, language or geographical area. FINDINGS Through the first screening, 11,710 documents for dengue, 2,757 for Zika, 2,706 for chikungunya, 24,611 for malaria, and 4,963 for yellow fever were identified. After applying the selection criteria, a total of 37 studies were included in this review. Key findings were the following: (1) a large number of studies showed the quality performance of their prediction models but except for dengue outbreaks, only few presented statistical prediction validity of EWS; (2) while entomological, epidemiological, and social media alarm indicators are potentially useful for outbreak warning, almost all studies focus primarily or exclusively on meteorological indicators, which tends to limit the prediction capacity; (3) no assessment of the integration of the EWS into a routine surveillance system could be found, and only few studies addressed the users' perspective of the tool; (4) almost all EWS tools require highly skilled users with advanced statistics; and (5) spatial prediction remains a limitation with no tool currently able to map high transmission areas at small spatial level. CONCLUSIONS In view of the escalating infectious diseases as global threats, gaps and challenges are significantly present within the EWS applications. While some advanced EWS showed high prediction abilities, the scarcity of tool assessments in terms of integration into existing national surveillance systems as well as of the feasibility of transforming model outputs into local vector control or action plans tends to limit in most cases the support of countries in controlling disease outbreaks.

中文翻译：

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基孔肯雅热、登革热、疟疾、黄热病和寨卡疫情的早期预警系统 (EWS)：证据是什么？范围审查。


背景技术早期预警系统（EWS）在基孔肯雅热、登革热、疟疾、黄热病和寨卡等易爆发疾病的背景下变得越来越重要。对所有 5 种疾病进行了范围界定审查，以总结 EWS 工具的结构和统计设计、纳入国家监测计划的可行性和用户对其应用的看法等方面的现有证据。方法 数据提取自 Cochrane 系统评价数据库 (CDSR)、Google Scholar、拉丁美洲和加勒比健康科学文献 (LILACS)、PubMed、Web of Science 和 WHO 图书馆数据库 (WHOLIS) 数据库，截至 2019 年 8 月。其中包括研究报告(a) 现有 EWS 的经验，包括已实施的工具； (b) 在特定环境中开发或实施 EWS。出版年份、语言或地理区域没有任何限制。结果 通过第一次筛选，确定了 11,710 份登革热文件、2,757 份寨卡文件、2,706 份基孔肯雅热文件、24,611 份疟疾文件和 4,963 份黄热病文件。应用选择标准后，共有 37 项研究纳入本次综述。 主要发现如下：（1）大量研究显示了其预测模型的质量性能，但除了登革热疫情外，只有少数研究提出了 EWS 的统计预测有效性； (2) 虽然昆虫学、流行病学和社交媒体警报指标对于疫情预警可能有用，但几乎所有研究都主要或专门关注气象指标，这往往会限制预测能力； (3) 没有找到对将 EWS 纳入常规监测系统的评估，并且只有很少的研究涉及用户对该工具的看法； (4) 几乎所有 EWS 工具都需要具有高级统计能力的高技能用户； (5) 空间预测仍然是一个限制，目前没有工具能够在小空间水平上绘制高透射区域的地图。结论 鉴于传染病不断升级成为全球威胁，EWS 应用中存在显着的差距和挑战。虽然一些先进的环境预警系统显示出较高的预测能力，但在融入现有国家监测系统方面缺乏工具评估，以及将模型输出转化为当地病媒控制或行动计划的可行性，在大多数情况下往往限制了各国的支持在控制疾病爆发方面。