In this work, we developed an automated system for the detection and classification of soil-transmitted helminths (STH) and Schistosoma (S.) mansoni eggs in microscopic images of fecal smears. We assembled an STH and S. mansoni dataset comprising over 3,000 field-of-view (FOV) images containing parasite eggs, extracted from more than 300 fecal smear prepared using the Kato-Katz technique. These images were acquired using Schistoscope—a cost-effective automated digital microscope. After annotating the STH and S. mansoni eggs, we employed a transfer learning approach to train an EfficientDet deep learning model, using 70% of the dataset for training, 20% for validation, and 10% for testing. The developed model successfully identified STH and S. mansoni eggs in the FOV images, achieving weighted average scores of Precision, Sensitivity, Specificity, and F-Score across four classes of helminths (A. lumbricoides, T. trichiura, hookworm, and S. mansoni). Our system highlights the potential of the Schistoscope, enhanced with artificial intelligence, for detecting STH and S. mansoni infections in remote, resource-limited settings and for supporting the monitoring and evaluation of neglected tropical disease (NTD) control programs. ... Read more

Traditionally, automated slide scanning involves capturing a rectangular grid of field-of-view (FoV) images which can be stitched together to create whole slide images, while the autofocusing algorithm captures a focal stack of images
to determine the best in-focus image. However, these methods can be timeconsuming due to the need for X-, Y- and Z-axis movements of the digital microscope while capturing multiple FoV images. In this paper, we propose a solution to minimise these redundancies by presenting an optimal procedure for automated slide scanning of circular membrane filters on a glass slide. We achieve this by following an optimal path in the sample plane, ensuring that only FoVs overlapping the filter membrane are captured. To capture the best infocus FoV image, we utilise a hill-climbing approach that tracks the peak of the mean of Gaussian gradient of the captured FoVs images along the Z-axis. We implemented this procedure to optimise the efficiency of the Schistoscope, an automated digital microscope developed to diagnose urogenital schistosomiasis by imaging Schistosoma haematobium eggs on 13 or 25 mm membrane filters. Our improved method reduces the automated slide scanning time by 63.18%and 72.52% for the respective filter sizes. This advancement greatly supportsthe practicality of the Schistoscope in large-scale schistosomiasis monitoringand evaluation programs in endemic regions. This will save time, resources andalso accelerate generation of data that is critical in achieving the targets for schistosomiasis elimination. ... Read more

Purpose: Automated diagnosis of urogenital schistosomiasis using digital microscopy images of urine slides is an essential step toward the elimination of schistosomiasis as a disease of public health concern in Sub-Saharan African countries. We create a robust image dataset of urine samples obtained from field settings and develop a two-stage diagnosis framework for urogenital schistosomiasis.

Approach: Urine samples obtained from field settings were captured using the Schistoscope device, and S. haematobium eggs present in the images were manually annotated by experts to create the SH dataset. Next, we develop a two-stage diagnosis framework, which consists of semantic segmentation of S. haematobium eggs using the DeepLabv3-MobileNetV3 deep convolutional neural network and a refined segmentation step using ellipse fitting approach to approximate the eggs with an automatically determined number of ellipses. We defined two linear inequality constraints as a function of the overlap coefficient and area of a fitted ellipses. False positive diagnosis resulting from over-segmentation was further minimized using these constraints. We evaluated the performance of our framework on 7605 images from 65 independent urine samples collected from field settings in Nigeria, by deploying our algorithm on an Edge AI system consisting of Raspberry Pi + Coral USB accelerator.

Result: The SH dataset contains 12,051 images from 103 independent urine samples and the developed urogenital schistosomiasis diagnosis framework achieved clinical sensitivity, specificity, and precision of 93.8%, 93.9%, and 93.8%, respectively, using results from an experienced microscopist as reference.

Conclusion: Our detection framework is a promising tool for the diagnosis of urogenital schistosomiasis as our results meet the World Health Organization target product profile requirements for monitoring and evaluation of schistosomiasis control programs.
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Schistosomiasis is a neglected tropical disease of Public Health importance affecting over 252 million people worldwide with Nigeria having a very high number of cases. It is caused by blood flukes of the genus Schistosoma and transmitted by freshwater snails. To achieve the current global elimination objectives, low-cost and easy-to-use diagnostic tools are critically needed. Recent innovations in optical and computer technologies have made handheld digital and smartphone-based microscopes a viable diagnostic approach. Development, validation and deployment of these diagnostic devices for field use, however, require the optimisation of its optical train for the registration of high-resolution images and the realisation of a robust system design that can be locally produced in low-income countries. Field research conducted in Nigeria with active involvement of key stakeholders in research and development (RD) led to the design of an initial prototype device for the diagnosis of urinary schistosomiasis, called Schistoscope 1.0. In this paper, we present further development of the Schistoscope 1.0 along two parallel design trajectories: A Raspberry Pi and a Smartphone-based Schistoscope. Specifically, we focused on the optimization of the optics, embodiment design and the electronics systems of the devices so as to produce a robust design with potential for local production. ... Read more

Schistosomiasis is a treatable and preventable neglected tropical disease of Public Health importance affecting over 250 million people worldwide while Nigeria is one of the high burden countries. Currently available diagnoses are cumbersome, low in sensitivity and not field-adaptable given the high skill required that are not available in the rural settings where the diseases are majorly prevalent. Democratizing access to diagnosis with a rapid, easy-to-use, accurate diagnosis is critical in currently stepped-up control, pre-elimination and elimination strategies for urinary schistosomiasis. In this paper, we describe the design process of a low-cost smartphone-based microscope for rapid diagnosis of urinary Schistosomiasis. Field research conducted in Nigeria with the active involvement of key stakeholders in the research and development (R&D) process validated our assumptions and enabled the development of our proof-of-concept into a working prototype in three iterative designs steps. Through this design process, we investigated the local development of technical optics for good quality imaging and explored the simplification of sample preparation techniques using commonly available materials. Starting from the first iteration, the output of each design step was used as the input to the subsequent iterations to optimize our system design. Insightful results and input from the field demonstrated that an adaptive design approach was needed to facilitate the rapid development and deployment of point-of-care diagnostic devices for use in low-resource settings. It is our goal that these devices will be locally manufactured in Nigeria to expand access to the test given her huge population and high disease burden, quick repairs, and easy maintenance on the field. ... Read more