Strengthening Infectious Disease Surveillance in Nigeria: A Focused Scoping Review of SORMAS and the Electronic Integrated Disease Surveillance and Response System
Abstract
Background
Re-emerging infectious diseases continue to present major public health challenges in low-resource settings where surveillance systems often operate under significant infrastructural, financial and workforce constraints. Nigeria has experienced recurrent outbreaks of Lassa fever, cholera, yellow fever and mpox during the past decade, highlighting persistent weaknesses in disease detection, reporting and outbreak response. Digital surveillance systems have increasingly been introduced to strengthen epidemic preparedness and improve surveillance performance, yet evidence describing the contribution of Nigeria's two principal electronic surveillance platforms remains fragmented across disease-specific investigations and implementation studies. This paper synthesises the available evidence on the Surveillance Outbreak Response Management and Analysis System (SORMAS) and the electronic Integrated Disease Surveillance and Response (eIDSR) system, examining their contribution to strengthening infectious disease surveillance within Nigeria's public health system.
Methods
A focused narrative synthesis was undertaken to examine digital tools for managing re-emerging infectious diseases in Nigeria. The review followed established scoping review methodology and identified studies published between 2015 and 2026. Twenty-three eligible publications were included, from which evidence relating specifically to SORMAS and eIDSR was synthesised. Findings were organised around surveillance performance, reporting timeliness, data quality, outbreak detection and implementation experiences.
Results
The evidence consistently demonstrates that both surveillance systems have strengthened infectious disease surveillance in Nigeria. SORMAS has enhanced case-based surveillance through real-time reporting, electronic case management, laboratory integration and improved contact tracing. The eIDSR system has strengthened routine surveillance reporting, improved reporting completeness, accelerated notification of priority diseases and enhanced communication between peripheral health facilities and surveillance authorities. Despite these advances, implementation continues to be influenced by infrastructure limitations, workforce capacity and long-term sustainability.
Conclusion
SORMAS and eIDSR have become integral components of Nigeria's surveillance architecture and have substantially improved surveillance performance across several epidemic-prone diseases. Continued investment in infrastructure, interoperability, workforce development and surveillance governance will be essential to maximise their long-term contribution to epidemic preparedness and health system resilience.
Keywords
Downloads
References
- Abernethy, A., Afsar, N., Anderson, B., Barfield, W., Bharel, M., Brown, J., ... & Yale, K. (2026). Toward a National Health Digital and Data Architecture: Laying the Foundation for Digital Transformation: Commission on Investment Imperatives for a Healthy Nation. NAM perspectives, 2026, 10-31478.
- Ahmed, M. M., Okesanya, O. J., Olaleke, N. O., Adigun, O. A., Adebayo, U. O., Oso, T. A., ... & Lucero-Prisno III, D. E. (2025, May). Integrating digital health innovations to achieve universal health coverage: promoting health outcomes and quality through global public health equity. In Healthcare (Vol. 13, No. 9, p. 1060). MDPI.
- Asogun, D., Arogundade, B., Unuabonah, F., Olugbenro, O., Asogun, J., Aluede, F., & Ehichioya, D. (2025). A Review of the Epidemiology of Lassa Fever in Nigeria. Microorganisms, 13(6), 1419.
- Atobatele, O. K., Hungbo, A. Q., & Adeyemi, C. H. R. I. S. T. I. A. N. A. (2019). Digital health technologies and real-time surveillance systems: transforming public health emergency preparedness through data-driven decision making. IRE Journals, 3(9), 417-21.
