The malaria system microApp: A new, mobile device-based tool for malaria diagnosis

Background: Malaria is a public health problem that affects remote areas worldwide. Climate change has contributed to the problem by allowing for the survival of Anopheles in previously uninhabited areas. As such, several groups have made developing news systems for the automated diagnosis of malaria a priority. Objective: The objective of this study was to develop a new, automated, mobile device-based diagnostic system for malaria. The system uses Giemsa-stained peripheral blood samples combined with light microscopy to identify the Plasmodium falciparum species in the ring stage of development. Methods: The system uses image processing and artificial intelligence techniques as well as a known face detection algorithm to identify Plasmodium parasites. The algorithm is based on integral image and haar-like features concepts, and makes use of weak classifiers with adaptive boosting learning. The search scope of the learning algorithm is reduced in the preprocessing step by removing the background around blood cells. Results: As a proof of concept experiment, the tool was used on 555 malaria-positive and 777 malaria-negative previously-made slides. The accuracy of the system was, on average, 91%, meaning that for every 100 parasite-infected samples, 91 were identified correctly. Conclusions: Accessibility barriers of low-resource countries can be addressed with low-cost diagnostic tools. Our system, developed for mobile devices (mobile phones and tablets), addresses this by enabling access to health centers in remote communities, and importantly, not depending on extensive malaria expertise or expensive diagnostic detection equipment.Peer ReviewedPostprint (published version

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

Immunochromatographic diagnostic test analysis using Google Glass.

We demonstrate a Google Glass-based rapid diagnostic test (RDT) reader platform capable of qualitative and quantitative measurements of various lateral flow immunochromatographic assays and similar biomedical diagnostics tests. Using a custom-written Glass application and without any external hardware attachments, one or more RDTs labeled with Quick Response (QR) code identifiers are simultaneously imaged using the built-in camera of the Google Glass that is based on a hands-free and voice-controlled interface and digitally transmitted to a server for digital processing. The acquired JPEG images are automatically processed to locate all the RDTs and, for each RDT, to produce a quantitative diagnostic result, which is returned to the Google Glass (i.e., the user) and also stored on a central server along with the RDT image, QR code, and other related information (e.g., demographic data). The same server also provides a dynamic spatiotemporal map and real-time statistics for uploaded RDT results accessible through Internet browsers. We tested this Google Glass-based diagnostic platform using qualitative (i.e., yes/no) human immunodeficiency virus (HIV) and quantitative prostate-specific antigen (PSA) tests. For the quantitative RDTs, we measured activated tests at various concentrations ranging from 0 to 200 ng/mL for free and total PSA. This wearable RDT reader platform running on Google Glass combines a hands-free sensing and image capture interface with powerful servers running our custom image processing codes, and it can be quite useful for real-time spatiotemporal tracking of various diseases and personal medical conditions, providing a valuable tool for epidemiology and mobile health

Mobile Phone Based Clinical Microscopy for Global Health Applications

Light microscopy provides a simple, cost-effective, and vital method for the diagnosis and screening of hematologic and infectious diseases. In many regions of the world, however, the required equipment is either unavailable or insufficiently portable, and operators may not possess adequate training to make full use of the images obtained. Counterintuitively, these same regions are often well served by mobile phone networks, suggesting the possibility of leveraging portable, camera-enabled mobile phones for diagnostic imaging and telemedicine. Toward this end we have built a mobile phone-mounted light microscope and demonstrated its potential for clinical use by imaging P. falciparum-infected and sickle red blood cells in brightfield and M. tuberculosis-infected sputum samples in fluorescence with LED excitation. In all cases resolution exceeded that necessary to detect blood cell and microorganism morphology, and with the tuberculosis samples we took further advantage of the digitized images to demonstrate automated bacillus counting via image analysis software. We expect such a telemedicine system for global healthcare via mobile phone – offering inexpensive brightfield and fluorescence microscopy integrated with automated image analysis – to provide an important tool for disease diagnosis and screening, particularly in the developing world and rural areas where laboratory facilities are scarce but mobile phone infrastructure is extensive

Mobile Hardware Based Implementation of a Novel, Efficient, Fuzzy Logic Inspired Edge Detection Technique for Analysis of Malaria Infected Microscopic Thin Blood Images

This paper proposes a novel, efficient, low complexity algorithm for edge detection, with a cheap, easily accessible, networkable hardware implementation, specifically focused on the analysis of malaria infected thin blood smears. The algorithm presents a new and dynamic thresholding technique that eliminates inter-cell interference based on histogram analysis. Following this, binary image morphological processing is performed which is shown to outperform the same operation on the much more complex greyscale images. Edge tracking is done via a simplified fuzzy logic inspired rule system. The entire system is implemented on multiple platforms to test widespread compatibility but primarily developed for a battery powered standalone raspberry pi with low power, low resolution touchscreen and hardware buttons. The entire algorithm was pitted against the much more complex but still very well performing Canny algorithm, which despite the age, is still one of the most comprehensive edge detection techniques available; modern variants were considered and reviewed, but ultimately given the level of outperformance, they were not viable options

Hardware implementation of Modified Annular Ring Ratio for Blood Cell Detection in Thin Blood Smear Images

Malaria continues to spread in endemic areas. This deadly disease is the subject of multiple researches in terms of patient diagnoses. Post treatment diagnoses are necessary to make sure that patients treated for malaria continue to be free from Plasmodium protozoan parasites. Fast and automated analyses are possible with image processing of blood cell samples. This paper proposes a modified version of an image processing algorithm named Annular Ring Ratio, which identifies and locates the blood cell present in the thin blood smear images, to make the algorithm amenable to efficient hardware implementation through the elimination of the costly division process. The Annular Ring Ratio process identifies circular shapes through the calculation of a ratio between two circular areas. With proper configuration it can detect cell and parasite positions leading to the identification of infected cells and further estimate the level of infections

On the performance of lightweight convolutional neural networks for malaria detection

Dissertation presented as the partial requirement for obtaining a Master's degree in Data Science and Advanced Analytics, specialization in Data ScienceMalaria is still a threat to millions of people. Despite the extreme importance of an early diagnosis for proper treatment in places where the disease is endemic, there is a significant disparity in terms of access to healthcare. The most widely used technique to identify malaria parasites is microscopy with Giemsa-stained blood slides. Notwithstanding its effectiveness, there are challenges in bringing it to remote places where electricity is needed, and there is a lack of skilled personnel to read the results accurately. This process can be accelerated via deep learning, as shown by extensive literature about the topic. However, many of these works are focused on performance alone, while the models are large and cannot be deployed to real-world applications. This work shows that pre-trained lightweight models such as MobileNet, MobileNetV2, NASNetMobile, and EfficientNetB0, which all were created to perform on smaller devices, can still maintain an outstanding performance despite their smaller size and having fewer parameters. Furthermore, as many weights in a network have been proven to not contribute to the result, pruning is applied on MobileNet. It is shown that the initial accuracy of 99.5% is kept as the size drastically decreases from the initial 18 MB to 5MB

The application of biomedical engineering techniques to the diagnosis and management of tropical diseases: A review

This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas). Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications

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