Hybrid Probabilistic Forecasting of Under-Five Malaria Admissions in Ghana: A Gaussian Process Regression with Holt-Winters Smoothing

📅 2026-05-30
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Malaria forecasting in sub-Saharan Africa faces significant challenges due to strong seasonality, reporting biases, and non-stationary transmission dynamics. This study proposes a novel hybrid probabilistic forecasting framework that integrates Gaussian process regression (GPR) with Holt-Winters exponential smoothing to predict monthly malaria admissions among children under five in Ghana. The approach effectively captures nonlinear patterns while preserving seasonal structure and ensuring long-term stability, and it provides rigorous quantification of predictive uncertainty. The model achieves an R² of 0.9906, with 94.2% of residuals falling within ±2σ, and forecasts monthly admissions between 8,000 and 12,200 cases from 2024 to 2028. These results reveal stable relative patterns amid regional ecological heterogeneity, offering high-precision decision support for national malaria control programs.
📝 Abstract
Accurate malaria forecasting remains a major challenge in sub-Saharan Africa, where strong seasonality, reporting uncertainty, and non-stationary transmission dynamics reduce the reliability of conventional models. In Ghana, district-level malaria surveillance requires forecasting frameworks that are probabilistically rigorous and robust under limited data. This study proposes a hybrid framework integrating Gaussian Process Regression (GPR) with Holt-Winters exponential smoothing for modelling monthly under-five malaria admissions. GPR captures non-linear behaviour and predictive uncertainty, while Holt-Winters stabilises long-horizon forecasts and preserves seasonal structure. Using ten years of district-level data (2014-2023), performance was evaluated via rolling-origin expanding-window validation. The hybrid model achieved $R^2 = 0.9906$ versus $0.8213$ for Holt-Winters alone, with $94.2\%$ of residuals within $\pm 2σ$ bounds. Forecasts for 2024-2028 project average monthly admissions from approximately 8{,}000 to 12{,}200 cases. Spatio-temporal analysis revealed pronounced ecological heterogeneity: northern high-burden districts exhibited stable relative patterns despite large absolute fluctuations. The framework provides a scalable probabilistic approach for malaria early warning and operational planning in endemic settings, supporting Ghana's national malaria control strategy.
Problem

Research questions and friction points this paper is trying to address.

malaria forecasting
under-five admissions
probabilistic modeling
seasonality
surveillance
Innovation

Methods, ideas, or system contributions that make the work stand out.

Gaussian Process Regression
Holt-Winters Smoothing
Probabilistic Forecasting
Malaria Surveillance
Hybrid Modeling
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