A decision support system for district-level disease surveillance was piloted with the Port Loko District Health Management Team in Sierra Leone. Through a qualitative evaluation, the study explores the impact of the system on disease surveillance workflows. Results indicate that the system aided decision making for operational tasks, and reduced the time taken to analyze and report surveillance data. In addition, the study discusses the challenges of deploying a pilot system during the Ebola recovery in Sierra Leone, and proposes a high-level architecture for a modular, interoperable decision support system for disease surveillance for public health decision makers in low-resource health systems.