Artificial Intelligence Models for Forecasting Mosquito-Borne Viral Diseases in Human Populations: A Global Systematic Review and Comparative Performance Analysis

Flavia Pennisi, Antonio Pinto, Fabio Borgonovo, Giovanni Scaglione, Riccardo Ligresti, Omar Enzo Santangelo, Sandro Provenzano, Andrea Gori, Vincenzo Baldo, Carlo Signorelli, Vincenza Gianfredi

Background: Mosquito-borne viral diseases are a growing global health threat, and artificial intelligence (AI) and machine learning (ML) are increasingly proposed as forecasting tools to support early-warning and response. However, the available evidence is fragmented across pathogens, settings and modelling approaches. This review provides, to the best of our knowledge, the first comprehensive comparative assessment of AI/ML models forecasting mosquito-borne viral diseases in human populations, jointly synthesising predictive performance across model families and appraising both methodological quality and operational readiness. Methods: Following PRISMA 2020, we searched PubMed, Embase and Scopus up to August 2025. We included studies applying AI/ML or statistical models to predict arboviral incidence, outbreaks or temporal trends and reporting at least one quantitative performance metric. Given the substantial heterogeneity in outcomes, predictors and time–space scales, we conducted a descriptive synthesis. Risk of bias and applicability were evaluated using PROBAST. Results: Ninety-eight studies met the inclusion criteria, of which 91 focused on dengue. The forecasts spanned national to city-level settings and annual-to-weekly resolutions. Across classification tasks, tree-ensemble models showed the most consistent performance, with accuracies typically above 0.85, while classical ML and deep-learning models showed wider variability. For regression tasks, errors increased with temporal horizon and spatial aggregation: short-term, fine-scale forecasts (e.g., weekly city level) often achieved low absolute errors, whereas long-horizon national models frequently exhibited very large errors and unstable performance. PROBAST assessment indicated that most studies (63/98) were at high risk of bias, with only 24 judged at low risk and limited external validation. Conclusions: AI/ML models, especially tree-ensemble approaches, show strong potential for short-term, fine-scale forecasting, but their reliability drops substantially at broader spatial and temporal scales. Most remain research-stage, with limited external validation and minimal operational deployment. This review clarifies current capabilities and highlights three priorities for real-world use: standardised reporting, rigorous external validation, and context-specific calibration.