[Breaking the "iceberg phenomenon": advances in community-based surveillance for infectious diseases]

In the context of accelerated globalization and frequent emergence of new infectious diseases, the establishment of a sensitive and efficient surveillance system has become crucial in the early warning and precise prevention and control of infectious diseases. Traditional hospital-based passive surveillance systems are significantly influenced by factors such as healthcare-seeking behavior and reporting biases. In contrast, community-based surveillance (CBS), which expands the surveillance network to communities to effectively identify un-visited cases and mild infections, can be a vital approach to break the "iceberg phenomenon" and improve the infectious disease surveillance system. This paper systematically summarizes the global progress, application scenarios, and technical frameworks of CBS to provide a theoretical foundation to construct multi-dimensional infectious disease surveillance. It is suggested to conduct technological innovation, community empowerment, and the integration of multi-source data to improve the application of CBS in the early warning of diseases, disease burden estimation, and health policy development.