Bayesian Inference of Nonlinear Malaria Dynamics in Ghana via an Ensemble Markov Chain Monte Carlo Sampler

Reliable quantification of malaria dynamics in sub-Saharan Africa is hindered by short, noisy, and spatially heterogeneous surveillance records. In Ghana, health-facility data from 2014 to 2023 reveal non-linear and age-specific fluctuations in hospital admissions, yet existing approaches struggle to capture stochastic variability or provide credible uncertainty bounds. This study develops a Bayesian nonlinear inference framework that integrates a cubic baseline with a damped oscillatory kernel, estimated via an affine-invariant ensemble Markov Chain Monte Carlo sampler. The framework accommodates limited data, models parameter uncertainty, and generates probabilistic forecasts for children under five years and individuals aged five years or more. Results show strong empirical adequacy ($R^2 = 0.9958$ for $<5$ years; $R^2 = 0.9956$ for $\geq 5$ years) with residual errors below $2\%$ and well-mixed posteriors confirming convergence. District-level analysis reveals pronounced spatial heterogeneity, with coefficients of variation ranging from $<0.07$ in urban centres such as Kumasi to $>3.3$ in peripheral districts such as Mpohor and Bia East. Forecasts for 2024-2026 indicate a gradual resurgence: from 137,000 to 149,000 cases among children under five years and from 348,000 to 375,000 cases among older individuals, with uncertainty widening over time. By producing probabilistic forecasts, this Bayesian framework provides a principled tool for anticipating malaria fluctuations and strengthening data-driven decision-making in Ghana's national malaria control strategy.

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

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.