Infectious Disease Surveillance System Research Articles

Mobile-based and open-source infectious disease surveillance and outbreak management in Tanzania

Abstract Introduction The PANDORA-ID-NET consortium aims to build capacity for effective outbreak response in sub-Saharan Africa. Part of this mission is to develop a real-time data sharing platform for disease outbreaks that leverages centralised data management and uses mobile technologies for data gathering and feedback. We have committed to using open-source technologies, so that the platform can be deployed on regional IT infrastructure and further developed by local staff, and collected data can be stored and processed in the region of origin. This abstract aims to describe how we identified a state of the art open-source system that fulfils these criteria, and the process of how we are extending it to function within the current infectious disease control framework in Tanzania, under our partnership with the Ifakara Health Institute (IHI). Methods To find state of the art open-source systems matching our criteria, we performed a rapid review of the literature. We screened 1022 articles and found 15 candidate systems, out of which only SORMAS satisfied the criteria. SORMAS was developed jointly by the Helmholtz Centre for Infection Research (HZI) and the Nigeria CDC, and was modeled on Nigeria's successful response to the Ebola outbreak. The system can be used for case management, contact tracing, surveillance, and laboratory sample management. Data is collected and synchronised using Android mobile devices (both online and offline) and data aggregation and analysis are performed in real-time via a web application Results Having chosen SORMAS, we established a collaboration between the SORMAS developer team and the PANDORA team. IHI are guiding ongoing work on adapting SORMAS to the Tanzanian health facility geography and the country's case definition guidelines for notifiable diseases. Conclusions Once adapted for Tanzania, SORMAS will fill an unoccupied niche in infectious disease control, improving the quality of collected case data and enabling better outbreak response Key messages A state of the art, mobile-based, open-source outbreak management and infectious disease surveillance system (SORMAS) is being deployed in Tanzania. We outline our experience with piloting SORMAS in Tanzania, building on the experience of our Nigerian and German partners, who rolled out this system nationally in Nigeria and other African countries.

Effect of Coronavirus Pandemic (Covid 19) on Nigerian Economy: A study of Tummy-Tummy Noodles Producing Firm in Kaduna, Nigeria

In Africa, the rate at which the incidence of co-vid 19 pandemic is escalating is alarming. Despite efforts made to reduce it through quarantines, lockdown, social/physical distancing and other measures by the Government, yet it is still on the rise especially in Nigeria. The research design adopted for this study is the descriptive design; while structured questionnaire was administered to raise data meant for empirical analysis. Findings from the study showed that Co-vid 19 has a positive and significant effect on Nigerian economy. In addition, Lockdown measure has a significant influence on economic activities of the firms in Nigeria. However, social / physical distancing was discovered to have an insignificant effect on the growth of the firms in Nigeria. Based on these findings, the study recommends that building situational awareness will require sustained investment in infectious disease surveillance, crisis management, and risk communications systems. Investments in these capacities are likely to surge after pandemic or epidemic events and then abate as other priorities emerge. If further recommends that Governments should avoid sweeping and overly broad restrictions on movement and personal liberty, and only move towards mandatory restrictions when scientifically warranted and necessary and when mechanisms for support of those affected can be ensured. This would enhance fast reduction of the spread, restores economies and businesses as well as the standard of living in the country.

Establishment of multi-point trigger and multi-channel surveillance mechanism for intelligent early warning of infectious diseases in China

This paper reviews the limitations of current infectious disease surveillance and early warning system in China, analyzes the concepts and countermeasures of the establishment of an intelligent early warning platform of infectious diseases based on multi-point trigger mechanism and multi-channel surveillance mechanism and proposes the realization routes for the purpose of facilitating capacity building and improvement of surveillance and early warning of infectious diseases in China.

First Prototype of the Infectious Diseases Seeker (IDS) Software for Prompt Identification of Infectious Diseases

