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Diagnosis of Schistosoma haematobium Infection with a Mobile Phone-Mounted Foldscope and a Reversed-Lens CellScope in Ghana

Richard K. D. EphraimDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Evans DuahDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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James S. CybulskiDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Manu PrakashDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Michael V. D'AmbrosioDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Daniel A. FletcherDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Jennifer KeiserDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Jason R. AndrewsDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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Isaac I. BogochDivision of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana; Department of Mechanical Engineering, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California; Department of Bioengineering, University of California, Berkeley, Berkeley, California; Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California; Divisions of Internal Medicine and Infectious Diseases, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada

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We evaluated two novel, portable microscopes and locally acquired, single-ply, paper towels as filter paper for the diagnosis of Schistosoma haematobium infection. The mobile phone-mounted Foldscope and reversed-lens CellScope had sensitivities of 55.9% and 67.6%, and specificities of 93.3% and 100.0%, respectively, compared with conventional light microscopy for diagnosing S. haematobium infection. With conventional light microscopy, urine filtration using single-ply paper towels as filter paper showed a sensitivity of 67.6% and specificity of 80.0% compared with centrifugation for the diagnosis of S. haematobium infection. With future improvements to diagnostic sensitivity, newer generation handheld and mobile phone microscopes may be valuable tools for global health applications.

Author Notes

* Address correspondence to Isaac I. Bogoch, Divisions of Internal Medicine and Infectious Diseases, Toronto General Hospital, 14EN- 209, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4. E-mail: isaac.bogoch@uhn.ca
† These authors contributed equally to this work.

Financial support: Isaac Bogoch is supported by Grand Challenges Canada.

Authors' addresses: Richard K. D. Ephraim and Evans Duah, Division of Medical Laboratory Technology, University of Cape Coast, Cape Coast, Ghana, E-mails: kdephraim@yahoo.com and ivanprecy@gmail.com. James S. Cybulski and Manu Prakash, Department of Mechanical Engineering, Stanford University, Stanford, CA, and Department of Bioengineering, Stanford University, Stanford, CA, E-mails: cybulski@stanford.edu and manup@stanford.edu. Michael V. D'Ambrosio and Daniel A. Fletcher, Department of Bioengineering, University of California, Berkeley, CA, E-mails: mdambrosio@berkeley.edu and fletch@berkeley.edu. Jennifer Keiser, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Basel, Switzerland, E-mail: jennifer.keiser@unibas.ch. Jason R. Andrews, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, E-mail: jandr@stanford.edu. Isaac I. Bogoch, Divisions of Internal Medicine and Infectious Diseases, Toronto General Hospital, Toronto, ON, Canada, E-mail: isaac.bogoch@uhn.ca.

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