- Barth-Jaeggi, T., Houngbedji, C. A., Palmeirim, M. S., Coulibaly, D., Krouman, A., Ressing, C., & Wyss, K. (2023). Introduction and acceptability of the Surveillance Outbreak Response Management and Analysis System (SORMAS) during the COVID-19 pandemic in Côte d’Ivoire. BMC Public Health, 23, Article 2189. https://doi.org/10.1186/s12889-023-17026-3
- Dalhat, M. M., Olayinka, A., Meremikwu, M. M., Dan-Nwafor, C., Iniobong, A., Ntoimo, L. F., Onoh, I., Mba, S., Ohonsi, C., & Arinze, C. (2022). Epidemiological trends of Lassa fever in Nigeria, 2018–2021. PLOS ONE, 17(12), e0279467. https://doi.org/10.1371/journal.pone.0279467
- Eneh, S. C., Okeke, C. A., & Okeke, C. (2025). The resurgence of Lassa fever in Nigeria: Economic impact, challenges and opportunities. BMC Public Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC12307277/
- Ezenwa-Ahanene, A., Salawu, A. T., & Adebowale, A. S. (2024). Descriptive epidemiology of Lassa fever, its trend, seasonality, and mortality predictors in Ebonyi State, South-East Nigeria, 2018–2022. BMC Public Health, 24, Article 3470. https://doi.org/10.1186/s12889-024-20840-y
- Gottlieb, M., Haas, M. R. C., Daniel, M., & Chan, T. M. (2021). The scoping review: a flexible, inclusive, and iterative approach to knowledge synthesis. AEM Education and Training, 5(3), e10609. https://doi.org/10.1002/aet2.10609
- Ibrahim, L. M., Okudo, I., Stephen, M., Ogundiran, O., Pantuvo, J. S., Oyaole, D. R., Tegegne, S. G., Khalid, A., Ilori, E., Ojo, O., Ihekweazu, C., Baraka, F., Mulombo, W. K., Lasuba, C. L. P., & Nsubuga, P. (2021). Electronic reporting of integrated disease surveillance and response: Lessons learned from northeast, Nigeria, 2019. BMC Public Health, 21, 1095. https://doi.org/10.1186/s12889-021-10957-9
- Mekbib, M. S., & Kibiye, D. (2025). Strengthening emergency response in hard-to-reach settings through mobile Public Health Emergency Operation Centre. Journal of Interventional Epidemiology and Public Health, 8(3), 1-17.
- Merson, L., Bourner, J., Jalloh, S., Erber, A., Salam, A. P., Flahault, A., & Olliaro, P. L. (2021). Clinical characterization of Lassa fever: A systematic review of clinical reports and research to inform clinical trial design. PLOS Neglected Tropical Diseases, 15(9), e0009788.
- Nigeria Centre for Disease Control and Prevention. (2025). Lassa fever situation report: Epidemiological week 34, 2025. Available at: https://ncdc.gov.ng/themes/common/files/sitreps/01fa4b52589086bf75895be3d6946b56.pdf, [Accessed: 04/01/2026]
- Nwafor, C. D., Ilori, E., Olayinka, A., Ochu, C., Olorundare, R., Edeh, E., ... & Ihekweazu, C. (2021). The One Health approach to incident management of the 2019 Lassa fever outbreak response in Nigeria. One Health, 13, 100346.
- Okwuraiwe, A. P., Onyeaghala, C. A., Ozoude, O. T., Suleiman, M. O., Abdu-Aguye, S. N., Ezekwelu, N. J., ... & Sobande, O. O. (2025). Clinical Outcomes of Severe Lassa Fever in West Africa: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 22(10), 1504.
- Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119–2126. https://doi.org/10.11124/JBIES-20-00167
- Peters, M. D., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2024). 10. Scoping reviews. JBI manual for evidence synthesis, 417-476. https://doi.org/10.46658/JBIMES-24-09
- Rohan, H. (2022). Beyond Lassa fever: systemic and structural barriers to disease detection and response in Sierra Leone. PLoS neglected tropical diseases, 16(5), e0010423.
