BackgroundDengue is the most common arboviral disease of humans, with more than one third of the world’s population at risk. Accurate prediction of dengue outbreaks may lead to public health interventions that mitigate the effect of the disease. Predicting infectious disease outbreaks is a challenging task; truly predictive methods are still in their infancy.MethodsWe describe a novel prediction method utilizing Fuzzy Association Rule Mining to extract relationships between clinical, meteorological, climatic, and socio-political data from Peru. These relationships are in the form of rules. The best set of rules is automatically chosen and forms a classifier. That classifier is then used to predict future dengue incidence as either HIGH (outbreak) or LOW (no outbreak), where these values are defined as being above and below the mean previous dengue incidence plus two standard deviations, respectively.ResultsOur automated method built three different fuzzy association rule models. Using the first two weekly models, we predicted dengue incidence three and four weeks in advance, respectively. The third prediction encompassed a four-week period, specifically four to seven weeks from time of prediction. Using previously unused test data for the period 4–7 weeks from time of prediction yielded a positive predictive value of 0.686, a negative predictive value of 0.976, a sensitivity of 0.615, and a specificity of 0.982.ConclusionsWe have developed a novel approach for dengue outbreak prediction. The method is general, could be extended for use in any geographical region, and has the potential to be extended to other environmentally influenced infections. The variables used in our method are widely available for most, if not all countries, enhancing the generalizability of our method.

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BackgroundElectronic disease surveillance systems can be extremely valuable tools; however, a critical step in system implementation is collecting data. Without accurate and complete data, statistical anomalies that are detected hold little meaning. Many people who have established successful surveillance systems acknowledge the initial data collection process to be one of the most challenging aspects of system implementation.MethodsThis discussion will describe the various methods for collecting data as well as describe some of the more common data feeds used in surveillance systems today. Given that every city/region/country looking to establish a surveillance capability has varying degrees of automated data, alternative data collection methods must be considered.ResultsWhile it would be ideal to collect automated electronic data in a real-time fashion without human intervention, data may also be effectively collected via telephone (both mobile and land lines), fax, and email. Another consideration is what type of data will be used in a surveillance system. If one data source is of high value to one locality, it should not be assumed that it will be as useful in another area. Determining what data sources work best for a particular area is a critical step in system implementation.ConclusionRegardless of data type and how they are collected, surveillance systems can be successful if the implementers and end users understand the limitations of both the data and the collection methodology and incorporate that knowledge into their interpretation procedures.

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