Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Cote d'Ivoire
Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Cote d'Ivoire
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DOI：
10.1371/journal.pntd.0004768
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发表时间：
2016-06-01
影响因子：
3.8
通讯作者：
Bogoch, Isaac I.
中科院分区：
文献类型：
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作者：
Coulibaly, Jean T.;Ouattara, Mamadou;Bogoch, Isaac I.
BackgroundHandheld光学显微镜使用紧凑的光学器件和移动的手机可以提高质量的医疗保健资源有限的设置，使访问迅速和准确的diagnosis.MethodologyLaboratory技术人员进行了培训，操作两个手持诊断设备（牛顿Nm 1显微镜和夹上版本的移动的手机为基础的CellScope）。这些设备的准确性进行了比较，传统的光学显微镜诊断血吸虫埃及血吸虫，S。在科特迪瓦农村地区进行的一项以社区为基础的调查中，将来自226个个体的10 ml过滤尿液的一个载玻片和单个Kato-Katz厚涂片置于Newton Nm 1显微镜和CellScope中检测血吸虫卵，并与常规显微镜进行比较。此外，121醋酸钠-醋酸-福尔马林（SAF）固定粪便样本进行了检查，牛顿Nm 1显微镜和传统的显微镜诊断肠道原虫进行了比较。haematobium，S.曼氏贾第鞭毛虫和溶组织内阿米巴/ E.通过常规显微镜测定，dispar分别为39.8%、5.3%、20.7%和4.9%。Newton Nm 1显微镜对S. mansoni和S.血吸虫感染的特异性分别为91.7%（95%置信区间（CI）59.8-99.6%）和81.1%（95% CI 71.2-88.3%），特异性分别为99.5%（95% CI 97.0-100%）和97.1%（95% CI 92.2-99.1%）。CellScope对S. mansoni和S.血吸虫的特异性分别为50.0%（95% CI 25.4-74.6%）和35.6%（95% CI 25.9-46.4%），特异性分别为99.5%（95% CI 97.0-100%）和100%（95% CI 86.7-100%）。对于嗜热脂肪地芽孢杆菌和E.溶组织菌/E. dispar，牛顿Nm 1显微镜的灵敏度分别为84.0%（95%CI 63.1-94.7%）和83.3%（95%CI 36.5-99.1%），和100% specificity.Conclusions/SignificanceHandheld诊断设备可以采用在社区为基础的调查资源有限的设置后，最低限度的培训实验室技术人员诊断肠道寄生虫。
BackgroundHandheld light microscopy using compact optics and mobile phones may improve the quality of health care in resource-constrained settings by enabling access to prompt and accurate diagnosis.MethodologyLaboratory technicians were trained to operate two handheld diagnostic devices (Newton Nm1microscope and a clip-on version of the mobile phone-based CellScope). The accuracy of these devices was compared to conventional lightmicroscopy for the diagnosis of Schistosoma haematobium, S. mansoni, and intestinal protozoa infection in a community-based survey in rural Cte d'Ivoire. One slide of 10 ml filtered urine and a single Kato-Katz thick smear from 226 individuals were subjected to the Newton Nm1 microscope and CellScope for detection of Schistosoma eggs and compared to conventional microscopy. Additionally, 121 sodium acetate-acetic acid-formalin (SAF)-fixed stool samples were examined by the Newton Nm1 microscope and compared to conventional microscopy for the diagnosis of intestinal protozoa.Principal FindingsThe prevalence of S. haematobium, S. mansoni, Giardia intestinalis, and Entamoeba histolytica/ E. dispar, as determined by conventional microscopy, was 39.8%, 5.3%, 20.7%, and 4.9%, respectively. The Newton Nm1 microscope had diagnostic sensitivities for S. mansoni and S. haematobium infection of 91.7% (95% confidence interval (CI) 59.8-99.6%) and 81.1% (95% CI 71.2-88.3%), respectively, and specificities of 99.5% (95% CI 97.0-100%) and 97.1%(95% CI 92.2-99.1%), respectively. The CellScope demonstrated sensitivities for S. mansoni and S. haematobium of 50.0%(95% CI 25.4-74.6%) and 35.6% (95% CI 25.9-46.4%), respectively, and specificities of 99.5% (95% CI 97.0-100%) and 100% (95% CI 86.7-100%), respectively. For G. intestinalis and E. histolytica/E. dispar, the Newton Nm1 microscope had sensitivity of 84.0%(95% CI 63.1-94.7%) and 83.3%(95% CI 36.5-99.1%), respectively, and 100% specificity.Conclusions/SignificanceHandheld diagnostic devices can be employed in community-based surveys in resource-constrained settings after minimal training of laboratory technicians to diagnose intestinal parasites.