Safety-Constrained Cascade Inference for Robust Malaria Cell Classification Under Field Corruptions

Abstract

Automated malaria diagnosis from thin blood-smear microscopy could meaningfully reduce the burden on under-resourced laboratories, but a model that maximises accuracy on clean laboratory images fails badly the moment an inexpensive smartphone camera introduces sensor noise. This paper introduces MalariaCascade, a two-stage inference system in which a lightweight MobileNetV2 sentinel (2,225,153 parameters) makes confident classifications at low compute cost and escalates uncertain cases to an EfficientNet-B3 expert (10,697,769 parameters) that sees only clean, standardised images regardless of how corrupted the incoming frame is. Structural isolation of the expert stage, not learned robustness, is the mechanism. The sentinel is trained under a safety-score objective that places an explicit floor on Recall(Parasitised) (>=0.95) and Recall(Uninfected) (>=0.40) before precision is optimised, ensuring the checkpoint satisfies clinical safety constraints by construction. On the NIH Malaria Cell Images Dataset (27,558 cells), the cascade reaches Accuracy=0.9736, Recall(Parasitised)=0.9570, Precision(Parasitised)=0.9912, F1=0.9738, and AUROC=0.9955 on the clean test set. Under Gaussian sensor noise at full severity, cascade Recall(Parasitised) degrades by only 2.4 pp (0.9570 to 0.9329), while the flat single-model baseline collapses by 63.0 pp (0.9584 to 0.3281). McNemar's test confirms the cascade improvement is statistically significant (chi^2=11.14, p=0.00085). An ablation isolating the structural property shows that routing clean images to the expert is responsible for a 16.8 pp Recall(Parasitised) advantage under sensor noise relative to a cascade where the expert also sees corrupted inputs.