Using longitudinal syndromic surveillance to describe small ruminant health in village production systems in Myanmar.

A novel syndromic surveillance approach was used to describe small ruminant health in Myanmar, to help overcome limitations in disease diagnosis common in many parts of the world, especially in low and middle income countries (LMICs). Observations were made from July 2015 to June 2016 of ten clinical syndromes in 12 goat herds and sheep flocks owned by smallholders in the Central Dry Zone. Strengths and weaknesses to using syndromic surveillance in a village setting were identified using a formal surveillance evaluation framework, 'SERVAL'. Larger reporting teams made disproportionately more reports than smaller ones (86% compared to 14% of all reports, with a reporting rate ratio of 4.3 95% CI 3.5-5.4), which may have affected surveillance sensitivity. The benefits of the syndromic surveillance included its relatively low cost and ability to produce quantitative disease estimates that could be used to prioritise further disease investigation and extension activities. In particular, significant mortality was observed, with monthly mortality of 3.0% (95% CI 2.5-3.7%) and 0.28% (0.15-0.53%) in young and adult animals, respectively, and a population attributable fraction of mortality for young animals of 82% (68-91%). Mortality was associated with ill-thrift in young animals but had not previously been considered an important production-limiting condition in Myanmar. This information contributes to an understanding of the prevalence of excessive mortality in smallholder goat and sheep production systems. It is a practical example of the use of syndromic surveillance in a LMIC livestock production system, the results of which can direct future disease research, treatment and prevention to improve the health and productivity of small ruminants in Myanmar.