Strengthening Neglected Tropical Diseases Surveillance through Community-Driven Digital Reporting: Evidence from Southern Nigeria
1
Environmental Health Science, Federal University of Technology Owerri, Owerri, Nigeria
2
Public Health, Federal University of Technology Owerri, Owerri, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Neglected tropical diseases (NTDs) remain under-detected in many endemic settings due to heavy reliance on passive, facility-based surveillance systems. These systems often miss cases because of stigma, distance to health facilities, weak health systems, and limited community trust, resulting in substantial hidden morbidity and poor understanding of why transmission persists in specific locations. Innovative, community-centred surveillance approaches are needed to strengthen monitoring, evaluation, and programme decision-making.
METHODS:
Between 2022 and 2024, a community-driven, image-based digital surveillance system was implemented across 45 communities in six southern Nigerian states, covering a population of 477,138. Community members, supported by trained local focal points, submitted anonymised images of suspected NTD morbidity via mobile platforms. Images were reviewed by a multidisciplinary expert panel. Surveillance outputs were used to identify morbidity hotspots. In Ondo State, a sequential explanatory mixed-methods study compared hotspot and moderate-prevalence communities using household surveys (n=550), environmental observations, climate measurements, and 65 key informant interviews to examine drivers of hotspot persistence.
RESULTS:
Community-driven digital surveillance generated significantly more reports than routine surveillance (p<0.01) and identified 386 confirmed NTD cases. Most confirmed cases had received no prior intervention (85%), and 43% had lived with symptoms for over one year, indicating substantial hidden morbidity. Hotspot persistence was associated with environmentally favourable conditions for vectors, poor sanitation, socioeconomic disadvantage, limited availability of NTD medicines, long travel distances to care, and low trust in formal health services. Qualitative findings highlighted delayed reporting, reliance on traditional care, and weak feedback mechanisms between communities and health authorities.
CONCLUSIONS:
Community-driven digital reporting strengthens NTD surveillance by uncovering hidden morbidity and generating actionable insights into the drivers of persistent hotspots. Integrating such approaches into routine surveillance systems can improve monitoring and evaluation, support targeted interventions, and enhance the responsiveness and equity of NTD control programmes.
Neglected tropical diseases (NTDs) remain under-detected in many endemic settings due to heavy reliance on passive, facility-based surveillance systems. These systems often miss cases because of stigma, distance to health facilities, weak health systems, and limited community trust, resulting in substantial hidden morbidity and poor understanding of why transmission persists in specific locations. Innovative, community-centred surveillance approaches are needed to strengthen monitoring, evaluation, and programme decision-making.
METHODS:
Between 2022 and 2024, a community-driven, image-based digital surveillance system was implemented across 45 communities in six southern Nigerian states, covering a population of 477,138. Community members, supported by trained local focal points, submitted anonymised images of suspected NTD morbidity via mobile platforms. Images were reviewed by a multidisciplinary expert panel. Surveillance outputs were used to identify morbidity hotspots. In Ondo State, a sequential explanatory mixed-methods study compared hotspot and moderate-prevalence communities using household surveys (n=550), environmental observations, climate measurements, and 65 key informant interviews to examine drivers of hotspot persistence.
RESULTS:
Community-driven digital surveillance generated significantly more reports than routine surveillance (p<0.01) and identified 386 confirmed NTD cases. Most confirmed cases had received no prior intervention (85%), and 43% had lived with symptoms for over one year, indicating substantial hidden morbidity. Hotspot persistence was associated with environmentally favourable conditions for vectors, poor sanitation, socioeconomic disadvantage, limited availability of NTD medicines, long travel distances to care, and low trust in formal health services. Qualitative findings highlighted delayed reporting, reliance on traditional care, and weak feedback mechanisms between communities and health authorities.
CONCLUSIONS:
Community-driven digital reporting strengthens NTD surveillance by uncovering hidden morbidity and generating actionable insights into the drivers of persistent hotspots. Integrating such approaches into routine surveillance systems can improve monitoring and evaluation, support targeted interventions, and enhance the responsiveness and equity of NTD control programmes.
| eISSN: | 2654-1459 |
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