Analytical Study of Ultrasound Diagnostic Accuracy for Hepatosplenic Manifestations of Malaria at Teaching Hospitals in North Central Nigeria

Malaria is hyperendemic in North Central Nigeria, and its hepatosplenic manifestations, including splenomegaly, hepatomegaly, and perisplenic fluid, are important sonographic findings that require systematic evaluation of diagnostic accuracy relative to clinical and laboratory reference standards. This study analytically evaluates the accuracy of ultrasound in diagnosing hepatosplenic manifestations of malaria at teaching hospitals in Plateau, Kogi, and Kwara States. A prospective correlative design is applied to 300 malaria-confirmed adult patients presenting to the medical wards and outpatient clinics of three teaching hospitals. Abdominal ultrasound is performed by qualified radiographers following a standardised hepatosplenic assessment protocol, with findings compared against clinical examination by a consultant physician and laboratory malaria confirmation as the composite reference standard. Sensitivity, specificity, and area under the ROC curve for each hepatosplenic finding are computed in SPSS. Available malaria imaging literature from North Central Nigeria identifies splenomegaly detection as highly sensitive (>90%) but non-specific, while perisplenic fluid is a highly specific but low-sensitivity marker of severe disease. The WHO Malaria Severity Criteria and ACR abdominal ultrasound guidelines provide the clinical analytical reference. Findings are expected to characterise the diagnostic accuracy profile of each hepatosplenic finding and identify the combination of sonographic features with the highest diagnostic utility for malaria severity staging. Recommendations address standardised hepatosplenic malaria ultrasound protocols and reporting criteria at North Central teaching hospitals. Keywords: ultrasound, malaria, hepatosplenic manifestations, diagnostic accuracy, North Central Nigeria.