Urban epidemiological surveillance systems have been implemented in various African settings to combat infectious diseases such as malaria. This study aims to compare the effectiveness of these systems in reducing infection rates over a three-year period between Congolese urban areas and Ethiopia. A comparative analysis will be employed using data collected over three years in both settings. The methodology involves assessing surveillance coverage, participant engagement, and feedback mechanisms to evaluate system efficacy. In Congolese urban areas, there was a significant reduction (30%) in malaria infection rates compared to Ethiopia's baseline rate of 50% pre-survey over the three-year period. The study concludes that the surveillance system implemented in Congolese urban areas has been effective in reducing malaria infections, with notable improvements in participant engagement and feedback mechanisms observed. Based on these findings, recommendations for improving surveillance effectiveness include enhancing community participation and increasing resource allocation to support ongoing monitoring efforts.