Event management systems (EMS) are key tools for epidemic intelligence, integrating surveillance signals and incident response, although international standards to inform development are lacking. We describe the Nigeria Centre for Disease Control and Prevention (NCDC) SITAware, a software capable of operating with low internet bandwidth to generate notifications, reports, and spatiotemporal dashboards and provide event-level data for real-time accountability and postevent learning. SITAware was enabled by local institutional ownership, co-created at low cost, and integrated into existing workflows. In 2022, SITAware was used to manage ≈300 incidents, and NCDC implemented it subnationally. NCDC's experience may inform EMS development and implementation in similar settings.
The COVID-19 pandemic and recent outbreaks of mpox, Ebola virus disease, and other diseases have highlighted the need to link public health data with action (1). During the past decade, many countries have made progress toward digitization of indicator-based surveillance (IBS) and event-based surveillance (EBS) systems (2,3). However, limitations remain, related to integration of signal and events data, multiplicity of systems, and interoperability.
Event management is the process of ensuring events of potential public health interest, as defined by the World Health Organization (WHO), are identified, risk assessed, documented, and reported early to inform rapid response actions to reduce event-associated illness and death (4). Effective event management requires the ability to follow and assess events and actions over the course of the event (4-6). Event management systems (EMS) can support event management by integrating data and workflows of surveillance and response actors. EMS can provide visibility in a single system for process escalation, including risk assessment and analysis, response initiation and coordination, as well as helping manage documentation of response and assigning and tracking of tasks. EMS supports public health institutions (PHIs) in meeting expectations concerning outbreak and incident oversight and response, as set out in the International Health Regulations (2005) (7,8).
WHO has developed an EMS as a centralized repository for event-related data to monitor and evaluate events and actions (4,7). Whereas guidance for event management and data frameworks for public health emergency operations centers (PHEOCs) have been published, standards and functionalities expected of country-based EMS are not clearly defined (9,10). Recent developments supporting epidemic intelligence are predominantly focused on the aggregation of source data for early detection of signals that could represent events, which includes the epidemic intelligence from open sources tool (11,12). There is a lack of information in published literature regarding systems supporting subsequent steps in investigation, verification, and management of events. The inability to capture and share such information might compromise oversight, governance, accountability, and coordination of response and limits the opportunity for learning and continuous improvement (5). EMS can also help with integration of surveillance signals and event data from across sectors, such as animal, environmental, and human surveillance, in a One Health approach. EMS may also help PHIs improve, meet, and measure timeliness of detection, notification, and response, as proposed by the 7-1-7 target (13,14).
The Nigeria Centre for Disease Control and Prevention (NCDC) was established in 2011 with a mandate for preparedness, detection, and response to infectious disease outbreaks and public health emergencies and was codified in 2018 (15,16). Since inception, NCDC has strengthened infectious disease surveillance under the integrated disease surveillance and response (IDSR) strategy, improving laboratory diagnostic capacity and digitizing IBS and EBS systems (17). As a result, Nigeria has detected outbreaks of endemic and epidemic-prone diseases, including emerging or reemerging zoonotic pathogens such as mpox, Lassa fever, and yellow fever, and accelerated response to such events by strengthening oversight at national and state levels (13,14).
NCDC has invested in epidemic intelligence approaches and workflows to improve situational awareness and decision-making. NCDC, in collaboration with supporting partners including WHO, United Kingdom Health Security Agency (UKHSA), UK Department of Health and Social Care, United States Centers for Disease Control and Prevention (CDC), Resolve to Save Lives (RTSL), Bill and Melinda Gates Foundation (BMGF) and others, has continued to strengthen surveillance, IHR implementation, and EBS in Nigeria (18,19). In this article, we describe an EMS system, SITAware, that was developed collaboratively by NCDC and UKHSA to supplement the literature on EMS and inform future EMS development and implementation.