Performance of a fully‐automated system on a WHO malaria microscopy evaluation slide set

Horning, Matthew P., Delahunt, Charles, Bachman, Christine M., Luchavez, Jennifer, Luna, Christian, Hu, Liming, Jaiswal, Mayoore S., Thompson, Clay M., Kulhare, Sourabh, Janko, Samantha, Wilson, Benjamin K., Ostbye, Travis, Mehanian, Martha, Gebrehiwot, Roman, Yun, Grace, Bell, David, Proux, Stephane, Carter, Jane Y., Oyibo, Wellington, Gamboa, Dionicia, Dhorda, Mehul, Vongpromek, Ranitha, Chiodini, Peter L., Ogutu, Bernhards, Long, Earl G., Tun, Kyaw, Burkot, Tom, Lilley, Ken, and Mehanian, Courosh (2021) Performance of a fully‐automated system on a WHO malaria microscopy evaluation slide set. Malaria Journal, 20. 110.

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Abstract

Background: Manual microscopy remains a widely-used tool for malaria diagnosis and clinical studies, but it has inconsistent quality in the field due to variability in training and field practices. Automated diagnostic systems based on machine learning hold promise to improve quality and reproducibility of field microscopy. The World Health Organization (WHO) has designed a 55-slide set (WHO 55) for their External Competence Assessment of Malaria Microscopists (ECAMM) programme, which can also serve as a valuable benchmark for automated systems. The performance of a fully-automated malaria diagnostic system, EasyScan GO, on a WHO 55 slide set was evaluated.

Methods: The WHO 55 slide set is designed to evaluate microscopist competence in three areas of malaria diagnosis using Giemsa-stained blood films, focused on crucial field needs: malaria parasite detection, malaria parasite species identification (ID), and malaria parasite quantitation. The EasyScan GO is a fully-automated system that combines scanning of Giemsa-stained blood films with assessment algorithms to deliver malaria diagnoses. This system was tested on a WHO 55 slide set.

Results: The EasyScan GO achieved 94.3 % detection accuracy, 82.9 % species ID accuracy, and 50 % quantitation accuracy, corresponding to WHO microscopy competence Levels 1, 2, and 1, respectively. This is, to our knowledge, the best performance of a fully-automated system on a WHO 55 set.

Conclusions: EasyScan GO’s expert ratings in detection and quantitation on the WHO 55 slide set point towards its potential value in drug efficacy use-cases, as well as in some case management situations with less stringent species ID needs. Improved runtime may enable use in general case management settings.

Item ID: 70884
Item Type: Article (Research - C1)
ISSN: 1475-2875
Keywords: Malaria, Automated diagnosis, Machine learning, Microscopy, WHO
Copyright Information: © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Date Deposited: 07 Dec 2021 01:46
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 50%
31 BIOLOGICAL SCIENCES > 3107 Microbiology > 310702 Infectious agents @ 50%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 100%
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