Development of an automated artificial intelligence-based system for urogenital schistosomiasis diagnosis using digital image analysis techniques and a robotized microscope

PLoS Negl Trop Dis. 2024 Nov 5;18(11):e0012614. doi: 10.1371/journal.pntd.0012614. eCollection 2024 Nov.

Abstract

Background: Urogenital schistosomiasis is considered a Neglected Tropical Disease (NTD) by the World Health Organization (WHO). It is estimated to affect 150 million people worldwide, with a high relevance in resource-poor settings of the African continent. The gold-standard diagnosis is still direct observation of Schistosoma haematobium eggs in urine samples by optical microscopy. Novel diagnostic techniques based on digital image analysis by Artificial Intelligence (AI) tools are a suitable alternative for schistosomiasis diagnosis.

Methodology: Digital images of 24 urine sediment samples were acquired in non-endemic settings. S. haematobium eggs were manually labeled in digital images by laboratory professionals and used for training YOLOv5 and YOLOv8 models, which would achieve automatic detection and localization of the eggs. Urine sediment images were also employed to perform binary classification of images to detect erythrocytes/leukocytes with the MobileNetv3Large, EfficientNetv2, and NasNetLarge models. A robotized microscope system was employed to automatically move the slide through the X-Y axis and to auto-focus the sample.

Results: A total number of 1189 labels were annotated in 1017 digital images from urine sediment samples. YOLOv5x training demonstrated a 99.3% precision, 99.4% recall, 99.3% F-score, and 99.4% mAP0.5 for S. haematobium detection. NasNetLarge has an 85.6% accuracy for erythrocyte/leukocyte detection with the test dataset. Convolutional neural network training and comparison demonstrated that YOLOv5x for the detection of eggs and NasNetLarge for the binary image classification to detect erythrocytes/leukocytes were the best options for our digital image database.

Conclusions: The development of low-cost novel diagnostic techniques based on the detection and identification of S. haematobium eggs in urine by AI tools would be a suitable alternative to conventional microscopy in non-endemic settings. This technical proof-of-principle study allows laying the basis for improving the system, and optimizing its implementation in the laboratories.

MeSH terms

  • Animals
  • Artificial Intelligence*
  • Humans
  • Image Processing, Computer-Assisted* / methods
  • Microscopy* / methods
  • Schistosoma haematobium* / isolation & purification
  • Schistosomiasis haematobia* / diagnosis
  • Schistosomiasis haematobia* / urine
  • Urine / parasitology

Grants and funding

This research was funded by the Microbiology Department of Vall d’Hebron University Hospital, the Computational Biology and Complex Systems Group, Physics Department of the Universitat Politècnica de Catalunya, the Cooperation Centre of the Universitat Politècnica de Catalunya (CCD-UPC) and the Signal & Data Processing Research Group at TecnoCampus. In addition, we acknowledge support by ISCIII (FIS PI20/00217 to JJ-M), Spanish national plan PEICTI, project WaterWritten (PID2023-14664OB-I00 to ESay) and Ministerio de Ciencia e Innovación (PID-2022-139216NB-I00,MCIN/AEI/10.13039/501100011033 to DL-C). All funders had roles in study design, data collection, statistical analysis and manuscript preparation and edition.