May 5, 2024
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Article

Edge Artificial Intelligence (AI) for real-time automatic quantification of filariasis in mobile microscopy

Publicated to: Plos Neglected Tropical Diseases. 18 (4): e0012117- - 2024-04-01 18(4), DOI: 10.1371/journal.pntd.0012117

Authors:

Lin, Lin; Dacal, Elena; Diez, Nuria; Carmona, Claudia; Ramirez, Alexandra Martin; Argos, Lourdes Baron; Bermejo-Pelaez, David; Caballero, Carla; Cuadrado, Daniel; Darias-Plasencia, Oscar; Garcia-Villena, Jaime; Bakarjiev, Alexander; Postigo, Maria; Recalde-Jaramillo, Ethan; Flores-Chavez, Maria; Santos, Andres; Ledesma-Carbayo, Maria Jesus; Rubio, Jose M; Luengo-Oroz, Miguel
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Affiliations

Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Inst Salud Carlos III Madrid, Madrid, Spain - Author
Fdn Mundo Sano, Madrid, Spain - Author
Inst Salud Carlos III Madrid, Malaria & Emerging Parasit Dis Lab, Natl Microbiol Ctr, Madrid, Spain - Author
Inst Salud Carlos III, CIBER Bioingn Biomat & Nanomed, Madrid, Spain - Author
Spotlab, Madrid, Spain - Author
Univ Politecn Madrid, Biomed Image Technol, ETSI Telecomunicac, Madrid, Spain - Author
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Abstract

Filariasis, a neglected tropical disease caused by roundworms, is a significant public health concern in many tropical countries. Microscopic examination of blood samples can detect and differentiate parasite species, but it is time consuming and requires expert microscopists, a resource that is not always available. In this context, artificial intelligence (AI) can assist in the diagnosis of this disease by automatically detecting and differentiating microfilariae. In line with the target product profile for lymphatic filariasis as defined by the World Health Organization, we developed an edge AI system running on a smartphone whose camera is aligned with the ocular of an optical microscope that detects and differentiates filarias species in real time without the internet connection. Our object detection algorithm that uses the Single-Shot Detection (SSD) MobileNet V2 detection model was developed with 115 cases, 85 cases with 1903 fields of view and 3342 labels for model training, and 30 cases with 484 fields of view and 873 labels for model validation before clinical validation, is able to detect microfilarias at 10x magnification and distinguishes four species of them at 40x magnification: Loa loa, Mansonella perstans, Wuchereria bancrofti, and Brugia malayi. We validated our augmented microscopy system in the clinical environment by replicating the diagnostic workflow encompassed examinations at 10x and 40x with the assistance of the AI models analyzing 18 samples with the AI running on a middle range smartphone. It achieved an overall precision of 94.14%, recall of 91.90% and F1 score of 93.01% for the screening algorithm and 95.46%, 97.81% and 96.62% for the species differentiation algorithm respectively. This innovative solution has the potential to support filariasis diagnosis and monitoring, particularly in resource-limited settings where access to expert technicians and laboratory equipment is scarce. Filariasis is a common tropical infectious disease. Depending on the parasite, it causes lymphoedema, elephantiasis, itching, blindness, etc. It is estimated that more than 1 billion people require preventive chemotherapy to stop the spread of this infection. The diagnosis of this disease is made through microscopical examination of a blood smear by a human expert, which is not always available. In this study we propose an edge Artificial Intelligence (AI) system that detects and quantifies four species of microfilariae (Loa loa, Mansonella perstans, Wuchereria bancrofti and Brugia malayi) using the camera of a smartphone attached to an optical microscope with a 3D printed adapter. The system works in real time and does not need internet connectivity as the AI models are run locally in a medium range smartphone. We have replicated the diagnostic workflow that is typically performed by an expert microscopist augmented by the support of the AI system.
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Keywords

AlgorithmAlgorithmsAnimalAnimalsArticleArtificial intelligenceBlood smearBrugia malayiClassification algorithmConvolutional neural networkCorrelation coefficientDetection algorithmDisease assessmentElephantiasis, filarialFeature extractionFilariasisHumanHumansIsolation and purificationLoa loaLymphatic filariasisMansonella perstansMedicineMicrofilaria (nematode larva)MicrofilariaeMicroscopyMobile microscopyOnchocerciasisParasite countParasitologyPolymerase chain reactionProceduresReal-time automatic quantificationSmartphoneSpecies differentiationWuchereria bancrofti

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Plos Neglected Tropical Diseases due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2024 there are still no calculated indicators, but in 2023, it was in position 6/47, thus managing to position itself as a Q1 (Primer Cuartil), in the category Parasitology.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2025-12-21:

  • Open Alex: 1
  • Google Scholar: 1
  • WoS: 6
  • Scopus: 8
  • Europe PMC: 4
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-12-21:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 50.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 51 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 28.
  • The number of mentions on the social network X (formerly Twitter): 11 (Altmetric).
  • The number of mentions in news outlets: 2 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Argentina.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (LIN, LIN) and Last Author (Luengo Oroz, Miguel Angel).

the authors responsible for correspondence tasks have been LEDESMA CARBAYO, MARIA JESUS and Luengo Oroz, Miguel Angel.

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Awards linked to the item

This work has been partially funded by the European Union's H2020 Innovation In SMEs research and innovation programme (grant agreement No 881062) and the Bill and Melinda Gates Foundation (grant number Edge-Spot project INV-051355). This work was supported by the Comunidad de Madrid Industrial Predoctoral grant (IND2019/TIC-17167 to LL and Universidad Politecnica de Madrid). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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