03245nas a2200313   4500000000100000008004100001653003200042653002000074653001800094653001300112653005800125653001800183100001700201700001300218700001400231700001800245700001300263700001300276700001500289700001400304700001200318700001300330245013900343856008500482300001200567490000700579520233100586022001402917       2017                            d10aNeglected Tropical Diseases10aComputer vision10aGlobal health10ahelminth10amHealth for Improved Access and Equity in Health Care10aPoint-of-care1 aHolmström O1 aLinder N1 aNgasala B1 aMårtensson A1 aLinder E1 aLundin M1 aMoilanen H1 aSuutala A1 aDiwan V1 aLundin J00aPoint-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium.  uhttp://www.tandfonline.com/doi/pdf/10.1080/16549716.2017.1337325?needAccess=true  a13373250 v103 a<p><strong>BACKGROUND: </strong>Microscopy remains the gold standard in the diagnosis of neglected tropical diseases. As resource limited, rural areas often lack laboratory equipment and trained personnel, new diagnostic techniques are needed. Low-cost, point-of-care imaging devices show potential in the diagnosis of these diseases. Novel, digital image analysis algorithms can be utilized to automate sample analysis.</p>

<p><strong>OBJECTIVE: </strong>Evaluation of the imaging performance of a miniature digital microscopy scanner for the diagnosis of soil-transmitted helminths and Schistosoma haematobium, and training of a deep learning-based image analysis algorithm for automated detection of soil-transmitted helminths in the captured images.</p>

<p><strong>METHODS: </strong>A total of 13 iodine-stained stool samples containing Ascaris lumbricoides, Trichuris trichiura and hookworm eggs and 4 urine samples containing Schistosoma haematobium were digitized using a reference whole slide-scanner and the mobile microscopy scanner. Parasites in the images were identified by visual examination and by analysis with a deep learning-based image analysis algorithm in the stool samples. Results were compared between the digital and visual analysis of the images showing helminth eggs.</p>

<p><strong>RESULTS: </strong>Parasite identification by visual analysis of digital slides captured with the mobile microscope was feasible for all analyzed parasites. Although the spatial resolution of the reference slide-scanner is higher, the resolution of the mobile microscope is sufficient for reliable identification and classification of all parasites studied. Digital image analysis of stool sample images captured with the mobile microscope showed high sensitivity for detection of all helminths studied (range of sensitivity&nbsp;=&nbsp;83.3-100%) in the test set (n&nbsp;=&nbsp;217) of manually labeled helminth eggs.</p>

<p><strong>CONCLUSIONS: </strong>In this proof-of-concept study, the imaging performance of a mobile, digital microscope was sufficient for visual detection of soil-transmitted helminths and Schistosoma haematobium. Furthermore, we show that deep learning-based image analysis can be utilized for the automated detection and classification of helminths in the captured images.</p>
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