Misclassification error and performance of individual, household, community and country risk factors for malaria infection among sub-Saharan children under five

Abstract

Very often, health workers are faced with lack of diagnostic materials in sub-Saharan countries, while the need is enormous because of several endemic problems affecting most often children. Malaria is one of the great public health problems in sub-Saharan African countries where 114 million people were infected in 2015, with approximately 400,000 deaths. Only 76% of persons suspected to be infected by malaria were submitted to a malaria diagnostic test in the public sector. The objective of our study is to analyze the classification error and the prediction performance of individuals, households, communities and countries factors as a diagnostic indicator for malaria parasite infection, considering the endemicity of household cluster. 61,292 children of 16 African countries from DHS and MIS surveys were included in analysis. Households and countries factors are the best sensitive tools for the malaria diagnosis among sub-Saharan African children with sensitivities more than 90% in low endemicity areas.

Keywords

• malaria
• sub-saharan african countries
• performance
• diagnostic tools
• endemicity