The rapid detection of ongoing outbreak — and the identification of causative pathogen — is pivotal for the early recognition of public health threats. The emergence and re-emergence of infectious diseases are linked to several determinants, both human factors — such as population density, travel, and trade — and ecological factors — like climate change and agricultural practices. Several technologies are available for the rapid molecular identification of pathogens [e.g. real-time polymerase chain reaction (PCR)], and together with on line monitoring tools of infectious disease activity and behaviour, they contribute to the surveillance system for infectious diseases. Web-based surveillance tools, infectious diseases modelling and epidemic intelligence methods represent crucial components for timely outbreak detection and rapid risk assessment. The study aims to integrate the current prevention and control system with a prediction tool for infectious diseases, based on regression analysis, to support decision makers, health care workers, and first responders to quickly and properly recognise an outbreak. This study has the intention to develop an infectious disease regressive prediction tool working with an off-line database built with specific epidemiological parameters of a set of infectious diseases of high consequences. The tool has been developed as a first prototype of a software solution called Infectious Diseases Seeker (IDS) and it had been established in two main steps, the database building stage and the software implementation stage (MATLAB® environment). The IDS has been tested with the epidemiological data of three outbreaks occurred recently: severe acute respiratory syndrome epidemic in China (2002–2003), plague outbreak in Madagascar (2017) and the Ebola virus disease outbreak in the Democratic Republic of Congo (2018). The outcomes are promising and they reveal that the software has been able to recognize and characterize these outbreaks. The future perspective about this software regards the developing of that tool as a useful and user-friendly predictive tool appropriate for first responders, health care workers, and public health decision makers to help them in predicting, assessing and contrasting outbreaks.

Infectious disease surveillance system descriptors: proposal for a comprehensive set.

To tailor a surveillance system to its objectives and to evaluate its fitness for purpose, an accurate description of its structural elements is essential. Existing recommendations for setting up a system seldom offer a comprehensive list of all surveillance elements to be considered. Moreover, there is sometimes confusion in the way terms describing these elements are interpreted. The objective of this paper is to propose a comprehensive set of surveillance system descriptors that can delineate the important elements and clarify the meaning of the terms used. We identified 20 descriptors that we classified in five categories: (i) surveillance scheme; (ii) population and cases; (iii) supplementary data; (iv) information flow; and (v) period of time. We tried to make the definitions of these descriptors as clear and simple as possible to avoid confusion or misinterpretation of the terms used. The relative importance of each element may vary depending on the objectives of the surveillance scheme. Surveillance descriptors should be reviewed periodically to document changes and to assess if the system continues to be fit for purpose. Together with the minimum requirements for variables and the planned outputs for disseminating the data, the surveillance descriptors can be used to define surveillance standards.

A Study on Healthcare Policy Response to Risks of Future Infectious Diseases: Focused on Infectious Disease Surveillance Systems

The purpose of this study is to make suggestions for the infectious disease surveillance systems as part of the government’s healthcare policy intended to minimize damage by implementing an appropriate and swift crisis management in the event of future infectious disease outbreaks. To that end, this descriptive study analyzes the infectious disease outbreaks and the management and control thereof in Korea and other countries, so as to suggest some approaches to infectious disease surveillance systems applicable to affected regions. The analysis results shed light on the causes of the spread of future infectious diseases over the past years, and the management systems that could possibly deal with the trial and error in the response policy. It seems crucial to roll out appropriate information, training and promotion programs as part of the national disaster response systems to prevent infectious diseases in relation to the roles of multiple relevant government agencies in the event of disasters especially amid the COVID-19 pandemic.

Evaluating 5.5 Years of Equinella: A Veterinary-Based Voluntary Infectious Disease Surveillance System of Equines in Switzerland.

Equine health is important in regard to trade, economy, society, and the veterinary, as well as public health. To reduce the burden of equine infectious diseases internationally, it is important to collect, review, and distribute equine health surveillance data as accurate and timely as possible. Within this study, we aimed at providing a comprehensive descriptive analysis of data submitted to Equinella, a voluntary veterinary-based surveillance system of non-notifiable equine infectious diseases and clinical signs, in Switzerland. This was achieved by reviewing the reports submitted since its relaunch in November 2013 and until April 2019, as well as assessing the data validity, activeness of participating veterinarians, coverage of the equine population, geographical representativeness, and timeliness of the system. In total, 630 reports have been submitted. Data validity ranged between 88.2 and 100%. The coverage of Equinella was assessed to be 50.8% of the Swiss equine population. Over the 5.5 years, of all 102 registered veterinarians, 67 (65.7%) submitted at least one report. On average, these veterinarians submitted 1.7 reports per year (median = 4 reports). More recently, in 2018, approximately only one-third [29 (28.4%)] of all registered veterinarians submitted at least one report. However, 59 (57.8%) have responded to the monthly reminder emails to confirm that they have not observed any relevant clinical case to be reported at least once (median number of confirmation per veterinarian = 9 of 12 reminder emails). The incidence of reports varied between cantons (member states of the Swiss confederation). The median timeliness of report submission was found to be 7 days. Overall, Equinella has been receiving reports since its initiation and contributed continuously to the surveillance of infectious diseases in the Swiss equine population and provided an output for the international equine community. Challenges encountered in achieving a higher number of submitted reports and increasing the coverage of the equine population, as well as the overall activeness of veterinarians, require further work. With our study, we provide a comprehensive overview of a veterinary-based voluntary surveillance system for equine health, assessed challenges of such, and suggest concrete improvements with transdisciplinary approaches for similar veterinary-based surveillance systems.

