Conference Abstract | Volume 8, Abstract 14 | Published: 16 Jul 2025
William Ngosa1,2,&, Charles Chileshe2, Miyoba Dindi2, Oscar Nzila1, Dabwitso Banda2, Nyambe Sinyanje2, Roma Chilengi2
1Lusaka Provincial Health Office, Lusaka, Zambia, 2Zambia National Public Health Institute, Lusaka, Zambia
&Corresponding author: William Ngosa, Lusaka Provincial Health Office, Lusaka, Zambia, Email: lingosawilliam@gmail.com
Received: 03 Jun 2024, Accepted: 11 Aug 2024, Published: 16 Jul 2025
This is part of the Proceedings of the Zambia Field Epidemiology Training Program Alumni Conference, September 11 – 13, 2024
Keywords: Enhanced, eIDSR, DHIS2, GPS, Outbreak data management
©William Ngosa et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: William Ngosa et al. Enhancing Disease Surveillance: Zambia’s Cholera Tracker 2019 to 2024. Journal of Interventional Epidemiology and Public Health. 2025;8 (Conf Proc 4):14. https://doi.org/10.37432/JIEPH-CONFPRO4-00014
In Zambia, managing outbreak data, as exemplified by recent crises like Cholera and Covid-19, has presented significant challenges. The 2023-2024 cholera outbreak alone recorded over 23,221 cases and 740 deaths. To address this, Zambia implemented the electronic Integrated Disease Surveillance (e-IDSR) system, aiming to overcome data management barriers during outbreaks.
Launched in 2019 and later enhanced in 2023, Zambia’s e-IDSR, powered by DHIS2, initially focused on capturing aggregate data at the district level across all 116 districts. However, it underwent upgrades to capture patient-level data, including for cholera, among the 16 immediate notifiable conditions outlined in the IDSR guidelines. Additionally, decentralization of data capturing from the district level to the facility level was implemented. The aggregate ND2 form was upgraded to include four sections: suspected cases, cases sent to the lab, confirmed cases, and deaths. The patient-level data entry process begins with demographic and GPS data entry, followed by stages for laboratory requests and results, case investigation, clinical information, and patient outcomes. The DHIS2 android application allows cases to be captured on mobile devices at facility level. Off-line capturing supports ongoing use in areas with poor internet access. Automated data exchange of laboratory results from the DISA laboratory system to eIDSR provides faster access to laboratory results.
During the cholera outbreak, the e-IDSR system recorded epidemiological data for over 33,980 cases, with approximately 30% having GPS coordinates across the 10 affected provinces. Lower-level facilities gained access to their data for epidemiological analysis, including utilization of the case investigation stage. Around 10% of cases had clinical and laboratory information entered. Although the integration of the system with laboratory systems showed promise, full establishment is pending.
The implementation of e-IDSR marks a pivotal step in outbreak data management. Real-time data capture and accessibility empower targeted interventions at specific levels. With e-IDSR, Zambia is better equipped to respond effectively to outbreaks, highlighting the importance of such systems in bolstering epidemiological and public health efforts. In conclusion, Zambia’s Cholera Tracker demonstrates the potential of electronic surveillance systems in revolutionizing disease outbreak response and management.
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