Integrating the crowdsourced image-based morbidity hotspot surveillance for neglected tropical diseases (CIMS-NTDs) into Nigeria's healthcare system: a mixed methods study

Background

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.

Methods

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.

Results

The training session had in attendance of 30 NTD personnel from the state, local government areas and wards. Results showed a >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.

Conclusions

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.