Currently submitted to: JMIR Public Health and Surveillance
Date Submitted: Nov 2, 2026
Open Peer Review Period: Nov 4, 2026 - Dec 30, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Integrated Disease Surveillance by Design: A Multisource Data Integration Framework for Latin America
ABSTRACT
Background:
Integrated Disease Surveillance Systems (IDSS) are increasingly recognized as essential for improving detection, monitoring, and response to infectious disease threats. In Latin America, however, implementation remains challenging in resource-constrained settings because relevant data are often fragmented across institutions, platforms, geographic scales, and governance structures. Malaria provides a particularly relevant use case because effective surveillance requires the integration of epidemiological, environmental, demographic, and intervention information.
Objective:
This study aimed to develop and implement a scalable and reproducible IDSS architecture for malaria and demonstrate its adaptability across five distinct national contexts in Latin America: Brazil, Ecuador, Peru, Honduras, and Panama.
Methods:
We developed an scalable and reproducible IDSS architecture that routinely integrates multiple data sources into harmonized weekly subnational panel. Country-specific pipelines were used to incorporate malaria surveillance records, hydrometeorological variables, land use and land cover indicators, population and migration data, socioeconomic variables, and malaria intervention information. Administrative units of analysis were selected according to surveillance practices and programmatic relevance within each country. Operational workflows standardized heterogeneous data while preserving country-specific requirements and supported dashboards, situational monitoring, and forecasting workflows.
Results:
The IDSS architecture was implemented across five heterogeneous surveillance contexts, integrating previously siloed datasets into harmonized, analysis-ready data products. Across countries, implementation differed in the types and completeness of available data, the geographic units used for analysis, data-governance arrangements, platform infrastructure, and the extent to which IDSS workflows were embedded within existing national surveillance systems. The resulting workflows supported spatial and temporal monitoring, visualization, and forecasting outputs for malaria surveillance and demonstrated the adaptability of a common multisource integration architecture to country-specific operational requirements. The framework can also support applications such as subnational stratification, intervention evaluation, resource planning, and cross-border surveillance.
Conclusions:
A scalable, reproducible malaria-focused IDSS can be adapted across heterogeneous geographic, institutional, and technological contexts in Latin America. Rather than requiring uniform surveillance structures across countries, the architecture provides a common framework for transforming fragmented multisource data into operational information products that can support routine surveillance and public health decision-making. Long-term sustainability will depend on continued collaboration among Ministries of Health, research institutions, and implementation partners, as well as sustained investment in governance, interoperability, and routine system use.
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