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

Richard K. D. Ephraim Division 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 Duah Division 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. Cybulski Division 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 Prakash Division 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'Ambrosio Division 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. Fletcher Division 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 Keiser Division 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. Andrews Division 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. Bogoch Division 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.

  • 1.

    Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA, 2006. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 42: 377382.

  • 2.

    Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ, 2006. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367: 15211532.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Hotez PJ, Brindley PJ, Bethony JM, King CH, Pearce EJ, Jacobson J, 2008. Helminth infections: the great neglected tropical diseases. J Clin Invest 118: 13111321.

  • 4.

    Stothard JR, Kabatereine NB, Tukahebwa EM, Kazibwe F, Mathieson W, Webster JP, Fenwick A, 2005. Field evaluation of the Meade Readiview handheld microscope for diagnosis of intestinal schistosomiasis in Ugandan school children. Am J Trop Med Hyg 73: 949955.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Stothard JR, Nabatte B, Sousa-Figueiredo JC, Kabatereine NB, 2014. Towards malaria microscopy at the point-of-contact: an assessment of the diagnostic performance of the Newton Nm1 microscope in Uganda. Parasitology 141: 17.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Bogoch II, Andrews JR, Speich B, Ame SM, Ali SM, Stothard JR, Utzinger J, Keiser J, 2014. Quantitative evaluation of a handheld light microscope for field diagnosis of soil-transmitted helminth infection. Am J Trop Med Hyg 91: 11381141.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Bogoch II, Andrews JR, Speich B, Utzinger J, Ame SM, Ali SM, Keiser J, 2013. Mobile phone microscopy for the diagnosis of soil-transmitted helminth infections: a proof-of-concept study. Am J Trop Med Hyg 88: 626629.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Bogoch II, Coulibaly JT, Andrews JR, Speich B, Keiser J, Stothard JR, N'Goran EK, Utzinger J, 2014. Evaluation of portable microscopic devices for the diagnosis of Schistosoma and soil-transmitted helminth infection. Parasitology 141: 18.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Ephraim RK, Duah E, Andrews JR, Bogoch II, 2014. Ultra-low-cost urine filtration for Schistosoma haematobium diagnosis: a proof-of-concept study. Am J Trop Med Hyg 91: 544546.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Weber MD, Blair DM, Clark VV, 1967. The pattern of schistosome egg distribution in a micturition flow. Cent Afr J Med 13: 7588.

  • 11.

    Cybulski JS, Clements J, Prakash M, 2014. Foldscope: origami-based paper microscope. PLoS ONE 9: e98781.

  • 12.

    Switz NA, D'Ambrosio MV, Fletcher DA, 2014. Low-cost mobile phone microscopy with a reversed mobile phone camera lens. PLoS ONE 9: e95330.

  • 13.

    Breslauer DN, Maamari RN, Switz NA, Lam WA, Fletcher DA, 2009. Mobile phone based clinical microscopy for global health applications. PLoS ONE 4: e6320.

  • 14.

    Skandarajah A, Reber CD, Switz NA, Fletcher DA, 2014. Quantitative imaging with a mobile phone microscope. PLoS ONE 9: e96906.

  • 15.

    WHO Expert Committee, 2002. Prevention and control of schistosomiasis and soil-transmitted helminthiasis. World Health Organ Tech Rev Ser 912: i–vi, 157.

  • 16.

    Smith ZJ, Chu K, Espenson AR, Rahimzadeh M, Gryshuk A, Molinaro M, Dwyre DM, Lane S, Matthews D, Wachsmann-Hogiu S, 2011. Cell-phone-based platform for biomedical device development and education applications. PLoS ONE 6: e17150.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Gyorkos TW, Ramsan M, Foum A, Khamis IS, 2001. Efficacy of new low-cost filtration device for recovering Schistosoma haematobium eggs from urine. J Clin Microbiol 39: 26812682.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Linder E, Grote A, Varjo S, Linder N, Lebbad M, Lundin M, Diwan V, Hannuksela J, Lundin J, 2013. On-chip imaging of Schistosoma haematobium eggs in urine for diagnosis by computer vision. PLoS Negl Trop Dis 7: e2547.

    • PubMed
    • Search Google Scholar
    • Export Citation
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