ArticleBMC public health2021
Comparing malaria early detection methods in a declining transmission setting in northwestern Ethiopia.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Early outbreak detection in endemic settings using a novel method applied to sparse Rift Valley fever incidence data.Scientific reports · 2026Article
- Epidemiology of malaria outbreak years in India provides key insights into malaria elimination.Malaria journal · 2026Article
- Primary health care data-based early warning system for dengue outbreaks: a nationwide case study in Brazil.Lancet regional health. Americas · 2025Article
- Evaluation of malaria outbreak detection methods, Uganda, 2022.Malaria journal · 2024Article
- Early warning systems for malaria outbreaks in Thailand: an anomaly detection approach.Malaria journal · 2024Article
- Early warning system using primary health care data in the post-COVID-19 pandemic era: Brazil nationwide case-study.Cadernos de saude publica · 2024Article
- Anomaly Detection in Endemic Disease Surveillance Data Using Machine Learning Techniques.Healthcare (Basel, Switzerland) · 2023Article
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Abstract
backgroundDespite remarkable progress in the reduction of malaria incidence, this disease remains a public health threat to a significant portion of the world's population. Surveillance, combined with early detection algorithms, can be an effective intervention strategy to inform timely public health responses to potential outbreaks. Our main objective was to compare the potential for detecting malaria outbreaks by selected event detection methods.
methodsWe used historical surveillance data with weekly counts of confirmed Plasmodium falciparum (including mixed) cases from the Amhara region of Ethiopia, where there was a resurgence of malaria in 2019 following several years of declining cases. We evaluated three methods for early detection of the 2019 malaria events: 1) the Centers for Disease Prevention and Control (CDC) Early Aberration Reporting System (EARS), 2) methods based on weekly statistical thresholds, including the WHO and Cullen methods, and 3) the Farrington methods.
resultsAll of the methods evaluated performed better than a naïve random alarm generator. We also found distinct trade-offs between the percent of events detected and the percent of true positive alarms. CDC EARS and weekly statistical threshold methods had high event sensitivities (80-100% CDC; 57-100% weekly statistical) and low to moderate alarm specificities (25-40% CDC; 16-61% weekly statistical). Farrington variants had a wide range of scores (20-100% sensitivities; 16-100% specificities) and could achieve various balances between sensitivity and specificity.
conclusionsOf the methods tested, we found that the Farrington improved method was most effective at maximizing both the percent of events detected and true positive alarms for our dataset (> 70% sensitivity and > 70% specificity). This method uses statistical models to establish thresholds while controlling for seasonality and multi-year trends, and we suggest that it and other model-based approaches should be considered more broadly for malaria early detection.
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