Integrated Training for Surveillance Officers

in Nigeria (ITSON)

Overview of Surveillance Outbreak

Response Management and Analysis
System (SORMAS)
 IDSR in Nigeria

Core IDSR functions IDSR Data Flow in Nigeria

 Identify and record
cases
 Report
 Analyze
 Investigate
 Prepare
 Respond
 Communicate
 M&E and feedback
2

SORMAS
 Challenges

• Failure to encompass all the components and actors involved in

a country’s disease surveillance and outbreak response

• No inter-linkage between case and contacts

• Delayed feedback and poor bi-directional information exchange

• Inability to handle larger, more complex outbreak

• Inability to use algorithms to trigger outbreak response

measures

SORMAS
 Conceptualization of SORMAS

• This is a mobile e-health system concerned with digitization of the

IDSR

• Rapid collection, reporting and analysis of disease/events data in real-

time for appropriate public health action

• It exists on two platforms: a Mobile application for offline entry and a

Web application for supervision and monitoring of activities

• It has modules covering monitoring and analysis of data, case

investigation, contact tracing, Event-based surveillance, case
management and sample testing
4

SORMAS
 Objectives

The main objectives for the development

of this tool were focused on:
⁻ Timely surveillance
⁻ Outbreak management
⁻ Analysis and reporting functionalities
⁻ User centered design
5

SORMAS
 Application of SORMAS

From 2017 till date, SORMAS has been used in

the response to the following disease
outbreaks:
⁻ Monkeypox outbreak
⁻ Meningitis
⁻ Lassa
⁻ COVID-19
6

SORMAS
 What SORMAS can achieve …1/2

•SORMAS has the potential of achieving the

following:
⁻ Standardization of data
⁻ Improved timeliness and completeness of reporting
⁻ Early detection, investigation, and response to outbreak or public
health events
⁻ Reduced manual data entry (from paper to spreadsheets) which is
prone to errors
7

SORMAS
 What SORMAS can achieve …2/2

•SORMAS has the potential of achieving the

following:
⁻ Rapid transmission of data
⁻ Better management of data through provision of international
security storage standards
⁻ Automated generation of Data visualizers (graphs, charts and maps)
⁻ Improved quality of data

SORMAS
 IDSR conventional information flow

WHO, ECOWAS, R-CDC

Aggregated monthly

National Centre for Disease Control N

CDC

Manual
data entry
Aggregated monthly Aggregated weekly weekly
(by Wednesday)
State/Regional Health Department Manual
State /Regional Epidemiologist data entry

weekly
Aggregated monthly Aggregated weekly
(by Tuesday) IDSR
001A IDSR
District / Local Government Area Health Dpt. IDSR 001B
Disease Surveillance Notification Officer (DSNO) 001B

Aggregated weekly immediate case based Laboratory

(by Monday) (phone/SMS)
IDSR
Local Health Care Facilities 001A
Field investigator 9

SORMAS
 IDSR information flow with SORMAS

WHO, ECOWAS, R-CDC

Aggregated monthly

National Centre for Disease Control CDC

N

Manual
data entry Aggregated monthly Aggregated weekly
(by Wednesday) weekly
State/Regional Health Department
State /Regional Epidemiologist Manual
data entry

Aggregated monthly Aggregated weekly weekly

(by Tuesday)
District / Local Government Area Health Dpt. IDSR
001A IDSR
Disease Surveillance Notification Officer (DSNO) 001B
IDSR
001B

Aggregated weekly immediate case based

(by Monday) (phone/sms)
Laboratory
Local Health Care Facilities IDSR
001A
Field investigator 10

SORMAS
 Paper based vs digital reporting
• Paper based reporting (IDSR, old • Digital reporting (example
monkeypox forms) mSERS, SORMAS)
 Simple technology  Real time information exchange
possible
 Information delay
 Updates and corrections difficult
 Easy updates and corrections

 Cost of manual data entry in database

 No manual data entry needed

 Cost for transport

 No transport of forms needed

 Difficult to change or adapt

 Adaptations of forms easy
 Immediate automated analysis
possible (e.g. mapping)
 Requires electricity and connectivity
and digital devices

11

SORMAS
 Surveillance and response work flow in
SORMAS®-open (e.g. Ebola)
Detect Validate & Analyze Control
notifications, screenings, rumors cases, controls, outbreaks isolation, treatment, follow-up

Laboratory
officer

Community Hospital
Informant Informant

Surveillance Surveillance Case Case Officer

officer supervisor Supervisor

Port of Entry
Officer

Contact Contact
Supervisor Officer

Citizen Rumor
Hotline Officer 12

SORMAS
 Information flow and interfaces from
SORMAS server

N
CDC

IHR ECOWAS
National CDC African PublicHealth
Laboratory Network

WHO Headquarters
13

SORMAS
 Personal/users of SORMAS
Detect Validate & Analyze Control
notifications, screenings, rumors cases, controls, outbreaks isolation, treatment, follow-up

