Integrating smartphone photography for trachoma, smartphone visual acuity assessment, and mobile autorefraction to enhance community-based public health monitoring

世界卫生组织(WHO)的目标是消除沙眼，沙眼是世界上感染沙眼的主要原因 失明。为了确定某个地区是否需要治疗沙眼，世卫组织建议进行眼科检查 根据沙眼分级认证人员以人口为基础的儿童样本。世界卫生组织的成功 消除沙眼运动造成了一些地区沙眼病例过多的情况 宣布消除沙眼，但沙眼病例太少，无法认证沙眼分级人员。采用基于智能手机的 沙眼远程医疗通过允许几乎没有临床经验的工作人员来解决这个问题 用于远程沙眼诊断的沙眼照片调查。然而，世卫组织目前的数据收集平台 对于沙眼调查，热带数据目前不支持眼部摄影。我们在这里提议 将智能手机照片与热带数据相结合，并添加功能，将其转变为更多 用户友好、开放访问的基于智能手机的调查模块套件。这将增强灵活性和 促进更广泛的健康调查，以便更好地针对有限的卫生资源。 这项研究的第一部分旨在开发和完善集成所需的硬件和软件 将智能手机结膜摄影引入热带数据平台，并评估 最终产品出现在秘鲁偏远的社区环境中。第一，摄影模块，视觉敏锐度 评估、自动折射、样本收集和用户定义的调查问卷将添加到现有 热带数据应用。其次，不同的智能手机型号和/或环境照明的影响将是 对每个模块进行了评估。第三，更新的移动应用程序将在少数村庄进行测试，以 确定每个孩子测试多个模块的可行性。 这项研究的第二部分验证了基于智能手机的系统在三种情况下使用时的组件 秘鲁不同的田野位置(如丛林、山脉、沙漠)。我们将检查灵敏度和特异度 相对于认证的人类评分员的智能手机摄影，相对于标准的智能手机视力 ETDRS视力，以及相对于人体屈光的自动屈光，并假设这些指标将 优于预定义的最低可接受标准。 加州大学洛杉矶分校普罗科特基金会和秘鲁的卡耶塔诺大学将合作实现这些目标。我们 将与世卫组织和热带数据组织密切合作，后者将积极参与这项研究 在整个开发和测试过程中。本研究具有很大的推广潜力和积极意义。 对健康的影响。

The World Health Organization (WHO) aims to eliminate trachoma, the world's leading infectious cause of blindness. To determine if trachoma treatment is needed in an area, the WHO recommends eye examinations on a population-based sample of children by personnel certified in trachoma grading. The WHO's successful trachoma elimination campaign has created a situation in which some areas have too many to trachoma cases to declare elimination but too few trachoma cases to certify trachoma graders. Adopting smartphone-based trachoma telemedicine addresses this issue by allowing workers with little clinical experience to perform trachoma photo-surveys for remote trachoma diagnoses. However, the WHO's current data collection platform for trachoma surveys, Tropical Data, does not currently support ocular photography. We propose here to integrate smartphone photography with Tropical Data and add functionality that will transform it into a more user-friendly, open access suite of smartphone-based survey modules. This would enhance flexibility and facilitate broader health surveys that can be used to better target limited health resources. This first part of the study aims to develop and refine the hardware and software necessary to integrate smartphone conjunctival photography into the Tropical Data platform, and to assess the feasibility of the resulting product in remote community-based settings in Peru. First, modules for photography, visual acuity assessment, autorefraction, sample collection, and user-defined questionnaires will be added to the existing Tropical Data application. Second, the impact of varying smartphone models and/or ambient lighting will be assessed for each module. Third, the updated mobile application will be tested in a small number of villages to determine the feasibility of testing multiple modules per child. The second part of the study validates the components of the smartphone-based system when used in three different field locations in Peru (e.g., jungle, mountains, desert). We will examine the sensitivity and specificity of smartphone photography relative to certified human graders, smartphone visual acuity relative to standard ETDRS visual acuity, and autorefraction relative to human refraction, and hypothesize that these metrics will be superior to pre-defined minimally acceptable criteria. The UCSF Proctor Foundation and Cayetano University in Peru will collaborate to achieve these goals. We will work in close cooperation with the WHO and Tropical Data, who will be actively engaged in this research throughout development and testing. This research has great potential for wide dissemination and positive impact on health.