Trends of reported outpatient malaria cases to assess the Test, Treat and Track (T3) policy in Kenya
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Background: Kenya reports over six million malaria cases annually. In 2012 the country adopted the Test, Treat and Track (T3) policy to ensure that all suspected malaria cases are tested, confirmed cases are treated with quality-assured drugs and timely accurate malaria surveillance are in place to guide policy and practice. Objective: To describe the trends of confirmed outpatient malaria cases and the consumption of artemisinin-based combination therapy (ACT) in the government health facilities in Kenya following the roll out of the T3 initiative. Design: A retrospective review study. Setting: All government health facilities in the 47 counties. Subjects: Secondary data on all outpatient malaria cases and ACT consumed as reported in the District Helth Information Software (DHIS). Results: Total malaria cases decreased from 8.5 to 6.8million cases in 2012 and 2015, respectively. Confirmed malaria cases increased from 1.97 (23%) to 4.9 (72%) million cases. The greatest decrease in total malaria cases and the greatest rise in confirmation of suspected cases occurred in the lower level health facilities. More confirmation of suspected cases occurred in the malaria endemic regions compared to other epidemiological zones. Excess ACT consumption reduced by 46% to reach 27% in 2015. Conclusion: Though there was increased confirmation of suspected malaria, still onethird of the outpatients were treated clinically in 2015. About one-third of ACTs were also used in excess in 2015. There is need for enhanced efforts to adhere to the T3 policy and malaria elimination guidelines.
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