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Integrated biological–behavioural surveillance in pandemic-threat warning systems

机译：大流行威胁预警系统中的生物行为综合监测

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Economically and politically disruptive disease outbreaks are a hallmark of the 21st century. Although pandemics are driven by human behaviours, current surveillance systems for identifying pandemic threats are largely reliant on the monitoring of disease outcomes in clinical settings. Standardized integrated biological–behavioural surveillance could, and should, be used in community settings to complement such clinical monitoring. The usefulness of such an approach has already been demonstrated in studies on human immunodeficiency virus, where integrated surveillance contributed to a biologically based and quantifiable understanding of the behavioural risk factors associated with the transmission dynamics of the virus. When designed according to Strengthening the Reporting of Observational Studies in Epidemiology criteria, integrated surveillance requires that both behavioural risk factors – i.e. exposure variables – and disease-indicator outcome variables be measured in behavioural surveys. In the field of pandemic threats, biological outcome data could address the weaknesses of self-reported data collected in behavioural surveys. Data from serosurveys of viruses with pandemic potential, collected under non-outbreak conditions, indicate that serosurveillance could be used to predict future outbreaks. When conducted together, behavioural surveys and serosurveys could warn of future pandemics, potentially before the disease appears in clinical settings. Traditional disease-outcome surveillance must be frequent and ongoing to remain useful but behavioural surveillance remains informative even if conducted much less often, since behaviour change occurs slowly over time. Only through knowledge of specific behavioural risk factors can interventions and policies that can prevent the next pandemic be developed.
机译：经济和政治上具有破坏性的疾病暴发是21世纪的标志。尽管大流行是由人类行为驱动的，但当前用于识别大流行威胁的监视系统在很大程度上取决于对临床环境中疾病结果的监视。可以并且应该在社区环境中使用标准化的生物行为综合监测，以补充这种临床监测。这种方法的有效性已经在人类免疫缺陷病毒的研究中得到了证明，在该研究中，综合监测有助于对与病毒传播动态有关的行为危险因素进行生物学上的量化了解。当根据“加强流行病学的观察研究报告标准”进行设计时，综合监测要求在行为调查中同时测量行为危险因素（即暴露变量）和疾病指标结果变量。在大流行威胁领域，生物学结果数据可以解决在行为调查中收集的自我报告数据的弱点。在非暴发条件下收集的具有大流行潜力的病毒血清调查数据表明，血清监测可用于预测未来暴发。当一起进行时，行为调查和血清调查可能会在未来流行病发生之前就对这种流行病发出警告。传统的疾病结果监测必须经常且持续进行，以保持有用，但是即使行为监测的频率降低，行为监测仍可提供有用的信息，因为随着时间的推移行为变化缓慢。只有通过了解特定的行为风险因素，才能制定出可以预防下一次大流行的干预措施和政策。

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