Using sentinel surveillance system data to characterize severe malaria illness and quality of malaria case management among hospitalized patients in Kenya, 2017–2024

Modifiable factors that suggested delayed care-seeking were associated with worse malaria outcomes in Kenya. Furthermore, gaps in diagnostic accuracy and adherence to treatment protocols for severe malaria were observed during chart review. These findings point to the importance of behaviour change strategies as well as messaging in the community that promote timely care-seeking, referrals and follow-up, especially for the youngest children. Potential malaria over-diagnosis underscores the need for strengthening quality assured microscopy programs with adequate training of microscopists and properly functioning microscopes and reagents, as well as an external quality assurance programme that routinely provide feedback on performance and identify areas for improvement.