Evaluations of Climate-Informed Early Warning Systems for Foodborne, Waterborne, and Vector-Borne Diseases: A Scoping Review

Maya M. Rao , Katherine R. O’Brien, Afrin Iqbal, Sarah E. Dumas, Timothy H. Holtz

Climate change is altering infectious disease risk over time and across geographies. These changing risks can negatively impact human health and pose challenges to health systems. Anticipating outbreaks before they happen and implementing adaptive measures can help reduce the burden of climate-sensitive infectious diseases. Climate-informed early warning systems (CIEWS) are integrated systems of climate and infectious disease risk monitoring, forecasting, and prediction that inform communication and preparedness efforts for timely action to reduce disease risk in advance of hazardous events. CIEWS can provide critical information for public health systems to adapt to the changing risk of infectious diseases. While extensive research has advanced predictive models for potential use in CIEWS, evidence of the effectiveness of these tools once operationalized has not been well described. In this scoping review, we examine the evidence base evaluating operational CIEWS targeting foodborne, waterborne, and vector-borne diseases. We conducted a search in Global Index Medicus, Scopus, and PubMed. Of the 9,917 unique articles screened, 21 met eligibility criteria. Included articles described 17 unique CIEWS and spanned five WHO regions (the Americas, Western Pacific, Africa, South-East Asia, and Eastern Mediterranean). All but one article presented a CIEWS for a vector-borne disease, with dengue most prominently represented. Most evaluations of CIEWS focused on statistical performance of the model, with only two evaluations of CIEWS effectiveness, and four evaluations of the system’s operational features. There are significant evidence gaps and a need for more research to demonstrate the effectiveness and cost-effectiveness of operational CIEWS, particularly for foodborne and waterborne diseases. Evaluations of CIEWS are critical for ensuring systems are useful, usable, and effectively informing anticipatory action for climate-sensitive infectious diseases.