Evaluating Plasmodium falciparum automatic detection and parasitemia estimation: A comparative study on thin blood smear images

• Published in: PloS one Vol. 19; no. 6; p. e0304789
• Main Authors: Acherar, Aniss, Tannier, Xavier, Tantaoui, Ilhame, Brossas, Jean-Yves, Thellier, Marc, Piarroux, Renaud
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.06.2024; Public Library of Science (PLoS)
• Subjects: Artificial intelligence; Artificial neural networks; Biology and Life Sciences; Blood; Comparative analysis; Comparative studies; Diagnostic tests; Disease transmission; Erythrocytes; Erythrocytes - parasitology; Estimation; Flow cytometry; Flow Cytometry - methods; Health aspects; Humans; Image Processing, Computer-Assisted - methods; Impact analysis; Infection; Insect bites; Laboratories; Leukocytes; Malaria; Malaria, Falciparum - blood; Malaria, Falciparum - diagnosis; Malaria, Falciparum - parasitology; Measurement methods; Medical imaging; Medical research; Medicine and Health Sciences; Medicine, Experimental; Microscopy; Microscopy - methods; Molecular biology; Mycology; Neural networks; Neural Networks, Computer; Parasitemia; Parasitemia - blood; Parasitemia - diagnosis; Parasitemia - parasitology; Parasites; Parasitology; Patients; Plasmodium falciparum; Plasmodium falciparum - isolation & purification; Research and Analysis Methods; Retrospective Studies; Vector-borne diseases; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0304789

Malaria is a deadly disease that is transmitted through mosquito bites. Microscopists use a microscope to examine thin blood smears at high magnification (1000x) to identify parasites in red blood cells (RBCs). Estimating parasitemia is essential in determining the severity of the Plasmodium falciparum infection and guiding treatment. However, this process is time-consuming, labor-intensive, and subject to variation, which can directly affect patient outcomes. In this retrospective study, we compared three methods for measuring parasitemia from a collection of anonymized thin blood smears of patients with Plasmodium falciparum obtained from the Clinical Department of Parasitology-Mycology, National Reference Center (NRC) for Malaria in Paris, France. We first analyzed the impact of the number of field images on parasitemia count using our framework, MALARIS, which features a top-classifier convolutional neural network (CNN). Additionally, we studied the variation between different microscopists using two manual techniques to demonstrate the need for a reliable and reproducible automated system. Finally, we included thin blood smear images from an additional 102 patients to compare the performance and correlation of our system with manual microscopy and flow cytometry. Our results showed strong correlations between the three methods, with a coefficient of determination between 0.87 and 0.92.