A syndemic or synergistic epidemic is a recent concept in epidemiology formed by uniting “synergy” (the interaction of two or more entities) and “emic” (on the people). Syndemic is defined as the aggregation of two or more concomitant or successive epidemics or disease clusters in a defined population with biological interactions, which exacerbate the prognosis and burden of disease and brought about by changes in socio-economic, environmental, cultural and/or political factors over time. Syndemogenesis is the processes, stages and ways of interactions that cause syndemic. The syndemic approach does not follow the biomedical approach to diseases in diagnosis, clinical description, and treatment independent of interaction with social contexts. There are three concomitant ways for syndemic interactions. First is mutual causality of diseases of the syndemic (e.g. X and Y, or Y and Z, or X and Z can cause of each). Secondly the synergistic interaction between the two diseases lead to an increase in the third one (both X and Y are effective on C separately and cause more burden of Z than the summation of increases X and Y would cause alone). Lastly serial causality (X causes Y and Y causes Z, and the increase of X and Y can lead to an excessive increase in Z).
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