Ogony Jack, Menya Diana, Mangeni Judith, Ayodo George, Karanja Simon
Department of Environmental Health and Disease Control, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Department of Epidemiology and Biostatistics, Moi University, Eldoret, Kenya.
Front Public Health. 2025 Jul 23;13:1526558. doi: 10.3389/fpubh.2025.1526558. eCollection 2025.
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 disease 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. Although healthcare facilities should be on the front line in protecting lives, they are often under pressure and are vulnerable to extreme weather events. Public healthcare preparedness and the associated health outcomes are less frequently considered.
This was a three-month follow-up prospective cohort study that determined public health facility vulnerability, preparedness, and health outcomes through a questionnaire administered to facilities in charge, guardians of children seeking health services, and those with acute febrile illnesses. Key Informant Interviews were conducted with selected members of the County's Health Management Team.
A total of 378 participants were successfully followed. A total of 17 (81.0%) facilities were able to diagnose and treat malaria, while 4 (18.0%) were only able to diagnose and treat dengue virus cases. In Bunyala Sub-County, 6 of the 10 facilities were located on or near floodplains or wetlands, while 5 (45.0%) facilities in Kisumu had the same location. The longest hospitalizations (>5 days) were observed at the Kisumu site, while the highest recovery rate [184 (96.8%)] was noted in Bunyala Sub-County compared to 171 (91.0%) in Kisumu.
Public health facilities are not only vulnerable but also unprepared to contain the rising climate change-driven infectious disease burden. Even though healthcare facilities are fairly able to diagnose and treat malaria, the majority lack the ability to diagnose and treat dengue fever. Longer hospitalization was highest among children diagnosed with dengue fever. There is a need for enhanced arboviral disease surveillance and policies on integrated multisectoral approaches to reduce health system vulnerabilities and increase preparedness.
气候变化和传染性健康风险正威胁着医疗保健系统，在全球范围内引发一系列毁灭性后果。这场危机正在改变许多病媒传播疾病控制项目的格局。撒哈拉以南国家面临着复杂的挑战，因为病媒传播疾病的模式正在转变，导致全球超过17%的死亡率。与气候变化相关的灾害在全球范围内不断增加，撒哈拉以南非洲是最易受灾的地区。尽管医疗保健设施应处于保护生命的第一线，但它们往往面临压力，容易受到极端天气事件的影响。公共卫生防范措施及相关健康结果较少受到关注。
这是一项为期三个月的随访前瞻性队列研究，通过向负责的医疗机构、寻求医疗服务的儿童监护人以及患有急性发热疾病的人发放问卷，确定公共卫生设施的脆弱性、防范能力和健康结果。对该县卫生管理团队的选定成员进行了关键信息访谈。
总共成功随访了378名参与者。共有17家（81.0%）医疗机构能够诊断和治疗疟疾，而4家（18.0%）只能诊断和治疗登革热病毒病例。在布尼亚拉县，10家医疗机构中有6家位于洪泛区或湿地之上或附近，而基苏木的5家（45.0%）医疗机构也处于相同位置。在基苏木的医疗机构观察到最长住院时间（>5天），而布尼亚拉县的康复率最高[184例（96.8%）]，相比之下，基苏木为171例（91.0%）。
公共卫生设施不仅脆弱不堪，而且无力应对气候变化导致的日益增加的传染病负担。尽管医疗保健设施有能力诊断和治疗疟疾，但大多数缺乏诊断和治疗登革热的能力。在诊断为登革热的儿童中，住院时间最长的情况最为常见。需要加强虫媒病毒疾病监测，并制定综合多部门方法的政策，以降低卫生系统的脆弱性并提高防范能力。
