Figure 1

The SIDARTHa model for integrated syndromic surveillance at the subnational level. SIDARTHa syndromic surveillance systems are implemented at subnational level and can be based on one or different kinds of data sources. In this way, the data analysis algorithms can be chosen and adjusted according to the immediate context. The syndromic surveillance results feed into the established surveillance and reporting system of the responsible subnational health authority augmenting existing (traditional) surveillance information. Syndromic information would only be reported to higher levels in aggregated form limiting problems arising from data privacy. Investigation of signals is done at subnational level but could also be done at national levels to allow for detection of events covering several jurisdictions. The data providing institutions should also receive access to syndromic surveillance results for their institution and/or jurisdiction which could be used by them for resource planning purposes.