Increase of emm1 isolates among group A Streptococcus strains causing scarlet fever in Shanghai, China

ObjectiveScarlet fever epidemics caused by group A Streptococcus (GAS) have been ongoing in China since 2011. However, limited data are available on the dynamic molecular characterizations of the epidemic strains. MethodEpidemiological data of scarlet fever in Shanghai were obtained from the National Notifiable Infectious Disease Surveillance System. Throat swabs of patients with scarlet fever and asymptomatic school-age children were cultured. Illumina sequencing was performed on 39emm1 isolates. ResultsThe annual incidence of scarlet fever was 7.5–19.4/100,000 persons in Shanghai during 2011–2015, with an average GAS carriage rate being 7.6% in school-age children. The proportion ofemm1 GAS strains increased from 3.8% in 2011 to 48.6% in 2014; they harbored a superantigen profile similar to emm12 isolates, except for the speA gene. Two predominant clones, SH001-emm12, and SH002-emm1, circulated in 66.9% of scarlet fever cases and 44.8% of carriers. Genomic analysis showed emm1 isolates throughout China constituted distinct clades, enriched by the presence of mobile genetic elements carrying the multidrug-resistant determinants ermB and tetM and virulence genes speA, speC, and spd1. ConclusionA significant increase in the proportion ofemm1 strains occurred in the GAS population, causing scarlet fever in China. Ongoing surveillance is warranted to monitor the dynamic changes of GAS clones.

Epidemiological Characteristics and Spatiotemporal Trend Analysis of Human Brucellosis in China, 1950-2018.

The rate of brucellosis, a zoonotic disease, has rapidly increased in humans brucellosis(HB) in recent years. In 1950–2018, a total of 684,380 HB cases (median 2274/year (interquartile range (IQR) 966–8325)) were reported to the National Infectious Disease Surveillance System in mainland China. The incidence of HB peaked in 2014 (4.32/100,000), and then showed a downward trend; we predict that it will maintain a steady downward trend in 2019–2020. Since 2015, the incidence of HB has shown opposite trends in the north and south of China; rates in the north have fallen and rates in the south have increased. In 2004–2018, the most significant increases in incidence of HB were in Yunnan (IQR 0.002–0.463/100,000), Hubei (IQR 0.000–0.338/100,000), and Guangdong (IQR 0.015–0.350/100,000). The areas where HB occurs have little overlap with areas with high per capita GDP in China. The “high–high” clusters of HB are located in northeastern China (Inner Mongolia, Heilongjiang, Jilin, Liaoning, Ningxia, Shanxi, and Gansu), and the “low–low” clusters of HB are located in southern China (Yunnan, Jiangxi, Shanghai, Guangxi, Guangdong, Zhejiang, Guizhou, and Hunan). In recent years, the incidence of HB in China has been controlled to some extent, but the incidence of HB has increased in southern China, and the disease has spread geographically in China from north to south. Further research is needed to address this change and to continue to explore the relationship between the incidence of HB and relevant factors.

Acute effects of air pollution on the incidence of hand, foot, and mouth disease in Wuhan, China

Previous studies have shown that exposure to ambient air pollution is associated with hand, foot, and mouth disease (HFMD), but the results are limited. Our study aimed to investigate the effects of several major air pollutants on HFMD in the warm and cold seasons in central China. A Poisson Generalized additive model (GAM) was used to assess the association between short-term exposure to ambient air pollution and the incidence of HFMD at Wuhan, China during 20152016. Daily cases of HFMD were extracted from the infectious disease surveillance systems of Hubei provincial center for disease control and prevention (Hubei CDC). Data on air pollution, including sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3), particulate matter (PM) with an aerodynamic diameter less than or equal to 10 μm (PM10), and PM with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) were obtained from 10 national air quality monitoring stations in Wuhan. We found that the association between air pollution and HFMD was most pronounced at lag days 10 and 11. The results of the single-pollutant model show that the associations of SO2, NO2, O3, PM10, and PM2.5 with HFMD were all statistically significant. The results of the multi-pollutant model showed that NO2, O3, PM10, and PM2.5 are reduced after excluding the confounding of co-pollutants. The seasonal analysis showed that the effect of air pollution in the cold season was higher than in the warm season. Our research provides more evidence related to air pollution and HFMD, and helps policy makers to develop regulations for the prevention and control of the disease.

