# Risk stratification of malaria among school-age children with mHealth spectroscopy of blood analysis

> **NIH NIH R33** · PURDUE UNIVERSITY · 2024 · $256,048

## Abstract

PROJECT SUMMARY/ABSTRACT
Malaria is one of the most serious public health problems in sub-Saharan Africa. School-age children are most
commonly infected with malaria parasites with an estimated 200 million at risk. Malaria screening for school-
age children in endemic countries is critical in two aspects: malaria transmission and educational performance
(human capital investment). Malaria rapid diagnostic test (RDT)-based interventions have shown to be
effective, but mass screening with malaria RDTs on a routine basis is expensive and impractical. As a result,
school-age children are often excluded. In this respect, risk stratification (prescreening) for malaria RDTs can
play a critical role in the diagnosis and management of malaria. We hypothesize that a combination of blood
hemoglobin level and acute undifferentiated febrile illness assessments can risk-stratify school-age children
who will benefit from malaria RDTs and avoid unnecessary RDTs. Malaria infections in school-age children are
strongly associated with anemia. Thus, noninvasive blood hemoglobin level readings can be highly beneficial
for identifying asymptomatic (undetected) afebrile malaria infections. We will take advantage of our recently
developed mHealth method that can reliably predict blood hemoglobin levels from digital photographs of the
inner eyelid taken by a low-end smartphone. In Aim 1 (R21 phase), we will perfect an mHealth blood
hemoglobin computation algorithm applied to school-age children (6 to 15 years of age) in Rwanda. The
proposed machine learning approach will hybridize deep learning and statistical learning to accurately and
precisely measure blood hemoglobin content among school-age children using an unmodified smartphone. In
Aim 2 (R33 phase), we will develop an mHealth risk-stratification model to determine the need of malaria RDTs
among school-age children. We will investigate the added value of mHealth blood hemoglobin assessments in
identifying patients who will benefit from malaria RDTs and will need confirmatory malaria diagnosis. We will
further formulate an advanced risk-stratification model that can forecast molecular test-confirmed malaria. In
Aim 3 (R33 phase), we will implement an mHealth application integrating malaria risk stratification with the
existing electronic health record (EHR) system. We will incorporate the mHealth technology into an Android-
based EHR-integrated mobile application for community health workers (CHWs) and health facilities in our
study settings. We will also include a digital reporting platform to replace paper-based patient data collection
for CHWs and allow for automatic transmission into the currently used EHR system in our study settings. After
successful completion, we expect to improve malaria diagnosis and management among school-age children,
by empowering CHWs and health facilities with less hardware-dependent mHealth technologies. The proposed
data-driven and connected mHealth technologies can maximize the n...

## Key facts

- **NIH application ID:** 11078948
- **Project number:** 4R33TW012486-03
- **Recipient organization:** PURDUE UNIVERSITY
- **Principal Investigator:** Young L Kim
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $256,048
- **Award type:** 4N
- **Project period:** 2022-09-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11078948

## Citation

> US National Institutes of Health, RePORTER application 11078948, Risk stratification of malaria among school-age children with mHealth spectroscopy of blood analysis (4R33TW012486-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11078948. Licensed CC0.

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