- Saleh, F., Popoola, B. O., Arinze, C., Elisha, A. A., Dan-Nwafor, C., Olajide, L., Ilori, E., Ochu, C. L., & Ihekweazu, C. A. (2022). Adapting public health response through lessons learnt: Nigeria’s experience from Lassa fever and COVID-19. BMJ Global Health, 7(Suppl. 7), e007993. https://doi.org/10.1136/bmjgh-2021-007993
- Sebastian, S. L., Susana, C. P. M., Said, P. Z. H., & Karen, B. (2026). Lessons in the Wake of a Lassa fever case in the Midwest US: epidemiology, management and preparedness gaps. BMC Infectious Diseases.
- Shen, Y., Yu, J., Zhou, J., & Hu, G. (2025). Twenty-five years of evolution and hurdles in electronic health records and interoperability in medical research: comprehensive review. Journal of Medical Internet Research, 27, e59024.
- Silenou, B. C., Nyirenda, J. L. Z., Zaghloul, A., Lange, B., Doerrbecker, J., Schenkel, K., & Krause, G. (2021). Availability and suitability of digital health tools in Africa for pandemic control: Scoping review and cluster analysis. JMIR Public Health and Surveillance, 7(12), e30106. https://doi.org/10.2196/30106
- Silenou, B. C., Tom-Aba, D., Adeoye, O., Arinze, C. C., Oyiri, F., Suleman, A. K., Yinka-Ogunleye, A., Adeyemo, A., Domatum, G., Balogun, M., Nguku, P., & Krause, G. (2020). Use of Surveillance Outbreak Response Management and Analysis System for human monkeypox outbreak, Nigeria, 2017–2019. Emerging Infectious Diseases, 26(2), 345–349. https://doi.org/10.3201/eid2602.191139
- Struelens, M. J., Ludden, C., Werner, G., Sintchenko, V., Jokelainen, P., & Ip, M. (2024). Real-time genomic surveillance for enhanced control of infectious diseases and antimicrobial resistance. Frontiers in Science, 2, 1298248.
- Tom-Aba, D., Silenou, B. C., Doerrbecker, J., Fourie, C., Leitner, C., Wahnschaffe, M., Strysewske, M., Arinze, C. C., & Krause, G. (2020). The Surveillance Outbreak Response Management and Analysis System (SORMAS): Digital health global goods maturity assessment. JMIR Public Health and Surveillance, 6(2), e15860. https://doi.org/10.2196/15860
- Tom-Aba, D., Toikkanen, S. E., Glöckner, S., Adeoye, O., Mall, S., Fähnrich, C., Denecke, K., Benzler, J., Kirchner, G., Schwarz, N., Poggensee, G., Silenou, B. C., Ameh, C. A., Nguku, P., Olubunmi, O., Ihekweazu, C., & Krause, G. (2018). User evaluation indicates high quality of the Surveillance Outbreak Response Management and Analysis System (SORMAS) after field deployment in Nigeria in 2015 and 2018. Studies in Health Technology and Informatics, 253, 233–237. https://doi.org/10.3233/978-1-61499-896-9-233
- Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., ... Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
- World Health Organization. (2023). Future surveillance for epidemic and pandemic diseases: a 2023 perspective. World Health Organization.
- World Health Organization. (2024, December 5). Lassa fever. Available at: https://www.who.int/news-room/fact-sheets/detail/lassa-fever, [Accessed: 04/01/2026]
- Woyessa, A. B., Maximore, L., Keller, D., Dogba, J., Pajibo, M., Johnson, K., ... & Mahmoud, N. (2019). Lesson learned from the investigation and response of Lassa fever outbreak, Margibi County, Liberia, 2018: case report. BMC infectious diseases, 19(1), 610.
- Yavlinsky, A., Lule, S. A., Burns, R., Zumla, A., McHugh, T. D., Ntoumi, F., Masanja, H., Mwakasungula, S., Abubakar, I., & Aldridge, R. W. (2020). Mobile-based and open-source case detection and infectious disease outbreak management systems: A review. Wellcome Open Research, 5, Article 37. https://doi.org/10.12688/wellcomeopenres.15723.1