title: EWORS: using a syndromic-based surveillance tool for disease outbreak detection in Indonesia.
abstract: BACKGROUND
  Electronic syndromic surveillance for early outbreak detection may be a simple, effective tool to rapidly bring reliable and actionable outbreak data to the attention of public health authorities in the developing world.
  
  
  METHODS
  Twenty-nine signs and symptoms from patients with conditions compatible with infectious diseases are collected from selected Provincial hospitals and analyzed daily. Data is e-mailed on a daily basis to a central data management and analysis center. Automated data analysis may be viewed at the hospital or the Early Warning Outbreak Response System (EWORS) hub at the central level (National Institute of Health Research and Development/NIHRD).
  
  
  CONCLUSIONS
  The Indonesian Ministry of Health (MoH) has adopted EWORS since 2006 and will use it as a complementary surveillance tool in wider catchment areas throughout the country. Socialization to more users is still being conducted under collaboration of three Directorate Generals (DGs) of the MoH; DG of NIHRD, DG of Medical Services and DG of Communicable Disease Control and Prevention. Currently, EWORS is being adapted to facilitate detecting a potential outbreak of pandemic influenza in the region, and automated procedures for outbreak detection have been added.
authors.affiliation: Biomedic and Pharmacy Research Center, National Institute of Health Research and Development, Indonesian Ministry of Health, Jakarta, Indonesia.
authors.forename: Hadi
authors.initials: H
authors.lastname: Siswoyo
authors.affiliation: Biomedic and Pharmacy Research Center, National Institute of Health Research and Development, Indonesian Ministry of Health, Jakarta, Indonesia.
authors.forename: Meda
authors.initials: M
authors.lastname: Permana
authors.affiliation: U.S. Naval Medical Research Unit No. 2 (NAMRU-2), Jakarta, Indonesia.
authors.forename: Ria P
authors.initials: RP
authors.lastname: Larasati
authors.affiliation: U.S. Naval Medical Research Unit No. 2 (NAMRU-2), Jakarta, Indonesia.
authors.forename: Jeffryman
authors.initials: J
authors.lastname: Farid
authors.affiliation: U.S. Naval Medical Research Unit No. 2 (NAMRU-2), Jakarta, Indonesia.
authors.forename: Asep
authors.initials: A
authors.lastname: Suryadi
authors.affiliation: Biomedic and Pharmacy Research Center, National Institute of Health Research and Development, Indonesian Ministry of Health, Jakarta, Indonesia.
authors.forename: Endang R
authors.initials: ER
authors.lastname: Sedyaningsih