A mathematical framework for combining decisions of multiple experts toward accurate and remote diagnosis of malaria using tele-microscopy.

We propose a methodology for digitally fusing diagnostic decisions made by multiple medical experts in order to improve accuracy of diagnosis. Toward this goal, we report an experimental study involving nine experts, where each one was given more than 8,000 digital microscopic images of individual human red blood cells and asked to identify malaria infected cells. The results of this experiment reveal that even highly trained medical experts are not always self-consistent in their diagnostic decisions and that there exists a fair level of disagreement among experts, even for binary decisions (i.e., infected vs. uninfected). To tackle this general medical diagnosis problem, we propose a probabilistic algorithm to fuse the decisions made by trained medical experts to robustly achieve higher levels of accuracy when compared to individual experts making such decisions. By modelling the decisions of experts as a three component mixture model and solving for the underlying parameters using the Expectation Maximisation algorithm, we demonstrate the efficacy of our approach which significantly improves the overall diagnostic accuracy of malaria infected cells. Additionally, we present a mathematical framework for performing 'slide-level' diagnosis by using individual 'cell-level' diagnosis data, shedding more light on the statistical rules that should govern the routine practice in examination of e.g., thin blood smear samples. This framework could be generalized for various other tele-pathology needs, and can be used by trained experts within an efficient tele-medicine platform

Automated Low-Cost Malaria Detection System in Thin Blood Slide Images Using Mobile Phones

Malaria, a deadly disease which according to the World Health Organisation (WHO) is responsible for the fatal illness in 200 million people around the world in 2010, is diagnosed using peripheral blood examination. The work undertaken in this research programme aims to develop an automated malaria parasite-detection system, using microscopic-image processing, that can be incorporated onto mobile phones. In this research study, the main objective is to achieve the performance equal to or better than the manual microscopy, which is the gold standard in malaria diagnosis, in order to produce a reliable automated diagnostic platform without expert intervention, for the effective treatment and eradication of the deadly disease. The work contributed to the field of mathematical morphology by proposing a novel method called the Annular Ring Ratio transform for blood component identification. It has also proposed an automated White Blood Cell and Red Blood Cell differentiation algorithm, which when combined with ARR transform method, has wide applications not only for malaria diagnosis but also for many blood related analysis involving microscopic examination. The research has undertaken investigations on infected cell identification which aids in the calculation of parasitemia, the measure of infection. In addition, an automated diagnostic tool to detect the sexual stage (gametocytes) of the species P.falciparum for post-treatment malaria diagnosis was developed. Furthermore, a parallel investigation was carried out on automated malaria diagnosis on fluorescent thin blood films and a WBC and infected cell differentiation algorithm was proposed. Finally, a mobile phone application based on the morphological image processing algorithms proposed in this thesis was developed. A complete malaria diagnostic unit using the mobile phones attached to a portable microscope was set up which has enormous potential not only for malaria diagnosis but also for the blood parasitological field where advancement in medical diagnostics using cellular smart phone technology is widely acknowledged

A novel deep learning-based point-of-care diagnostic method for detecting Plasmodium falciparum with fluorescence digital microscopy

Background Malaria remains a major global health problem with a need for improved field-usable diagnostic tests. We have developed a portable, low-cost digital microscope scanner, capable of both brightfield and fluorescence imaging. Here, we used the instrument to digitize blood smears, and applied deep learning (DL) algorithms to detect Plasmodium falciparum parasites. Methods Thin blood smears (n = 125) were collected from patients with microscopy-confirmed P. falciparum infections in rural Tanzania, prior to and after initiation of artemisinin-based combination therapy. The samples were stained using the 4′,6-diamidino-2-phenylindole fluorogen and digitized using the prototype microscope scanner. Two DL algorithms were trained to detect malaria parasites in the samples, and results compared to the visual assessment of both the digitized samples, and the Giemsa-stained thick smears. Results Detection of P. falciparum parasites in the digitized thin blood smears was possible both by visual assessment and by DL-based analysis with a strong correlation in results (r = 0.99, p <0.01). A moderately strong correlation was observed between the DL-based thin smear analysis and the visual thick smear-analysis (r = 0.74, p <0.01). Low levels of parasites were detected by DL-based analysis on day three following treatment initiation, but a small number of fluorescent signals were detected also in microscopy-negative samples. Conclusion Quantification of P. falciparum parasites in DAPI-stained thin smears is feasible using DL-supported, point-of-care digital microscopy, with a high correlation to visual assessment of samples. Fluorescent signals from artefacts in samples with low infection levels represented the main challenge for the digital analysis, thus highlighting the importance of minimizing sample contaminations. The proposed method could support malaria diagnostics and monitoring of treatment response through automated quantification of parasitaemia and is likely to be applicable also for diagnostics of other Plasmodium species and other infectious diseases.Peer reviewe

Plasmodium life cycle stage classification based quantification of malaria parasitaemia in thin blood smears.

