Effectiveness and challenges of digital tools implementation for enhancing infectious disease surveillance data quality in low- and middle-income countries: A systematic review protocol.

Background: Monitoring infectious diseases is essential for preventing and controlling outbreaks, especially in low- and middle-income countries (LMICs), where issues like poor infrastructure, lack of trained staff, and limited resources can make data collection challenging. Digital tools such as mobile health apps and electronic reporting systems show promise in addressing these problems. However, it's still unclear how well these tools actually improve the quality of data, like how quickly information is reported, how accurate it is, whether all necessary data is captured, and if the data can be trusted.

Objectives: This review aims to explore three main points: (1) how digital tools influence the quality of infectious disease data in LMICs; (2) what factors help or hinder their successful use; and (3) what recommendations can be made for policymakers and health workers based on the evidence.

Methods: We will search several databases, including PubMed/MEDLINE, EMBASE, Scopus, CINAHL, and Google Scholar, for studies published from January 2000 to July 2025. To further reduce publication bias, we will search the following institutional repositories (African Health Observatory and Indian Council of Medical Research). The types of studies are randomised trials, quasi-experimental studies, and mixed-methods evaluations that compare digital solutions with traditional methods in LMIC settings. Data extracted will include outcomes such as delays in reporting, error rates, and completeness, and factors like infrastructure and workforce readiness. The quality of each study will be assessed using ROBINS-I for non-randomized studies and ROB2 for randomized controlled trials. Where possible, we will combine data statistically using meta-analysis and analyse qualitative findings for deeper insights.

Expected Outcomes: This review will offer a clear picture of how effective digital tools are in improving disease surveillance. It will identify common challenges, such as poor connectivity and issues with system integration, and emphasize factors that lead to success, like proper training and government support. Overall, the findings will help shape better strategies to strengthen digital disease monitoring, finally contributing to stronger global health security.