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MeSH Disease

Fever (1)

Malaria (1)

COVID-19 (1)


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plexin A2 (1)


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    Connected Diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya.

    Authors: Shannen Van Duijn; Angela Siteyi; Sherzel Smith; Emmanuel Milimo; Leon Stijvers; Monica Oguttu; Michael Amollo; Edward Okeyo; Lilyana Dayo; Titus Kwambai; Dickens Onyango; Tobias Rinke de Wit

    doi:10.21203/rs.3.rs-36894/v2 Date: 2020-06-19 Source: ResearchSquare

    Background: In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever MESHD to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria MESHD is currently not sufficient to control malaria MESHD. Transition to domestic funding is challenged by UHC efforts and recent COVID-19 MESHD outbreak. Herewith we present a digital approach to improve efficiencies in diagnosis and treatment of malaria MESHD in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu.Methods: Our intervention was performed Oct HGNC 2017 – Dec 2018 across five private providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled to malaria MESHD treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews.Results: In total 11,689 febrile patients were digitally tested through five private providers. Malaria MESHD positivity ranged from 7.4% to 30.2% between providers, significantly more amongst the poor (p< 0.05). Prescription of antimalarials was substantially aberrant from National Guidelines, with 28% over-prescription (4.6%-63.3% per provider) and prescription of branded versus generic antimalarials differing amongst facilities and correlating with the socioeconomic status of clients. Challenges were encountered transitioning from microscopy to RDT.Conclusion: We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria MESHD diagnostics to earmark digital entitlements for correct malaria MESHD treatment of patients. This approach has large cost-saving and quality improvement potential.

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MeSH Disease
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