Table 2 Key features and algorithms for febrile patients compatible with suspected malaria for developing case description and contents of SMOT tool and SP

Muhe, [24]

1999

Ethiopia

Fever with a previous malaria attack or pallor or splenomegaly had sensitivities of 80% and 69% and specificities of 65% and 81% in high and low risk settings, respectively

Health workers should be trained to detect pallor and splenomegaly because these two signs improve the specificity for malaria

Ong Lean Suan, [25]

1990

Singapore

Integrated Malaria Expert system (IMEX): was implemented as four modules, initialization, diagnosis, treatment, and drug information. Decision-making (diagnosis) was based on input data and information

IMEX is a tool to assist medical personnel in the diagnosis and treatment of malaria, to improve management of malaria patients and to formalize and document knowledge on malaria

Thwing, [26]

2017

Senegal

A year-long study in 16 health posts was conducted to determine an algorithm’s capacity to identify patients with Plasmodium falciparum infection: ≥ 37.5 °C or history of fever; performed RDT, absence of cough, sputum, sore throat, skin rash, drainage in the previous 2 days

In all but the lowest malaria transmission zone, use of the algorithm excludes an unacceptably large proportion of patients with malaria from receiving an RDT at their first visit, denying them timely diagnosis and treatment

Weber, [27]

1996

Gambia

Fever above 38 °C and without intermittent fever and/or moderate to severe pallor, shaking was associated with the presence of parasitaemia

Compared with the pediatrician’s diagnosis, the sensitivity and specificity of the Integrated Management of Childhood Illness (IMCI) algorithm was 87% and 8% for malaria parasitaemia (any level), and 100% and 9% for malaria parasitaemia (above 5000 parasites/µl)

The draft IMCI algorithm was not proven for malaria. Its use without microscopy would result in considerable overtreatment, especially in a low transmission area or during a low transmission season in countries with seasonal malaria

Duodu, [28]

2014

Ghana

An algorithm for malaria diagnosis and treatment using fuzzy logic was designed and simulated using MATLAB 7.8.0 via 13 malaria suspected cases; it included: Imputed data: age, sex, temperature, pulse rate, BMI; Process: Diagnosis; Output: prescribed drug. Prescribe drugs based on the degree of infection

The medical doctors’ diagnosis had accuracy of 61.5%, while the designed algorithm was 76.9% accurate

Mwangi, [29]

2005

Kenya

A clinical algorithm was generated based on examination of 1602 persons of all age groups for a range of signs and symptoms and malaria parasitemia.. problems were considered on the basis of their association with malaria. The age-optimized algorithms could identify about 66% of cases among those < 15 years of age but only 23% of cases among adults

Clinical algorithms therefore appear to have little utility in malaria diagnosis, performing even worse in the older age groups,

Bojang, [30]

2000

Gambian

Symptoms which contributed to the malaria: feels hot, absent of rash and cough, vomiting, reduced feeding, sleeping, and shivering

88% sensitivity and 62% specificity; compared with the pediatrician

The algorithm could be used for malaria diagnosis

Chandramohan, [31]

2001

India

Sign and symptoms of 1945 children and 2885 adults who presented with fever were recorded. Fever, shivering, chill, No cough and runny nose, feels hot to touch were common. Sensitivity: 60%, specificity: 61%)

malaria diagnosis in areas of low endemicity requires microscopy to be accurate

Case management, Guide for tutors, [32]

2012

WHO

This training module described many useful malaria suspected and confirmed case studies with various signs and symptoms and clinical features

Common signs and symptoms used in the case histories included fever (in most cases was ≥ 37.5), vomiting, poor feel and nutrition, headache, backache, fatigue, nausea, absence of rash and neck stiffness

Pulse rate, blood pressure, and travel history compatible with suspected malaria were reported in the most case studies

This training module on malaria case management has been developed to support the staff involved in malaria control and elimination programmes in the effective organization of malaria diagnosis and case management services

Redd, [33]

1996

Malawi

The rectal temperature of 37.7 °C or higher, splenomegaly, or nailbed pallor was 85% sensitive in identifying parasitaemic children and 41% specific

These results suggest that better clinical definitions are feasible, that splenomegaly and pallor are helpful in identifying children with malaria, and that much overtreatment of children without parasitaemia could be avoided