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September 10, 2025Open Access

A Machine Learning Approach to the Prediction of Malaria in Under-five Children: Analysis of the 2021 Nigerian Malaria Indicator Survey

SMSbongiseni Makhosonke MthethwaUniversity of KwaZulu-Natal SMSileshi Fanta MelesseUmkhuseli Innovation and Research Management

Key Points

Random Forest achieves 79% accuracy, making it the top-performing machine learning model for malaria prediction.
Support Vector Machines demonstrate strong accuracy and AUC, offering alternative predictive power for malaria in children.
The analysis utilized the 2021 Nigeria Malaria Indicator Survey, involving over 10,000 children tested with RDT.
These findings underscore the potential for improved malaria interventions through targeted predictive analytics.

Abstract

Background Malaria remains a major cause of illness and death among children under five in Nigeria, despite efforts to control transmission. Accurate and reliable prediction of malaria outbreaks is crucial for health authorities to take timely measures. This study aims to identify the most robust machine learning classification algorithms for predicting the status of malaria in children under five (0-59 months). Methods The 2021 Nigeria Malaria Indicator Survey (NMIS) included 10,655 children under five who were tested for malaria using the Rapid Diagnostic Test (RDT). Various machine learning models were explored, including Decision Trees, K-Nearest Neighbor, Naïve Bayes, Random Forest, Support Vector Machines, and Survey Logistic Regression, and their performance was evaluated through metrics such as accuracy, AUC, balanced accuracy, F1-Score, negative predictive value, precision, sensitivity, and specificity. Results Random Forest (RF) is the most robust and balanced classification model due to its superior accuracy (79%), precision (77%), recall (62%), F1-score (69%), and AUC (80%). Support Vector Machine (SVM) also demonstrated strong performance, particularly in accuracy (74%) and AUC (80%). Survey Logistic Regression (SLR) and Decision Tree (DT) offered moderate results but fell short compared to RF and SVM, indicating the need for further optimization. Naive Bayes (NB) and K-Nearest Neighbors (KNN) had limitations, making them less reliable for this task. Conclusion In conclusion, the study reveals that RF and SVM are the best classification models for predicting malaria status in children under five years old. RF is reliable and balanced, while SVM is preferred for recall. SLR and DT show potential but require optimization. NB and KNN have significant performance gaps, making them less suitable. These findings will help policymakers and malaria intervention programs address key factors, enabling more targeted public health interventions to reduce the malaria burden on young children and improve the well-being of vulnerable populations in Nigeria.

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