Overview of the model evaluation process, illustrating the endemic channel, observed and predicted hospitalized dengue cases, outbreak weeks (when number of cases exceeds the endemic channel), the generated probability of the number of cases to exceed the endemic channel and, the alarm signals which indicate when the probability of an outbreak crosses the cut-off, warranting for a possibly disease outbreak in the forthcoming period (here is 12 weeks ahead of the prediction week).

Overview of the model evaluation process, illustrating the endemic channel, observed and predicted hospitalized dengue cases, outbreak weeks (when number of cases exceeds the endemic channel), the generated probability of the number of cases to exceed the endemic channel and, the alarm signals which indicate when the probability of an outbreak crosses the cut-off, warranting for a possibly disease outbreak in the forthcoming period (here is 12 weeks ahead of the prediction week).</p

Map of the 137 priority dengue localities (sentinel) where EWARS is implemented, Mexico 2023.

The shapefile of the political divisions of Mexico belongs to INEGI 2022 edition, with a scale of 1:4000000 available online and freely accessible. (https://www.inegi.org.mx/temas/mg/).</p

The process: From research to operational implementation.

<p>(1) Retrospective analysis of alarm indicators for dengue outbreaks. (2) Use of algorithms to generate prospective early warning system (EWS). (3) Prospective randomised controlled trial of early warning and response system (EWARS). (4) Associated EWARS publications (5) Scale up of EWARS. ^a Bowman et al.2016; ^b Cluster-randomized controlled trial for dengue early warning systems <i>(in-prep)</i>; ^c Runge-Ranzinger et al. 2016; ^d WHO-TDR. Early Warning and Response System (EWARS) for Dengue Outbreaks: Operational Guide <i>(in-press);</i> ^e WHO-TDR. Technical handbook. 2016.</p

Priority research areas in the EWARS and improved vector control programme.

<p>Priority research areas in the EWARS and improved vector control programme.</p

Evidence generation to inform policy decisions and further research requirements.

<p>IR, Implementation Research; OR, Operational Research.</p