Advance Warning and Response Systems in Kenya: A Scoping Review

Area of Science:

• Public Health
• Epidemiology
• Health Security

Background:

• Infectious diseases (IDs) pose a significant global health threat, causing millions of deaths annually.
• Kenya's Advance Warning and Response Systems (AW&RS) are crucial for detecting and responding to ID outbreaks, aligning with International Health Regulations.
• Understanding the enablers and barriers of AW&RS is vital for enhancing health security and preparedness.

Purpose of the Study:

• To map evidence on Kenya's AW&RS, identifying key components and their effectiveness.
• To analyze the enablers and barriers influencing the successful detection of infectious diseases, including climate-sensitive ones.
• To provide insights for improving surveillance systems and health security in Kenya.

Main Methods:

• A comprehensive literature search was conducted across major scientific databases (Cochrane Library, MEDLINE, EMBASE, Web of Science, Africa Index Medicus, SCOPUS) and grey literature sources.
• Study selection and data extraction were performed by two independent reviewers, with discrepancies resolved through discussion.
• Results were synthesized using narrative and thematic analysis to identify patterns and key findings.

Main Results:

• Integrated Disease Surveillance and Response (IDSR) and cohort surveillance systems were most prevalent, with a focus on malaria and studies concentrated in Nairobi County.
• Most systems utilized hospital-based data and automated alerts to monitor disease burden and outbreaks, with noted associations between environmental factors and disease incidence (e.g., malaria, RVF, cholera).
• Skilled personnel emerged as a key enabler, while inadequate finances presented a significant barrier to effective AW&RS implementation.

Conclusions:

• AW&RS in Kenya primarily rely on IDSR and cohort-based surveillance, with observed climate-related disease trends requiring further investigation into causal links.
• Insufficient funding remains a critical impediment to the effective operation and implementation of AW&RS.
• Future research should focus on assessing cost drivers and economic factors that impact the overall effectiveness of these vital surveillance systems.