Visual inspection for the quantification of malaria parasitaemiain (MP) and classification of life cycle stage are hard and time taking. Even though, automated techniques for the quantification of MP and their classification are reported in the literature. However, either reported techniques are imperfect or cannot deal with special issues such as anemia and hemoglobinopathies due to clumps of red blood cells (RBCs). The focus of the current work is to examine the thin blood smear microscopic images stained with Giemsa by digital image processing techniques, grading MP on independent factors (RBCs morphology) and classification of its life cycle stage. For the classification of the life cycle of malaria parasite the k-nearest neighbor, Naïve Bayes and multi-class support vector machine are employed for classification based on histograms of oriented gradients and local binary pattern features. The proposed methodology is based on inductive technique, segment malaria parasites through the adaptive machine learning techniques. The quantification accuracy of RBCs is enhanced; RBCs clumps are split by analysis of concavity regions for focal points. Further, classification of infected and non-infected RBCs has been made to grade MP precisely. The training and testing of the proposed approach on benchmark dataset with respect to ground truth data, yield 96.75% MP sensitivity and 94.59% specificity. Additionally, the proposed approach addresses the process with independent factors (RBCs morphology). Finally, it is an economical solution for MP grading in immense testing

Malaria Parasitic Detection using a New Deep Boosted and Ensemble Learning Framework

Malaria is a potentially fatal plasmodium parasite injected by female anopheles mosquitoes that infect red blood cells and millions worldwide yearly. However, specialists' manual screening in clinical practice is laborious and prone to error. Therefore, a novel Deep Boosted and Ensemble Learning (DBEL) framework, comprising the stacking of new Boosted-BR-STM convolutional neural networks (CNN) and the ensemble ML classifiers, is developed to screen malaria parasite images. The proposed Boosted-BR-STM is based on a new dilated-convolutional block-based split transform merge (STM) and feature-map Squeezing-Boosting (SB) ideas. Moreover, the new STM block uses regional and boundary operations to learn the malaria parasite's homogeneity, heterogeneity, and boundary with patterns. Furthermore, the diverse boosted channels are attained by employing Transfer Learning-based new feature-map SB in STM blocks at the abstract, medium, and conclusion levels to learn minute intensity and texture variation of the parasitic pattern. The proposed DBEL framework implicates the stacking of prominent and diverse boosted channels and provides the generated discriminative features of the developed Boosted-BR-STM to the ensemble of ML classifiers. The proposed framework improves the discrimination ability and generalization of ensemble learning. Moreover, the deep feature spaces of the developed Boosted-BR-STM and customized CNNs are fed into ML classifiers for comparative analysis. The proposed DBEL framework outperforms the existing techniques on the NIH malaria dataset that are enhanced using discrete wavelet transform to enrich feature space. The proposed DBEL framework achieved Accuracy (98.50%), Sensitivity (0.9920), F-score (0.9850), and AUC (0.997), which suggest it to be utilized for malaria parasite screening.Comment: 26 pages, 10 figures, 9 Table

A Systematic Review on Automatic Detection of Plasmodium Parasite

Plasmodium parasite is the main cause of malaria which has taken many lives. Some research works have been conducted to detect the Plasmodium parasite automatically. This research aims to identify the development of current research in the area of Plasmodium parasite detection. The research uses a systematic literature review (SLR) approach comprising three stages, namely planning, conducting, and reporting. The search process is based on the keywords which were determined in advance. The selection process involves the inclusion and exclusion criteria. The search yields 45 literatures from five different digital libraries. The identification process finds out that 28 methods are applied and mainly categorizes as machine learning algorithms with performance achievements between 60% and 95%. Overall, the research of Plasmodium parasite detection today has focused on the development with artificial intelligence specifically related to machine and deep learning. These approaches are believed as the most effective approach to detect Plasmodium parasites

Advances and challenges in automated malaria diagnosis using digital microscopy imaging with artificial intelligence tools: A review

