Systematic review on evaluation tools applicable to One Health surveillance systems: A call for adapted methodology

Developing and implementing effective surveillance programs for infectious diseases (ID) and antimicrobial resistance (AMR) requires the integration of information across relevant disciplines and sectors. Yet, establishing and sustaining collaboration at each step of the surveillance process, and modalities to translate integrated surveillance results into actions, are not well understood. This systematic review was designed to map and explore peer-reviewed tools that were either designed or used for evaluation of integrated surveillance systems for ID or AMR, and to identify the limitations of these tools and remaining methodological or knowledge gaps. A systematic search was conducted using keywords related to: "Evaluation", "Surveillance" and "One Health" in four databases (Medline, Embase, Web of Science and CAB abstract) up to the 28th of October 2022. Articles were selected if they presented an evaluation tool for integrated surveillance systems for ID or AMR (methodological study) or an application of such a tool (case study). All selected articles went through a quality check using the MetaQAT tool. Of 25 articles retrieved, 13 presented a methodological study, while 12 described a case study. Three main types of evaluation were identified through 17 tools: theoretical, process and impact evaluations. Both methodological and case study papers predominantly considered organizational and operational aspects in their evaluation. Although costs and/or impacts were discussed in some case studies, only one article reported an economic impact analysis. Evaluation of One Health integration and multisectoral collaboration was included in four methodological and four case study articles. One major challenge identified in this systematic review is the lack of clear guidance and standardized criteria for the comprehensive evaluation of complex integrated surveillance systems. To overcome this, it is essential to develop, validate, and apply methodologies adapted to these evaluation needs.