Examining the spatio-temporal patterns of diarrhoeal disease incidence from routinely collected clinical data

在肯尼亚，五岁以下儿童中的腹泻病是一个重大的公共卫生问题，以前与地理风险因素有关。卫生机构收集和生成数据以支持常规病人护理的提供，因此可以成为人口一级卫生情报的一个可行来源，以便对最有需要的人和地区进行优化和针对性的干预。更好地了解个别卫生机构的需求和利用情况也可以揭示覆盖范围的差距，提高卫生系统的整体效率。然而，由于对常规卫生数据的完整性和准确性的担忧，撒哈拉以南非洲历来没有充分利用这些数据。这项研究将评估肯尼亚卫生机构产生的常规数据的质量，并将制定方法促进将其用于分析目的。然后，它将通过卫生设施量化儿童腹泻疾病的发病率，描述设施之间的差异，并创建统计模型，描述与患者水平和地理风险因素的关联。由于将使用真实世界的数据，如果卫生服务经理采纳其建议，这项研究可能会在肯尼亚产生立竿见影的影响，并被证明在制定干预措施以减少儿童腹泻疾病的发病率和改善健康结果方面有用。与肯尼亚的研究合作者发展工作关系也有助于在卫生服务机构内建立分析能力，并有助于更广泛地投资于促进常规卫生数据的记录、存储和分析的系统。

Diarrhoeal disease amongst children under five years of age is a significant public health issue in Kenya,and has previously been linked to geographic risk factors. Health facilities collect and generate data tosupport the delivery of routine patient care, and could therefore be a viable source of population-levelhealth intelligence to optimise and target interventions to those people and localities with greatest need.A better understanding of demand and utilisation at individual facilities could also reveal gaps incoverage and improve the overall efficiency of the health system.However, routine health data has historically been under-utilised in sub-Saharan Africa owing to concernsaround its completeness and accuracy. This study will evaluate the quality of the routine data generatedby health facilities in Kenya, and will develop methods to facilitate its use for analytical purposes. It willthen quantify the incidence of childhood diarrhoeal disease by health facility, describe the variationbetween facilities, and create statistical models describing the association with patient-level andgeographic risk factors.As real-world data will be used, this study could have immediate impact in Kenya if its recommendationsare adopted by health service managers, and prove useful in the development of interventions to reduceincidence and improve health outcomes of childhood diarrhoeal disease. Developing workingrelationships with study collaborators in Kenya could also help to build analytical capacity within thehealth service, and could contribute to a broader case for greater investment in systems facilitating therecording, storage and analysis of routine health data.