Malaria is an infectious disease caused by parasites of the genus Plasmodium spp. It is transmitted to humans by the bite of an infected female Anopheles mosquito. It is the most common disease in resource-poor settings, with 241 illion malaria cases reported in 2020 according to the World Health Organization. Optical microscopy examination of blood smears is the gold standard technique for malaria diagnosis; however, it is a time-consuming method and a well-trained microscopist is needed to perform the microbiological diagnosis. New techniques based on digital imaging analysis by deep learning and artificial intelligence methods are a challenging alternative tool for the diagnosis of infectious diseases. In particular, systems based on Convolutional Neural Networks for image detection of the malaria parasites emulate the microscopy visualization of an expert. Microscope automation provides a fast and low-cost diagnosis, requiring less supervision. Smartphones are a suitable option for microscopic diagnosis, allowing image capture and software identification of parasites. In addition, image analysis techniques could be a fast and optimal solution for the diagnosis of malaria, tuberculosis, or Neglected Tropical Diseases in endemic areas with low resources. The implementation of automated diagnosis by using smartphone applications and new digital imaging technologies in low-income areas is a challenge to achieve. Moreover, automating the movement of the microscope slide and image autofocusing of the samples by hardware implementation would systemize the procedure. These new diagnostic tools would join the global effort to fight against pandemic malaria and other infectious and poverty-related diseases.The project is funded by the Microbiology Department of Vall d’Hebron Universitary Hospital, the Cooperation Centre of the Universitat Politècnica de Catalunya (CCD-UPC) and the Probitas FoundationPostprint (published version

Advances and challenges in automated malaria diagnosis using digital microscopy imaging with artificial intelligence tools : A review

Malaria is an infectious disease caused by parasites of the genus Plasmodium spp. It is transmitted to humans by the bite of an infected female Anopheles mosquito. It is the most common disease in resource-poor settings, with 241 million malaria cases reported in 2020 according to the World Health Organization. Optical microscopy examination of blood smears is the gold standard technique for malaria diagnosis; however, it is a time-consuming method and a well-trained microscopist is needed to perform the microbiological diagnosis. New techniques based on digital imaging analysis by deep learning and artificial intelligence methods are a challenging alternative tool for the diagnosis of infectious diseases. In particular, systems based on Convolutional Neural Networks for image detection of the malaria parasites emulate the microscopy visualization of an expert. Microscope automation provides a fast and low-cost diagnosis, requiring less supervision. Smartphones are a suitable option for microscopic diagnosis, allowing image capture and software identification of parasites. In addition, image analysis techniques could be a fast and optimal solution for the diagnosis of malaria, tuberculosis, or Neglected Tropical Diseases in endemic areas with low resources. The implementation of automated diagnosis by using smartphone applications and new digital imaging technologies in low-income areas is a challenge to achieve. Moreover, automating the movement of the microscope slide and image autofocusing of the samples by hardware implementation would systemize the procedure. These new diagnostic tools would join the global effort to fight against pandemic malaria and other infectious and poverty-related diseases

Advances and challenges in automated malaria diagnosis using digital microscopy imaging with artificial intelligence tools: A review

Deep learning; Malaria diagnosis; Microscopic examinationAprenentatge profund; Diagnòstic de malària; Examen microscòpicAprendizaje profundo; Diagnóstico de malaria; Examen microscópicoMalaria is an infectious disease caused by parasites of the genus Plasmodium spp. It is transmitted to humans by the bite of an infected female Anopheles mosquito. It is the most common disease in resource-poor settings, with 241 million malaria cases reported in 2020 according to the World Health Organization. Optical microscopy examination of blood smears is the gold standard technique for malaria diagnosis; however, it is a time-consuming method and a well-trained microscopist is needed to perform the microbiological diagnosis. New techniques based on digital imaging analysis by deep learning and artificial intelligence methods are a challenging alternative tool for the diagnosis of infectious diseases. In particular, systems based on Convolutional Neural Networks for image detection of the malaria parasites emulate the microscopy visualization of an expert. Microscope automation provides a fast and low-cost diagnosis, requiring less supervision. Smartphones are a suitable option for microscopic diagnosis, allowing image capture and software identification of parasites. In addition, image analysis techniques could be a fast and optimal solution for the diagnosis of malaria, tuberculosis, or Neglected Tropical Diseases in endemic areas with low resources. The implementation of automated diagnosis by using smartphone applications and new digital imaging technologies in low-income areas is a challenge to achieve. Moreover, automating the movement of the microscope slide and image autofocusing of the samples by hardware implementation would systemize the procedure. These new diagnostic tools would join the global effort to fight against pandemic malaria and other infectious and poverty-related diseases.The project is funded by the Microbiology Department of Vall d’Hebron Universitary Hospital, the Cooperation Centre of the Universitat Politècnica de Catalunya (CCD-UPC) and the Probitas Foundation