PONE-D-25-30726 Effectiveness and Challenges of Digital Tools Implementation for Enhancing Infectious Disease Surveillance Data Quality in Low- and Middle-Income Countries: A Systematic Review Protocol PLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Partly

Reviewer #2: Yes

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This is a systematic review protocol to collate the evidence regarding the Effectiveness and Challenges of Digital Tools Implementation for Enhancing Infectious Disease Surveillance Data Quality in Low- and Middle-Income Countries. The review protocol is well-written and I think the topic is quite relevant and novel. The rationale is well established given the challenges faced by traditional surveillance in LMICs and the growing adoption of digital tools. However, there are areas where clarity, flow, and organization could be improved for better readability and impact. Firstly, while the focus on LMICs is appropriate, the protocol would benefit from explicitly stating the criteria used to define LMICs (e.g., World Bank classification) and specifying which countries or regions are included. This will enhance reproducibility and transparency. Secondly, there is lot of repetition, avoid repeating ideas (e.g., importance of surveillance, LMIC challenges) across sections. Consolidate related information into a single, strong paragraph per theme.

Other concerns pointwise

Abstract:

1. The PROSPERO ID 1023840 is not traceable. Please check.

2. Language for sentence “we are interested in studies…….” should be changed to “types of studies will be included for better professional language.

3. ROBINS tool can be used for non-randomized studies, but for RCTs, ROB2 tool should be used.

Introduction:

1. References should be placed at appropriate places. For e.g., in the first paragraph, Nathan et al is placed inappropriately. Please cite reference for “The last two decades have been characterized by integrating digital technology into health care, which has led to several digital health platforms for strengthening infectious disease surveillance”.

2. The last paragraph in the introduction is just a repetition and has already been mentioned in the introduction, can be omitted.

Methods:

1. Although you broadly describe eligible study designs and populations, it would help to list explicit inclusion and exclusion criteria

2. A detailed search strategy for all databases should be provided.

3. The authors should clarify the rationale for selecting studies published only between January 2000 and April 2025. Explaining why this timeframe was chosen will help justify the scope of the review and ensure that relevant earlier or more recent studies are not inadvertently excluded.

4. The methodology for selection of studies should be explained explicitly. The authors have not mentioned the Ti/Ab screening followed by full text screening.

5. Mention how to tackle deduplication of citations, manually or through software or both.

6. The title “I. Qualitative Synthesis” seems misleading since the paragraph is about Quantitative synthesis.

7. You mention following PRISMA 2020, which is excellent. Consider specifying that the final review report will include a PRISMA flow diagram to show the study selection process

8. The whole section of “Quantitative analysis Approach to Meta-analysis” is a repetition described previously also. Please clarify.

9. Your plan for thematic analysis and mixed-methods integration is strong. Consider specifying the software or frameworks.

Overall, minor grammatical issues such as inconsistent capitalization (e.g., “Infrastructural”), missing commas, and awkward phrasing appear throughout. Maintain consistent terminology (e.g., “digital surveillance tools” vs. “digital platforms”). Break long paragraphs into smaller ones for readability, especially in the Background section.

Reviewer #2: The protocol has been written in a very appropriate way including all the steps needed for conducting a systematic review. However, there are some minor concerns which author can take care of:

a) Please provide the reference s for the tools/ guidelines to be used in developing the systematic reviews such as PRISMA 2020, JBI etc.

b) Qualitative and Quantitative section needs to be updated. In qualitative sysnthesis author talked about meta analysis of studies having same methodology, which is part of the quantitative synthesis.

c) There is a need of data extraction for to be added in supplementary section having all details pertaining to the data needed for qualitative and quantitative synthesis.

d) Author could check for the word limit of each of the section according to the journal requirement

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Reviewer #1: Yes: Meenakshi Sachdeva

Reviewer #2: No

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Effectiveness and Challenges of Digital Tools Implementation for Enhancing Infectious Disease Surveillance Data Quality in Low- and Middle-Income Countries: A Systematic Review Protocol

PONE-D-25-30726R1

Dear Dr. Abiodun,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Pasyodun Koralage Buddhika Mahesh

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have done the necessary changes and incorporated the suggestions. The manuscript is now fit for publication.

Reviewer #2: None. The comments have been addressed appropriately. Data extraction sheet has been added and the protocol is now well formulated.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Dr Meenakshi Sachdeva

Reviewer #2: No

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