Table 2.
Diagnostic characteristics of clinical findings for PCR-confirmed P. falciparum infection
| Children < 15 years old (n = 98) | Adults ≥ 15 years old (n = 400) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | Sensitivity | Specificity | Positive LR | Negative LR | n | Sensitivity | Specificity | Positive LR | Negative LR | |
| Epidemiological history | ||||||||||
| Sex | 98 | |||||||||
| Female | .560 | .479 | 1.08 | .92 | 400 | .404 | .443 | .73 | 1.34 | |
| District of residence | 94 | 385 | ||||||||
| Douala I | .213 | .574 | .50 | 1.37 | .168 | .685 | .53 | 1.21 | ||
| Douala II | .191 | .915 | 2.25 | .88 | .130 | .913 | .91 | .95 | ||
| Douala III | .383 | .766 | 1.64 | .81 | .298 | .697 | .98 | 1.01 | ||
| Douala IV | .021 | .957 | .50 | 1.02 | .038 | .925 | .51 | 1.04 | ||
| Douala V | .128 | .809 | .68 | 1.08 | .252 | .815 | 1.36 | .92 | ||
| Douala VI | .043 | 1.000 | 1.00 | .96 | .031 | .988 | 2.59 | .98 | ||
| Outside Douala | .021 | .979 | 1.00 | .084 | .976 | 3.56 | .94 | |||
| Travel | 98 | 397 | ||||||||
| Anywhere | .160 | .792 | .77 | 1.06 | .343 | .707 | 1.17 | .93 | ||
| Northern Regions | .040 | 1.000 | *** | .96 | .030 | .992 | 3.93 | .98 | ||
| Medication use | 398 | |||||||||
| Antipyretic | 98 | .580 | .667 | 1.74 | .63 | .415 | .620 | 1.09 | .94 | |
| Antimalarial | 98 | .280 | .854 | 1.92 | .84 | .193 | .852 | 1.30 | .95 | |
| Traditional remedy | 97 | .061 | .917 | .74 | 1.02 | .156 | .919 | 1.91 | .92 | |
| Clinical history | ||||||||||
| Fever at presentation | 90 | 393 | ||||||||
| ≥ 37.5 °C | .787 | .326 | 1.17 | .65 | .641 | .355 | .99 | 1.01 | ||
| ≥ 40.0 °C | .149 | .953 | 3.20 | .89 | .053 | .989 | 4.67 | .96 | ||
| Fatigue | 98 | 400 | ||||||||
| Any severity | .940 | .125 | 1.07 | .48 | .926 | .072 | 1.00 | 1.02 | ||
| Moderate-Severe | .740 | .479 | 1.42 | .54 | .610 | .538 | 1.32 | .72 | ||
| Headache | 90 | 399 | ||||||||
| Any severity | .812 | .217 | 1.04 | .86 | .837 | .186 | 1.03 | .88 | ||
| Moderate-Severe | .489 | .867 | 3.67 | .59 | .452 | .712 | 1.57 | .77 | ||
| Myalgias/Arthralgias | 96 | 399 | ||||||||
| Any severity | .540 | .652 | 1.55 | .71 | .800 | .231 | 1.04 | .87 | ||
| Moderate-Severe | .240 | .891 | 2.21 | .85 | .526 | .610 | 1.35 | .78 | ||
| Anorexia | 98 | 398 | ||||||||
| Any severity | .840 | .417 | 1.44 | .38 | .662 | .424 | 1.15 | .80 | ||
| Moderate-Severe | .600 | .688 | 1.92 | .58 | .360 | .802 | 1.82 | .80 | ||
| Chills | 98 | 398 | ||||||||
| Any severity | .660 | .525 | 1.76 | .54 | .596 | .496 | 1.18 | .82 | ||
| Moderate-Severe | .400 | .833 | 2.40 | .72 | .375 | .798 | 1.86 | .78 | ||
| Abdominal pain | 95 | 397 | ||||||||
| Any severity | .633 | .478 | 1.21 | .77 | .511 | .706 | 1.74 | .69 | ||
| Moderate-Severe | .408 | .848 | 2.68 | .70 | .259 | .878 | 2.12 | .84 | ||
| Dizzy/Lightheaded | 94 | 399 | ||||||||
| Any severity | .479 | .783 | 2.20 | .67 | .422 | .674 | 1.30 | .86 | ||
| Moderate-Severe | .354 | .870 | 2.72 | .74 | .178 | .848 | 1.17 | .97 | ||
| Nausea | 94 | 396 | ||||||||
| Any severity | .490 | .733 | 1.84 | .70 | .368 | .781 | 1.68 | .81 | ||
| Moderate-Severe | .449 | .911 | 5.05 | .60 | .206 | .889 | 1.86 | .89 | ||
| Constipation | 96 | 398 | ||||||||
| Any severity | .306 | .830 | 1.80 | .84 | .200 | .741 | .774 | 1.08 | ||
| Moderate-Severe | .143 | .894 | 1.34 | .96 | .104 | .909 | 1.14 | .99 | ||
| Emesis | 88 | |||||||||
| Any frequency | .386 | .818 | 2.13 | .75 | 381 | .161 | .922 | 2.07 | .91 | |
| ≥ 2 times/day | .250 | .977 | 11.00 | .77 | .089 | .996 | 22.80 | .91 | ||
| Dyspnea | 95 | 398 | ||||||||
| Any severity | .125 | .936 | 1.96 | .93 | .215 | .886 | 1.88 | .89 | ||
| Moderate-Severe | .104 | .957 | 2.45 | .94 | .111 | .935 | 1.70 | .95 | ||
| Diarrhoea | 96 | 385 | ||||||||
| Any frequency | .104 | .958 | 2.50 | .93 | .055 | .969 | 1.76 | .98 | ||
| ≥ 2 times/day | .042 | 1.000 | *** (2) | .96 | .023 | .098 | 1.51 | .99 | ||
| Bleeding/Haemorrhage | 97 | 393 | ||||||||
| Any severity | .061 | .958 | 1.47 | .98 | .038 | .98 | 1.61 | .99 | ||
| Moderate-Severe | .020 | 1.000 | *** (1) | .98 | .000 | .992 | 1.96 | .99 | ||
| Cutaneous eruptions | 97 | 399 | ||||||||
| Any severity | .000 | .915 | .000 | 1.09 | .044 | .981 | 2.35 | .97 | ||
| Moderate-Severe | .000 | .957 | .000 | 1.04 | .015 | .992 | 1.96 | .99 | ||
| Point of care testing | ||||||||||
| RDT | 98 | 397 | ||||||||
| Any positive | .800 | .958 | 19.20 | 0.21 | .585 | .981 | 30.66 | .42 | ||
| HRP-2 positive | .360 | .979 | 17.28 | 0.65 | .274 | .981 | 14.36 | .74 | ||
| Both HRP-2/LDH positive | .440 | .979 | 21.12 | 0.57 | .296 | 1.00 | *** (40) | .70 | ||
| Anaemia | 98 | 399 | ||||||||
| Any severity | .700 | .646 | 1.98 | .56 | .338 | .654 | .98 | 1.01 | ||
| Moderate-Severe | .540 | .833 | 3.24 | .55 | .169 | .814 | .91 | 1.02 | ||
| Severe | .180 | .958 | 4.32 | .86 | .029 | .958 | .70 | 1.01 | ||
LR: likelihood ratio. Clinically significant likelihood ratios bolded
***Indicated LR could not be calculated as all the patients (number listed in parentheses) with the symptom/sign were found to be P. falciparum positive
Northern regions include Adamaoua, North, and Far-North