Automated Image-Diagnosis for Female Genital Schistosomiasis

背景和潜在影响就公共卫生负担和经济增长而言，血吸虫病是第二大破坏性热带疾病。全世界有2.4亿多人患有血吸虫病。自2007年以来，默克公司一直在其合作伙伴世界卫生组织的默克血吸虫病消除计划范围内与这一被忽视的热带病作斗争，并每年捐赠多达2.5亿片吡喹酮片用于治疗。默克公司和世卫组织承诺将继续开展防治该疾病的工作，直至将其消灭。女性生殖器血吸虫病（FGS）是由于农村社区，特别是妇女和女孩在日常家务和活动中接触受污染的淡水水体而未经治疗感染血血吸虫而获得的。FGS影响了5600万非洲妇女和女孩。FGS可逐渐演变为生殖器官损害，其特征为生育能力低下或不孕症、异位妊娠、自然流产、早产、出生体重低和孕产妇死亡。此外，FGS增加了对HIV和HPV感染以及子宫颈癌的易感性，这一担忧和生物学上的合理性是存在的。尽管如此，FGS仍然在很大程度上被低估、误诊和未经治疗。FGS的特点是病变的模式，表现在子宫颈和阴道，如均匀和颗粒状的沙质斑块。目前，消除FGS的一个关键挑战是没有适合流行环境的金标准诊断。实验室诊断目前不足，卫生保健专业人员的低怀疑指数可能导致性传播感染的误诊。自动影像诊断系统可以通过为当地医疗保健专业人员提供低成本的即时诊断帮助，改善FGS的治疗和研究项目。这将有助于诊断FGS，改善患者的治疗效果，并有助于提高认识和治疗方案更好地针对高危社区。该博士研究项目旨在为FGS建立一个开源、自动化、基于图像的数字化护理点诊断系统，以便在资源贫乏的环境中运行。随后，该工具可与默克的临床合作伙伴在全球卫生环境中进行试验。目标将包括设计和实现在超低功耗环境中使用的轻量级网络架构，评估数据增强方法以丰富有限的临床数据集，研究模型可解释性和诊断报告的最佳实践，以建立与临床医生和最终用户的信任。通过这一研究项目和创建一个记录良好的开源工具，第二个目标将是使类似的解决方案能够在其他资源有限的全球卫生应用中重现。该项目属于EPSRC医学成像研究领域，是更广泛的医疗技术组合的一部分，并以早期诊断研究为优先目标。该项目是与默克公司合作的。

Context and Potential Impact Schistosomiasis is the second most devastating tropical disease in terms of public health burden and economic growth. More than 240 million people worldwide suffer from schistosomiasis. Merck has been fighting against this Neglected Tropical Disease with its partner, the World Health Organization, since 2007 in the scope of its Merck Schistosomiasis Elimination Program and donates up to 250 million praziquantel tablets for treatment per year. Merck and WHO committed themselves to continue their work in fighting the disease until its elimination. Female Genital Schistosomiasis (FGS) is acquired from untreated infection with Schistosoma haematobium, which results from contact with contaminated freshwater bodies used by rural communities, specifically by women and girls, for daily chores and activities. FGS affects 56 million African women and girls. FGS can gradually evolve towards reproductive organ damage characterized by sub-fertility or infertility, ectopic pregnancy, spontaneous abortion, premature birth, low birth weight and maternal death. Additionally, there is concern and biological plausibility that FGS increases susceptibility to HIV and HPV infection, and cervical cancer. Nevertheless, FGS remains largely underreported, under- and misdiagnosed and untreated. FGS is characterized by a pattern of lesions that manifest at the cervix and the vagina, such as homogeneous and grainy sandy patches. At present, a key challenge in eliminating FGS is that there is no gold-standard diagnostic suitable for endemic settings. Laboratory diagnostics are currently inadequate and a low index of suspicion among healthcare professionals can lead to misdiagnosis of sexually transmitted infections. An automated image diagnostic system could improve FGS treatment and research programs by providing a low-cost, point-of-care diagnostic aid for local healthcare professionals. This would help diagnose FGS, leading to better patient outcomes, and help awareness and treatment programs to better target at-risk communities. Aims and Objectives The doctoral research project aims to build an open-source, automated, image-based, digital point-of-care diagnostic system for FGS to operate in resource-poor settings. This tool could subsequently be trialed in a global health setting with Merck's clinical partners. Objectives will include designing and implementing a lightweight network architecture for use in an ultra-low powered environment, evaluating data augmentation methods for enriching limited clinical datasets and investigating best practice for model explainability and diagnostic reporting to build trust with clinicians and end-users. Through this research project and the creation of a well-documented, open-source tool, a secondary goal will be to enable reproducibility of similar solutions in other resource-constrained global health applications. EPSRC Alignment and Industrial Collaboration This project falls within the EPSRC Medical Imaging research area, part of the broader Healthcare Technologies portfolio, and targets the Earlier Diagnosis research priority. The project is in collaboration with Merck.