An outbreak of acute gastroenteritis caused by Sapovirus in a community of Guangdong province

Objective: To investigate the epidemiological characteristics and clinic symptoms of an outbreak of infectious diarrhea caused by Sapovirus, in CT community, Zhaoqing, Guangdong province. Methods: Retrospective study of field epidemiology investigation was carried out and Chi-square test was used enteroviruses were detected by RT-PCR in swab, fecal specimens and water samples. Results: A total of 422 cases were identified in this outbreak, with the prevalence as 11.95%. Cases mainly concentrated between 21 and 24, December, with curves noticed by point- source and peaked on the 22(nd). Symptoms mainly appeared as vomiting, with watery stool. Patients were founded in every village, with the highest prevalence appeared in the elderly (25.20%) but involved in every age group. Sapovirus infection was most frequently seen in the population under 25 years of age, with overall prevalence as 16.41%. People older than 50 years of age took the second place (12.05%), and the lowest was seen between 25 to 49 years age group (8.42%). Sapovirus was detected in both swab and fecal specimens, with the positive rate as 38.78%. Both general and heat- resistant coliformed-bacteria were detected in the 24 monitored water samples, with the qualification rates as 95.83%, 45.83% and 50.00%, respectively. However, Sapovirus was not detected in any of the water samples. Conclusions: Our findings confirmed that an outbreak, caused by sapovirus infection in CT community was most likely related to the central water supply. The surveillance system for infectious diarrheal diseases should be improved and both public health awareness and surveillance programs on drinking water should be strengthened.

PADI-web: A multilingual event-based surveillance system for monitoring animal infectious diseases

Global animal disease outbreak detection and monitoring rely on official sources, such as intergovernmental organisations, as well as digital media and other unofficial outlets. Manually extracting relevant information from unofficial sources is time-consuming. The Platform for Automated extraction of animal Disease Information from the web (PADI-web) is an automated biosurveillance system devoted to online news source monitoring for the detection of emerging/new animal infectious diseases by the French Epidemic Intelligence System. The tool automatically collects news via customised multilingual queries, classifies them and extracts epidemiological information. We detail each step of the PADI-web pipeline, with a focus on the new user-oriented features.

Real-time surveillance of infectious diseases and other health conditions during the arbaeenia mass gathering, Kerbala, Iraq, 2016: a teaching case-study

The Arbaeenia mass gathering (MG) is considered the largest religious MG in Iraq and occurs annually in the city of Kerbala with participation of several million visitors from different countries and most Iraqi provinces. This MG places attendants at a significant risk for contracting communicable diseases, sustaining injuries, and facing complications of health problems related to chronic diseases due to overcrowding and intensive physical activity. The goal of this case study to build the capacity of trainees on how to improve the surveillance systems for infectious diseases and other health conditions during MGs. This case study is based on the implementation of a real time surveillance system for illness and health problems affecting people attending the Arbaeenia MG in 2016 which enabled the surveillance team in Iraq to rapidly detect and respond to disease outbreaks. This case study teaches students how MGs offer an opportunity to improve existing surveillance systems or establish new ones. The case study is designed for training Novice field epidemiology trainees. The case study can be administered in 3-4 hours. Used as adjunct training material, the case study provides the trainees with competencies to use real time technology for surveillance data collection, analysis and timely response during the event.

Effectiveness of the Integrated TB Surveillance System — China, 2018–2019

What is already known about this topic? China’s national health information system provides important support and means for deepening the country’s medical and health reform, for improving relevant delivery services, for enhancing the level of scientific management of health, and for promoting the goal of basic medical and health services for everyone in China. What is added by this report? To further the construction of the national health information system, the National Center for Tuberculosis Control and Prevention of China CDC, started a pilot project for a new tuberculosis (TB) integrated health (iHealth) surveillance system, which was integrated with regional health information platforms. The goal was to explore automatic data exchange between hospitals and disease control facilities to reduce the workload of data-entry. What are the implications for public health practice? This pilot proved that data sharing and automatic exchanges between different information systems can be achieved through a unified surveillance dataset, which could provide a reference point for the construction of surveillance systems for other infectious diseases or for the entire public health information system.

