Epidemiological Study and Time Series Modeling of Waterborne and Foodborne Disease Outbreaks in Northwestern Iran: 2016-2023

Fatemeh  Rostampour; Lida  Sattarnezhad; Mohammad  Heidari; Sarieh  Zolfi; Ehsan  Rikhtegar

doi:10.18502/ijph.v54i10.20144

Fatemeh Rostampour Department of Biostatistics and Epidemiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
Lida Sattarnezhad Department of Prevention Communicable Diseases, Urmia University of Medical Sciences, Urmia, Iran
Mohammad Heidari Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Science, Urmia, Iran
Sarieh Zolfi Urmia Deputy for Health Affairs, Urmia University Medical Sciences, Urmia, Iran
Ehsan Rikhtegar Urmia Deputy for Health Affairs, Urmia University Medical Sciences, Urmia, Iran

DOI: https://doi.org/10.18502/ijph.v54i10.20144

Keywords: Outbreaks; Waterborne and foodborne diseases; Time series

Abstract

Background: Outbreaks of waterborne and foodborne illnesses arise from the consumption of contaminated food or water. Factors contributing to these outbreaks include improper food storage, inadequate hygiene during food preparation, and environmental contamination. This descriptive-analytical study aimed to investigate the epidemiology and time series modeling of waterborne and foodborne disease outbreaks in West Azerbaijan Province from Jan 2016 to Dec 2023.

Methods: Data recorded in the health deputy's portal system were utilized for analysis. The variables examined included age, sex, number of patients, hospitalizations, fatalities, presenting symptoms, and spatial and geographical data related to the outbreaks. Box–Jenkins models were employed for time series analysis. Descriptive statistics were computed using SPSS 26 software, while modeling was conducted using R Studio 2021.09.2 and Minitab 22.2.1 software

Results: During the study period, 1306 outbreaks were reported, resulting in 2686 cases of illness, 792 hospitalizations, and 7 fatalities. The causative agent of waterborne and foodborne outbreaks was identified through laboratory testing in 43% the cases. Entamoeba histolytica (31%) was the most commonly identified pathogen, followed by E. coli (27%), and Shigella (18%). The most common locations of outbreaks were in cities (57.9%) and at home (86.9%). The ARIMA(0,0,0)(1,0,0)12 model was determined to be the most effective model for predicting future cases.

Conclusion: Water- and foodborne diseases pose a significant threat due to their rapid spread, with incidence rates increasing from 5.25 per 100,000 (2016) to 9.51 per 100,000 (2023). Fruits, juices, meat, and drinking water were primary contamination sources. Public education on food handling and safe water access are crucial for reducing disease transmission.