key: cord-1011693-jx2i7f3f authors: González-Alcaide, Gregorio; Llorente, Pedro; Ramos-Rincón, José-Manuel title: Systematic analysis of the scientific literature on population surveillance date: 2020-10-01 journal: Heliyon DOI: 10.1016/j.heliyon.2020.e05141 sha: aa02e9271f100d41ed54005c8ea26f9014b9744a doc_id: 1011693 cord_uid: jx2i7f3f INTRODUCTION: Population surveillance provides data on the health status of the population through continuous scrutiny of different indicators. Identifying risk factors is essential for the quickly detecting and controlling of epidemic outbreaks and reducing the incidence of cross-infections and non-communicable diseases. The objective of the present study is to analyze research on population surveillance, identifying the main topics of interest for investigators in the area. METHOD: ology. We included documents indexed in the Web of Science Core Collection in the period from 2000 to 2019 and assigned with the generic Medical Subject Heading (MeSH) “population surveillance” or its related terms (“public health surveillance,” “sentinel surveillance” or “biosurveillance”). A co-occurrence analysis was undertaken to identify the document clusters comprising the main research topics. Scientific production, collaboration, and citation patterns in each of the clusters were characterized bibliometrically. We also analyzed research on coronaviruses, relating the results obtained to the management of the COVID-19 pandemic. RESULTS: We included 39,184 documents, which reflected a steady growth in scientific output driven by papers on “Public, Environmental & Occupational Health” (21.62% of the documents) and “Infectious Diseases” (10.49%). Research activity was concentrated in North America (36.41%) and Europe (32.09%). The USA led research in the area (40.14% of documents). Ten topic clusters were identified, including “Disease Outbreaks,” which is closely related to two other clusters (“Genetics” and “Influenza”). Other clusters of note were “Cross Infections” as well as one that brought together general public health concepts and topics related to non-communicable diseases (cardiovascular and coronary diseases, mental diseases, diabetes, wound and injuries, stroke, and asthma). The rest of the clusters addressed “Neoplasms,” “HIV,” “Pregnancy,” “Substance Abuse/Obesity,” and “Tuberculosis.” Although research on coronavirus has focused on population surveillance only occasionally, some papers have analyzed and collated guidelines whose relevance to the dissemination and management of the COVID-19 pandemic has become obvious. Topics include tracing the spread of the virus, limiting mass gatherings that would facilitate its propagation, and the imposition of quarantines. There were important differences in the scientific production and citation of different clusters: the documents on mental illnesses, stroke, substance abuse/obesity, and cross-infections had much higher citations than the clusters on disease outbreaks, tuberculosis, and especially coronavirus, where these values are substantially lower. CONCLUSIONS: The role of population surveillance should be strengthened, promoting research and the development of public health surveillance systems in countries whose contribution to the area is limited. The last two decades of the 20 th century were marked by the spread of the It is increasingly evident that public health problems transcend national 104 borders, so they must be addressed in a coordinated and global way [8] . For 105 that to happen, it is necessary to strengthen public health surveillance systems 106 in countries of all income levels. This can help governments to tackle epidemic 107 outbreaks of infectious diseases that could potentially spread across the globe, 108 but moreover, it can also aid in the control of non-communicable diseases 109 (NCDs). These illnesses are traditionally known as diseases of affluence and 110 associated with high-income countries, but they also have a global impact and 111 an increasing effect on low-and middle-income countries [9] . Furthermore, a 112 global commitment and coordinated efforts are also necessary to address 113 neglected tropical diseases along with diseases related to malnutrition, 114 behavioral risk factors, and health inequalities-which all disproportionately 115 affect countries with less developed health and research systems [10, 11] . Diseases. Three years later, participants at the 21st World Health Assembly 132 endorsed the idea that surveillance was an essential function of public health 133 practice, defining it as "the epidemiological study of a disease as a dynamic 134 process involving the ecology of the infectious agent, the host, the reservoirs, 135 and the vectors, as well as the complex mechanisms concerned in the spread of 136 infection and the extent to which this spread occurs" [16, 17] . They also adopted 137 the concept of population surveillance, understood as "the systematic collection 138 and use of epidemiologic information for the planning, implementation, and 139 assessment of disease control" [18] . The epidemiological surveillance unit thus 140 assumed an active role in the processes to monitor disease transmission and 141 control. 142 One of the main debates at the time was whether surveillance organisms should 143 have any direct responsibility for disease control [15, 16, 19] . The fact that 144 surveillance was not a clearly differentiated field from epidemiology also 145 J o u r n a l P r e -p r o o f generated controversy. Thacker & Berkelman [17] recognized this problem of 146 terminology, proposing "public health surveillance" as a term to define "the 147 ongoing systematic collection, analysis, interpretation and dissemination of 148 health data ... [that] does not include administration of the prevention and 149 control programs, but does include an intended link with those programs." 