Surveillance Officer Case Officer

Community
LGA-DSNO Executes case based
Informant Investigates case,
refers suspect cases control measures (e.g.
identifies contact persons isolation)
in community to hospital
informant Surveillance
Supervisor Case Supervisor
Hospital Informant state epidemiologist MD, head of isolation
Notifies suspect cases Coordinates surveillance facility
officers Coordinates case based
control measures
Laboratory Officer
Point of Entry Officer Documents and reports Contact Officer
Notifies suspect cases at laboratory results Assistant LGA-DSNO
airports, ports and border Conducts follow-up of
crossing N National CDC contact persons
CDC Incident Command
Centre
Rumour Officer Assesses risk, coordinates Contact Supervisor
State DSNO national response State epidemiologist
Receives calls on events Coordinates follow- up of
from general population Supranational Centre contact persons
Regional CDC, WAHO,
WHO
International coordination 14

SORMAS
 Surveillance officer

• Verify
– Name and contact details

15

SORMAS
 Surveillance officer

• Verify
– Name and contact details
– Hospitalization data

16

SORMAS
 Surveillance officer

• Verify
– Name and contact details
– Hospitalization data
– Symptoms and onset
dates

17

SORMAS
 Surveillance officer

• Verify
– Name and contact details
– Hospitalization data
– Symptoms and onset
dates
• Classify case

18

SORMAS
 Surveillance officer

• Verify
– Name and contact details
– Hospitalization data
– Symptoms and onset
dates
• Classify case
• Assess exposures

19

SORMAS
 Surveillance officer

• Verify
– Name and contact details
– Hospitalization data
– Symptoms and onset
dates
• Classify case
• Assess exposures
• Initiate laboratory testing

20

SORMAS
 Surveillance officer
• Verify
– Name and contact details
– Hospitalization data
– Symptoms and onset dates
• Classify case
• Assess exposures
• Initiate laboratory testing
• Identify contact persons

21

SORMAS
 How I can use this at my job

TOPIC HOW CAN I USE THIS AT MY JOB

Introduction to public health surveillance  

Identify priority diseases, conditions and

 
events
Report priority disease ,events and
 
conditions
Role of Laboratory  

Collect and Organize Data  

Analyze Data  

Interpret Data  

Outbreak investigation (Descriptive

 
Epidemiology)
22

SORMAS
 Summary

• SORMAS has led to the acceleration of detection

and management of outbreaks
• Immediate information exchange for all health
officers involved
• Adherence to national surveillance and
international health regulations

23
Mobile Strengthening Epidemic
Response Systems (mSERS)
 Outline
• What is mSERS
• Overview of weekly IDSR 002 Reporting via mSERS
• Status of Deployment

• Revised National IDSR Technical Guideline

• How does it work
• Sormas mSERS
 What is mSERS?
mSERS is a platform that automates bi-directional data
collection while enabling supervision and oversight of
the entire reporting process

Functions of mSERS
 Data gathering/collection –rumour notifications and
weekly reporting

 Information feedback – information to Health Care

Workers, report receipts, validation confirmations and
report submission reminders
Overview of IDSR 002 Reporting via mSERS
• mSERS is currently used for weekly IDSR 002 reporting
• Structured to follow the IDSR 002 format and timeline for
reporting
• Web-based application portal for both the LGA, National and
state level access to mSERS database
• Server application hosted at the NCDC
• Reports monitored using 2 indicators
– Reporting rates (Number of LGAs reporting in a state)
– Timeliness of reports (All reports sent and received on Tuesdays)
How does it work
• mSERS is now embedded into SORMAS
• Hence weekly reports from the LGA are expected to
be reported via the SORMAS web-based application
How does it work: IDSR002 Report
• Open your web browser (Chrome preferred)
• On the address bar; type
https://sormas.org.ng/sormas-ui
• Enter your login credentials and click login
How does it work: IDSR002 Report

• On the menu bar click on Msers

• It will open as follow:
 How does it work: IDSR002 Report
• To enter new report click on NEW AGGREGATE REPORT
How does it work: IDSR002 Report
• Input your aggregate reports C=CASES, L=LAB
CONFIRMATIONS and D=DEATHS
• Click save to submit.
Revised National IDSR Technical Guideline
Priority Diseases for Case-Based Reporting (Report
via SORMAS)

Priority Diseases for Weekly IDSR002 Reporting

(Report via mSERS)

Priority Diseases for Monthly Reporting (DHIS)