@article{102587,
  keywords = {Digital diagnostics, Deep learning, Neglected tropical disease, Primary Health Care, point of care, Whole slide imaging},
  author = {von Bahr J and Suutala A and Kucukel H and Kaingu H and Kinyua F and Muinde M and Osundwa K and Ronald W and Muinde J and Ngasala B and Lundin M and Mårtensson A and Linder N and Lundin J},
  title = {AI-supported versus manual microscopy of Kato-Katz smears for diagnosis of soil-transmitted helminth infections in a primary healthcare setting},
  abstract = {<p>Soil-transmitted helminths primarily comprise Ascaris lumbricoides, Trichuris trichiura, and hookworms, infecting more than 600&nbsp;million people globally, particularly in underserved communities. Manual microscopy of Kato-Katz thick smears is a widely used diagnostic method in monitoring and control programs, but is time-consuming, requires on-site experts and has low sensitivity, especially for light intensity infections. In this study, portable whole-slide scanners and deep learning-based artificial intelligence (AI) were deployed in a primary healthcare setting in Kenya. Stool samples (n = 965) were collected from school children and Kato-Katz thick smears were digitized for AI-based detection. Light-intensity infections accounted for 96.7% of cases. Three diagnostic methods - manual microscopy, autonomous AI and human expert-verified AI - were compared to a composite reference standard, which combined expert-verified helminth eggs in physical and digital smears. Sensitivity for A. lumbricoides, T. trichiura and hookworms was 50.0%, 31.2%, and 77.8% for manual microscopy; 50.0%, 84.4%, and 87.4% for the autonomous AI; and 100%, 93.8%, and 92.2% for expert-verified AI in smears suitable for analysis (n = 704). Specificity exceeded 97% across all methods. The expert-verified AI had higher sensitivity than the other methods while maintaining high specificity for the detection of soil-transmitted helminths in Kato-Katz thick smears, especially in light-intensity infections.</p>
},
  year = {2025},
  journal = {Scientific Reports},
  volume = {15},
  pages = {1-12},
  publisher = {Springer Science and Business Media LLC},
  issn = {2045-2322},
  url = {https://www.nature.com/articles/s41598-025-07309-7#citeas},
  doi = {10.1038/s41598-025-07309-7},
  language = {eng},
}