02650nas a2200253   4500000000100000008004100001260003400042653002500076653002500101653002400126653003900150653001900189653001200208100001400220700001800234700001500252700001400267700001300281700001700294700001800311245017600329520186600505022002502371       2025                            d  bOxford University Press (OUP)10aCommunity engagement10adigital surveillance10aDisease elimination10aNeglected tropical diseases (NTDs)10aPublic health 10aNigeria1 aBosede AO1 aOyamienlen CS1 aEkeleme UG1 aUdujih OG1 aMetuh CE1 aOparaocha ET1 aChukwuocha UM00aIntegrating the crowdsourced image-based morbidity hotspot surveillance for neglected tropical diseases (CIMS-NTDs) into Nigeria's healthcare system: a mixed methods study3 a<p><strong>Background</strong></p>

<p>Traditional surveillance systems for neglected tropical diseases (NTDs) often suffer from underreporting, delays and limited reach, hindering effective disease control. This study describes the integration process of crowdsourced image-based morbidity hotspot surveillance for NTDs (CIMS-NTDs) into the government-led NTD program and assesses its operational performance and stakeholder experience.</p>

<p><strong>Methods</strong></p>

<p>A mixed methods study embedded in an implementation research framework was conducted in Ondo State, Nigeria. A quasi-experimental design was used to compare CIMS-NTDs with the existing surveillance approach, while key informant interviews were used to explore stakeholder perceptions. Quantitative data were analysed using descriptive statistics and the Mann–Whitney U test, and qualitative data underwent reflexive thematic analysis.</p>

<p><strong>Results</strong></p>

<p>The training session had in attendance of 30 NTD personnel from the state, local government areas and wards. Results showed a &amp;gt;400% improvement in CIMS-NTDs knowledge following the training session. CIMS-NTDs outperformed traditional surveillance, with 62 confirmed case reports versus only 3 under the conventional system (p=0.023). Onchocerciasis was the most frequently reported NTD (62.9%). Key informants highlighted improved community engagement, data accuracy and reporting efficiency but noted challenges such as digital accessibility and funding constraints.</p>

<p><strong>Conclusions</strong></p>

<p>Integrating digital surveillance into national NTD programs enhances case detection, reporting and intervention strategies. Sustainable adoption requires government funding, capacity building and expanded digital infrastructure to improve accessibility and impact.</p>
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