World Health Organization Event-Based Surveillance During the First 4 Months of the 2022 Ukraine Crisis

Following a nearly decade-long war in Eastern Ukraine, the conflict escalated in February 2022, and the World Health Organization swiftly began enhanced event-based surveillance (EBS) for the early detection of public health threats in Ukraine and refugee-hosting countries. The aim of this study was to assess the characteristics and trends of signals documented by WHO, especially examining how potential threats to human health in Ukraine and other affected countries were identified and presented during the first 4 months of the Ukraine crisis. The EBS process relied on the daily screening of information coming from different sources, and signals were categorized by public health risks. Between February 26 and June 30, 2022, a total of 208,484 articles were screened in the Epidemic Intelligence from Open Sources system and other sources, identifying 832 recorded signals. Most (94.1%) signals were reported within 2 days of publication of the relevant pieces of information. The most common categories of signals reported were "healthcare capacity" (n=283, 34.0%), followed by "technological hazards" (n=129, 15.5%), "population movement" (n=80, 9.6%), and "infectious diseases" (n=79, 9.5%). Among all signals, 85.5% were relevant to Ukraine. In Ukraine, the largest number of signals (20.4%) were reported from the city of Donetska. Although, resource intensiveness and appropriate balance for desired sensitivity and scope remains a challenge, EBS remains a vital surveillance method to rapidly identify potential health threats during public health events and humanitarian crises-when routine surveillance is weak or disrupted-and to contribute crucial data to guide health information management and planning.