JMIR Publications

ABSTRACT

Background:

Mass gatherings such as religious, sporting, musical, sociocultural, and other occasions that draw large crowds pose public health challenges and concerns related to global health. A leading global concern regarding mass gatherings is the possible importation and exportation of infectious diseases as they spread from the attendees to the general population, resulting in epidemic outbreaks. Governments and health authorities use technological interventions to support public health surveillance to prevent and control infectious diseases.

Objective:

This study aimed to review evidence on the effectiveness of public health digital surveillance systems for infectious disease prevention and control at mass gathering events.

Methods:

A systematic literature search on the topic was conducted using the Ovid MEDLINE, Embase, CINHAL, and Scopus databases to examine relevant articles published in English from Dec 2021 to Jan 2022. Interventional studies describing or evaluating the effectiveness of public health digital surveillance systems for infectious disease prevention and control at mass gatherings were included in the analysis. Due to the lack of appraisal tools for interventional studies describing and evaluating public health digital surveillance systems at mass gatherings, a critical appraisal tool was developed and used to assess the quality of the included studies.

Results:

Eight articles were included in the review and three types of mass gatherings were identified: religious (the Hajj and Prayagraj Kumbh), sporting (the Olympic and Paralympic Games, the Federation Internationale Football Association World Cup, and the Micronesian Games), and cultural (the Festival of Pacific Arts) events. Seven studies described surveillance systems implemented at mass gathering events and one study described and evaluated an enhanced surveillance system that was implemented for an event. Four studies reported the implementation of a surveillance system: 2 studies described the enhancement of the system that was implemented for an event; 1 reported a pilot implementation of a surveillance system; and 1 reported an evaluation of an enhanced system. The types of systems investigated were 2 syndromic, 1 participatory, 1 syndromic and event-based, 1 indicator-based and event-based, and 1 event-based surveillance system. Five studies reported timeliness as an outcome generated after implementing or enhancing the system without measuring its effectiveness. Only one study followed the Centres for Disease Control guidelines for evaluating public health surveillance systems and outcomes of enhanced systems based on the systems' attributes, in order to measure their effectiveness.

Conclusions:

Based on the review of the research literature and the analysis of the included studies, this study found no evidence of the effectiveness of public health digital surveillance systems for infectious disease prevention and control at mass gatherings.