EPIDEMIOLOGIA DO ESGOTO COMO ESTRATÉGIA PARA MONITORAMENTO COMUNITÁRIO, MAPEAMENTO DE FOCOS EMERGENTES E ELABORAÇÃO DE SISTEMAS DE ALERTA RÁPIDO PARA COVID-19

The ability to monitor the spread of diseases is essential for prevention, intervention and control practices. In this context, wastewater-based epidemiology (WBE) has been applied to empirically evaluate the exposure of populations to chemical substances and pathogens of emerging concern in near real time. During the current COVID-19 pandemic, WBE remains an innovative epidemiological tool, with the potential to complement infectious disease surveillance systems. Recent studies on WBE and COVID-19 are based on the monitoring of viral RNA fragments as target biomarkers for SARS-CoV-2 via RT-qPCR and allied techniques. Literature results have been shown the potential of WBE as an innovative tool to monitor viral spread in large communities, map contagion curves and hotspots, identify the contribution of asymptomatic individuals, and subsidize early warning systems for disease outbreaks. WBE can offer less expensive responses for monitoring large populations compared to individual clinical tests which are not feasible on large scales. This aspect is important in terms of health surveillance and associated public policies, notably where clinical tests are scarce or underestimated and in less developed regions with inadequate sanitation conditions.

Hydroclimatic drivers of highly seasonal leptospirosis incidence suggest prominent soil reservoir of pathogenic Leptospira spp. in rural western China.

Climate exerts complex influences on leptospirosis transmission, affecting human behavior, zoonotic host population dynamics, and survival of the pathogen in the environment. Here, we describe the spatiotemporal distribution of leptospirosis incidence reported to China’s National Infectious Disease Surveillance System from 2004–2014 in an endemic region in western China, and employ distributed lag models at annual and sub-annual scales to analyze its association with hydroclimatic risk factors and explore evidence for the potential role of a soil reservoir in the transmission of Leptospira spp. More than 97% of the 2,934 reported leptospirosis cases occurred during the harvest season between August and October, and most commonly affected farmers (83%). Using a distributed lag Poisson regression framework, we characterized incidence rate ratios (IRRs) associated with interquartile range increases in precipitation of 3.45 (95% confidence interval 2.57–4.64) over 0-1-year lags, and 1.90 (1.18–3.06) over 0-15-week lags. Adjusting for soil moisture decreased IRRs for precipitation at both timescales (yearly adjusted IRR: 1.05, 0.74–1.49; weekly adjusted IRR: 1.36, 0.72–2.57), suggesting precipitation effects may be mediated through soil moisture. Increased soil moisture was positively associated with leptospirosis at both timescales, suggesting that the survival of pathogenic Leptospira spp. in moist soils may be a critical control on harvest-associated leptospirosis transmission in the study region. These results support the hypothesis that soils may serve as an environmental reservoir and may play a significant yet underrecognized role in leptospirosis transmission.

A Feasibility Study on Infectious Disease Surveillance System for Barangay Health Centers of Makati City

Purpose – An Infectious Disease Surveillance System will allow for the easier transition of the latest medical reports from all public medical facilities in the City and detect any epidemic or outbreak, based number of reports per disease and its corresponding geolocation, as well as existing predictive or seasonal models and historical data from the local health department. Method – The researchers utilized the descriptive developmental approach, where a feasibility study was conducted first before creating a prototype and used surveys, questionnaires, and interviews to gather data. In system development, the waterfall model was used, developed the different module or units individually, tested it then integrated the modules into singular system and finally tested it again. Results – The developed Infectious Disease Surveillance System was evaluated by randomly-selected personnel from the IT and non-IT group in terms of functional suitability, compatibility, usability, reliability, and security of the ISO 25010 software quality model and obtained an overall evaluation of Very Acceptable with an overall composite mean rating of 4.33. Conclusion –The developed system is feasible according to the results of the product, organizational, financial, technical, and market feasibility analysis. Most respondents believed that the system was interesting and expressed various degrees of desire to procure the system for their professional needs. The developed system has a moderate to high potential attractiveness to the industry given its timeliness and relevance. However, factors that may affect marketability include the reduction of budget allotment for healthcare by the national government and minimal number of potential customers (public and private health institutions). Recommendations – Based on the conclusions derived from the conduct of this study, the following suggestions are recommended, maximize the rollout of the Makatizen Cards to include children to ensure every citizen can be detected in the system database; utilize the location data of confirmed cases of an infectious disease to track the spread of the disease from one person to another which will be useful in identifying the patient zero of a new previously undiscovered infection and; the developed system can be integrated with the existing disaster and risk management system of Makati City.

