Actual or Artefactual Increase: an assessment of Inconsistent Inpatient Reporting Gaps on Malaria in Endemic Coastal Counties, Kenya, 2021.

  • Vector-borne
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Inconsistencies were noted in the reported malaria coastal Kenya. Kwale reported a 1790% increase in confirmed cases between January and February 2021. The annual malaria incidence in Kilifi increased by 22.9% in 2020. Reported mortality data was 2.1/100,000 compared to the estimated 11/100,000. We assessed malaria inpatient reporting and related gaps in the three Kenyan coastal counties.

We reviewed inpatient malaria records in private and public admitting facilities in Mombasa, Kwale, and Kilifi counties from September 2020 through August 2021. We used a data abstraction tool adapted from the Division of National Malaria Program. We compared this with malaria inpatient reports on Kenya electronic reporting platform(KHIS tracker) and summarized data in frequencies and proportions. We also conducted key informant interviews to identify contributors to reporting gaps. We analyzed qualitative data by comparison of responses to similarities and differences and classification into themes and sub-themes.

Admitting facilities visited were 21/50(42%). Fifty-two percent (11/21) were public facilities. Only 10 reported inpatient data on the malaria tracker. Out of the 1692 records reviewed, 52.5% (889/1692) were not reported on the malaria tracker; 641/889 (72%) by private facilities and 112/889 (12.6%) by public facilities. We identified 18 deaths during the review against 106 reported on the tracker. Twenty-one key informants were interviewed. They reported gaps in training on International Classification of Disease (ICD) 10 in the last 3 years; review of malaria inpatient data and varying knowledge on coding by Plasmodium species.

The majority of private health facilities were not reporting inpatient malaria cases on the national tracker despite having the highest number of malaria admissions. We conducted on-job training on disease coding and reporting on the KHIS tracker.

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