Risk of Malaria Scoring System | Gambian Children

Patient selection: child from 6 months to 9 years with fever or history of fever

Parameters (10, of which only 9 are used for each of the scores):

(1) sleepy

(2) feeding

(3) cough

(4) shivering

(5) feeling hot

(6) cough not heard

(7) pallor of palm

(8) absence of rash

(9) respiratory rate

(10) spleen

If the patient a parasitemia >= 5,000 per µL and temperature >= 38°C then coefficients in Column A are used.

If the patient a parasitemia >= 5,000 per µL and temperature < 38°C then coefficients in Column B are used.

score based on number of signs and symptoms present =

= SUM(points for all 10 terms)

score based on the sum of the rounded regression coefficients =

= SUM(ROUND(coefficients for all 10 terms to integers)

score based on the sum of the regression coefficients =

= SUM(nonrounded coefficients for all 10 terms)

Interpretation:

• minimum number of signs and symptoms: 0

• maximum number of signs and symptoms: 9 for column A and 8 for column B

• maximum score for column A with coefficients: 11.18

• maximum score for column B with coefficients: 8.26

• maximum score for column A with coefficients rounded: 12

• maximum score for column B with coefficients rounded: 9

• The child was said to have malaria if the number of signs and symptoms was >= 6 or if the sum of the rounded coefficients was >= 8.

• Looking at the data in Table 4 the cutoff for the unrounded coefficients would be >= 9.

Performance:

• The sensitivity for the selected cutoff for signs and symptoms was 89% and specificity was 61%.

• The sensitivity for the selected cutoff for signs and symptoms was 88% and specificity was 64%.