Utility of emergency call centre, dispatch and ambulance data for syndromic surveillance of infectious diseases: a scoping review.

BackgroundSyndromic surveillance can supplement conventional health surveillance by analyzing less-specific, near-real-time data for an indication of disease occurrence. Emergency medical call centre dispatch and ambulance data are examples of routinely and efficiently collected syndromic data that might assist in infectious disease surveillance. Scientific literature on the subject is scarce and an overview of results is lacking.MethodsA scoping review including (i) review of the peer-reviewed literature, (ii) review of grey literature and (iii) interviews with key informants.ResultsForty-four records were selected: 20 peer reviewed and 24 grey publications describing 44 studies and systems. Most publications focused on detecting respiratory illnesses or on outbreak detection at mass gatherings. Most used retrospective data; some described outcomes of temporary systems; only two described continuously active dispatch- and ambulance-based syndromic surveillance. Key informants interviewed valued dispatch- and ambulance-based syndromic surveillance as a potentially useful addition to infectious disease surveillance. Perceived benefits were its potential timeliness, standardization of data and clinical value of the data.ConclusionsVarious dispatch- and ambulance-based syndromic surveillance systems for infectious diseases have been reported, although only roughly half are documented in peer-reviewed literature and most concerned retrospective research instead of continuously active surveillance systems. Dispatch- and ambulance-based syndromic data were mostly assessed in relation to respiratory illnesses; reported use for other infectious disease syndromes is limited. They are perceived by experts in the field of emergency surveillance to achieve time gains in detection of infectious disease outbreaks and to provide a useful addition to traditional surveillance efforts.

Practice and thinking for the breakthrough of infectious disease surveillance system in Shanghai

The recent developed diarrhea and acute respiratory infections surveillance systems were a breakthrough of the infectious disease surveillance and monitoring in Shanghai. This series "Infectious Disease Surveillance in Shanghai" briefly introduced current experiences of the updated surveillance systems, in order to provide evidences for promotion in other disease surveillance and to enhance the connection between different surveillance systems.

Evaluation of the trends in the incidence of infectious diseases using the syndromic surveillance system, early warning and response unit, Mongolia, from 2009 to 2017: a retrospective descriptive multi-year analytical study

BackgroundIn recent times, emerging and re-emerging infectious diseases are posing a public health threat in developing countries, and vigilant surveillance is necessary to prepare against these threats. Analyses of multi-year comprehensive infectious disease syndrome data are required in Mongolia, but have not been conducted till date. This study aimed to describe the trends in the incidence of infectious disease syndromes in Mongolia during 2009–2017 using a nationwide syndrome surveillance system for infectious diseases established in 2009.MethodsWe analyzed time trends using monthly data on the incidence of infectious disease syndromes such as acute fever with rash (AFR), acute fever with vesicular rash (AFVR), acute jaundice (AJ), acute watery diarrhea (AWD), acute bloody diarrhea (ABD), foodborne disease (FD) and nosocomial infection (NI) reported from January 1, 2009 to December 31, 2017. Time series forecasting models based on the data up to 2017 estimated the future trends in the incidence of syndromes up to December 2020.ResultsDuring the study, the overall prevalence of infectious disease syndromes was 71.8/10,000 population nationwide. The average number of reported infectious disease syndromes was 14,519 (5229-55,132) per year. The major types were AFR (38.7%), AFVR (31.7%), AJ (13.9%), ABD (10.2%), and AWD (1.8%), accounting for 96.4% of all reported syndromes. The most prevalent syndromes were AJ between 2009 and 2012 (59.5–48.7%), AFVR between 2013 and 2014 (54.5–59%), AFR between 2015 and 2016 (67.6–65.9%), and AFVR in 2017 (62.2%). There were increases in the prevalence of AFR, with the monthly number of cases being 37.7 ± 6.1 during 2015–2016; this could be related to the measles outbreak in Mongolia during that period. The AFVR incidence rate showed winter’s multiplicative seasonal fluctuations with a peak of 10.6 ± 2 cases per 10,000 population in 2017. AJ outbreaks were identified in 2010, 2011, and 2012, and these could be associated with hepatitis A outbreaks. Prospective time series forecasting showed increasing trends in the rates of AFVR and ABD.ConclusionsThe evidence-based method for infectious disease syndromes was useful in gaining an understanding of the current situation, and predicting the future trends of various infectious diseases in Mongolia.