Factors Associated with Delayed Healthcare Presentation Among Adult Patients with Febrile Illness in Migori County: A Systematic Review

Introduction: Febrile sickness constitutes a common healthcare seeking cause in malaria endemic regions. Despite the continued relevance of malaria as one of the causative agents, it is not the sole source of febrile symptoms. There are several other infections which can result in febrile symptoms. In Migori County, various community and health systems related factors may play an important role in influencing the time taken by the adults in moving from the development of symptoms to health care utilization.  Objective: To identify and summarize the factors which contribute to delayed healthcare utilization by febrile adults with particular focus on studies that could be useful in Migori County and western Kenya region.  Methods: Systematic literature review was carried out using PRISMA 2020.  Findings: The results show that delay in presentation is dependent on a variety of related factors. These can include lack of perception of illness severity during early stages of the disease, self-medication and home treatment, lack of information, distance and access, financial challenges, long waiting periods, perception of quality of service, availability of medication. Findings from Western Kenya reveal that the level of delay in visits to healthcare facilities after fever onset was high and the use of pharmacies and drug shops, as well as other forms of informal health services, was common. Findings specific to Migori include the use of home remedies, self-medication, transport issues, long waiting times, financial challenges and perceptions of illness severity.  Conclusion: There are various factors that contribute to delayed healthcare visits. These need to be incorporated in interventions in Migori County.