Public health facility vulnerabilities, preparedness and health outcomes for P. falciparum and Dengue virus infected children under 5 years with acute febrile illnesses in Western Kenya.

Abstract

<title>Abstract</title> <bold>Introduction</bold> Climate change and infectious-health risks are threatening healthcare systems cascading into devastating consequences globally. This crisis is altering the footprints of many vector-borne diseases control programs. Sub-Saharan countries face complex challenges as patterns of vector borne diseases transform, causing more than 17% of the global mortality. Climate change related disasters are increasing worldwide, with Sub-Saharan Africa being the most prone region. While healthcare facilities should be at the frontline in protecting lives, they are often under pressure and vulnerable to extreme weather events. Public healthcare preparedness and the associated health outcomes are less frequently considered. <bold>Methodology</bold> This was a three-month follow up prospective cohort study which determined public health facility vulnerability, preparedness and health outcomes through questionnaire administered to facility in charges, guardian of the children seeking health services and has acute febrile illnesses. Key Informant Interview was administered to selected members of the County Health Management Team. <bold>Result</bold> A total of 378 participants were successfully followed up. Seventeen (81.0%) facilities were able to diagnose and treat malaria while 4 (18.0%) only were able to manage dengue virus cases. In Bunyala Sub County, 6 of the 10 facilities were located on or near floodplains or wetlands with 5(45.0%) in Kisumu. The longest hospitalizations(&gt; 5 days) were observed in Kisumu site while highest recovery rate (184 (96.8%) was noted in Bunyala Subcounty compared to171 (91.0%) in Kisumu. <bold>Conclusion</bold> Public health facilities are not only vulnerable but are also unprepared to contain the rising climate change inflicted infectious disease burden. Even though healthcare facilities are fairly able to diagnose and treat malaria, the majority lacked the capability to diagnose and manage dengue fever. Longer hospitalization (&gt; 5 nights) was highest among children diagnosed with dengue fever. There is need to enhance arboviral disease surveillance and integrate multisectoral approaches to fortify health systems’ vulnerabilities and preparedness .