150 Thacker et al. [20] highlighted the relevance of the latter aspect, which could 151 facilitate the rapid implementation of measures to prevent and control 152 epidemics. This link represented a step forward with regard to population 153 surveillance, implying that the information collected should serve for decision-154 making on public health action. The WHO adopted this term, which was 155 already increasingly in circulation, emphasizing the methodological approaches 156 that characterized surveillance activities. Unlike other types of data collection, 157 surveillance was concerned with practicability, uniformity, and rapidity over condition that could affect the health status of a specific population or 175 geographical area [23] , while biosurveillance has to do with the relevance of 176 monitoring specific information sources that could be relevant to detect 177 epidemic outbreaks derived from accidents, bioterrorism, or based on the 178 deliberate release of virus, bacteria, toxins, or other harmful agents [24] . It is 179 also important to note the One Health approach, whose purpose is to promote a 180 "worldwide strategy for expanding interdisciplinary collaborations and 181 communications in all aspects of health care for humans, animals and the 182 environment" [25] , "with the goal of achieving optimal health outcomes 183 recognizing the interconnection between people, animals, plants, and their 184 shared environment" [26] . The methodological process was as follows: descriptor also included all of the more specific terms included in the thesaurus: 248 "public health surveillance," "sentinel surveillance" (which includes as 249 synonyms "syndromic surveillance," "biosurveillance system," and "sentinel 250 health event"), and "biosurveillance." Table 1 Monitoring the rate of occurrence of specific conditions to assess the stability or change in health levels of a population. It is also the study of disease rates in a specific cohort such as in a geographic area or population subgroup to estimate trends in a larger population. (From Last, Dictionary of Epidemiology, 2d ed). To identify the main research topics in the field of population surveillance, a co-300 word analysis was performed to determine the frequency and co-occurrence of 301 MeSH terms assigned to the documents. To do this, we generated a matrix that 302 quantified the joint appearance of the 11,271 MeSH terms assigned to the 303 documents. This matrix, in turn, was used to generate a co-occurrence network 304 showing the relationships between the high-frequency MeSH terms (> 100 databases; thus for these years, data were incomplete at the time of the bibliographic 369 search. The major thematic categories reflected in the scientific output for the area were With regard to the distribution of the scientific output among the top- The size of the nodes is proportional to the number of documents assigning the 521 descriptor, and the thickness of the ties reflects the intensity of the co-occurrence. 522 With regard to the types of studies performed, retrospective designs were the 560 most frequent (n=3850, 9.82%), followed by cross-sectional studies (n=3610, 561 9.21%), surveys and questionnaires (n=3555, 9.07%), follow-up studies (n=2785, 562 7.1%), cohort studies (n=2611, 6.66%) and prospective studies (n=2602, 6.64%). Annex 2 presents the complete list of MeSH terms related to these descriptors 564 (> 99 documents). Finally, we observed a predominance of the descriptor "humans" (n=36,821, 823 We observed a high level of international collaboration in the coronavirus 824 cluster (35.25% of the documents), whose outbreaks prior to COVID-19 were 825 mainly limited to Asia and the Middle East, and in the tuberculosis cluster 826 (36.87%), whose incidence is concentrated in Asian and African countries. This aspect is essential not only for responding to disease outbreaks that may 834 originate in these countries but also because these so-called diseases of 835 "affluence" are actually undeclared pandemics whose presence is increasing in persons. Writing about SARS, Greaves [101] deemed that the most appropriate 873 surveillance would take the form of a clinician-based notification system, which 874 would be swifter than laboratory-based systems. Indeed, the initial delay at the We undertook a bibliometric analysis of research generated on different 901 diseases and public health aspects from the population surveillance perspective. For that reason, we did not consider publications that focused on other facets, 903 like basic research or treatment approaches to the diseases described. Public health surveillance of AIDS and HIV infections Opportunities for enhanced strategic use of surveys, medical records, and 942 program data for HIV surveillance of key populations: Scoping Assessing the severity of the novel influenza A/H1N1 pandemic Council of Europe launches investigation into H1N1 pandemic Calibrated response to emerging infections The past, present, and future of public health surveillance CDC confirms person-to-person 954 spread of new coronavirus in the United States The World Health Organization and the 958 transition from "international" to "global" public health Rethinking the "diseases of affluence" paradigm: global patterns of nutritional 962 risks in relation to economic development Neglected tropical diseases: progress 965 towards addressing the chronic pandemic Quantifying changes 968 in global health inequality: The Gini and Slope Inequality Indices A population health 972 surveillance theory Public health surveillance: historical origins, methods 975 and evaluation Public health surveillance and infectious disease detection The surveillance of communicable diseases of national 979 importance National and international surveillance of communicable diseases. 982 WHO Chron Public health surveillance in the United States World Health Organization Evolution of the concept of surveillance in the United States The science of public health 991 surveillance A dictionary of epidemiology World Health Organization. Public Health Surveillance Switzerland: WHO; 2020 Sentinel health events (occupational): a basis for physician recognition and 999 public health surveillance Landscape of international event-based biosurveillance. Emerg Health Threats 1003 One Health Initiative. One Health Initiative will unite human and 1005 veterinary medicine Public health research literature 1012 on infectious diseases: coverage and gaps in Europe Knowledge mapping for 1015 bioterrorism-related literature Infectious disease informatics and 1017 biosurveillance Biosurveillance: a review and update Winter Olympic Biosurveillance System Comprehensive exploration of urban health by 1024 bibliometric analysis: 35 years and 11,299 articles A bibliometric analysis of U.S.-based 1027 research on the behavioral risk factor surveillance system Comparison of the h-Index scores among pathogens identified as emerging 1031 hazards in North America Use of bibliometric analysis to assess the scientific productivity and impact 1035 of the global emerging infections surveillance and response system program Global research on syndromic 1038 surveillance from 1993 to 2017: bibliometric analysis and visualization Forty-two years of responding to Ebola virus outbreaks in Sub-1042 Saharan Africa: A review Global research trends of World Health Organization's top 1045 eight emerging pathogens Bibliometric analysis of severe acute 1048 respiratory syndrome-related research in the beginning stage Coronavirus mapping in scientific 1051 publications: When science advances rapidly and collectively, is access to this 1052 knowledge open to society? 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