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

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 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.