{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:06:27Z","timestamp":1793149587630,"version":"4.5.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Soil-transmitted helminths primarily comprise <jats:italic>Ascaris lumbricoides<\/jats:italic>, <jats:italic>Trichuris trichiura<\/jats:italic>, and hookworms, infecting more than 600\u00a0million 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 (<jats:italic>n<\/jats:italic>\u2009=\u2009965) 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 <jats:italic>A. lumbricoides<\/jats:italic>, <jats:italic>T. trichiura<\/jats:italic> 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 (<jats:italic>n<\/jats:italic>\u2009=\u2009704). 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.<\/jats:p>","DOI":"10.1038\/s41598-025-07309-7","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T08:29:43Z","timestamp":1751012983000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["AI-supported versus manual microscopy of Kato-Katz smears for diagnosis of soil-transmitted helminth infections in a primary healthcare setting"],"prefix":"10.1038","volume":"15","author":[{"given":"Joar","family":"von Bahr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Suutala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Kucukel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison","family":"Kaingu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Kinyua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Muinde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevan","family":"Osundwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wigina","family":"Ronald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Muinde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billy","family":"Ngasala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Lundin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"M\u00e5rtensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Linder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Lundin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"7309_CR1","doi-asserted-by":"publisher","first-page":"e0008001","DOI":"10.1371\/journal.pntd.0008001","volume":"14","author":"PJ Hotez","year":"2020","unstructured":"Hotez, P. J., Aksoy, S., Brindley, P. J. & Kamhawi, S. What constitutes a neglected tropical disease? PLoS Negl. Trop. Dis. 14, e0008001 (2020).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR2","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/bmb\/ldp046","volume":"93","author":"N Feasey","year":"2010","unstructured":"Feasey, N., Wansbrough-Jones, M., Mabey, D. C. W. & Solomon, A. W. Neglected tropical diseases. Br. Med. Bull. 93, 179\u2013200 (2010).","journal-title":"Br. Med. Bull."},{"key":"7309_CR3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s40249-024-01238-9","volume":"13","author":"J Chen","year":"2024","unstructured":"Chen, J., Gong, Y., Chen, Q., Li, S. & Zhou, Y. Global burden of soil-transmitted helminth infections, 1990\u20132021. Infect. Dis. Poverty. 13, 77 (2024).","journal-title":"Infect. Dis. Poverty"},{"key":"7309_CR4","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1016\/S0140-6736(18)32335-3","volume":"392","author":"HALE Collaborators","year":"2018","unstructured":"GBD 2017 DALYs and & Collaborators, H. A. L. E. Global, regional, and National disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990\u20132017: a systematic analysis for the global burden of disease study 2017. Lancet 392, 1859\u20131922 (2018).","journal-title":"Lancet"},{"key":"7309_CR5","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1016\/S0140-6736(06)68653-4","volume":"367","author":"J Bethony","year":"2006","unstructured":"Bethony, J. et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367, 1521\u20131532 (2006).","journal-title":"Lancet"},{"key":"7309_CR6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3390\/tropicalmed2030036","volume":"2","author":"AK Mitra","year":"2017","unstructured":"Mitra, A. K. & Mawson, A. R. Neglected tropical diseases: epidemiology and global burden. Trop. Med. Infect. Dis. 2, 36 (2017).","journal-title":"Trop. Med. Infect. Dis."},{"key":"7309_CR7","doi-asserted-by":"publisher","first-page":"e0003717","DOI":"10.1371\/journal.pgph.0003717","volume":"4","author":"SC Ugwu","year":"2024","unstructured":"Ugwu, S. C. et al. The impact of community based interventions for the prevention and control of soil-transmitted helminths: A systematic review and meta-analysis. PLOS Glob Public. Health. 4, e0003717 (2024).","journal-title":"PLOS Glob Public. Health"},{"key":"7309_CR8","unstructured":"World Health Organization. Diagnostic Target Product Profile for Monitoring and Evaluation of Soil-Transmitted Helminth Control Programmes (World Health Organization, 2021)."},{"key":"7309_CR9","unstructured":"Montresor, A. et al. Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at Community Level: A Guide for Managers of Control Programmes \/ A. Montresor \u2026 Et Al] (World Health Organization, 1998)."},{"key":"7309_CR10","unstructured":"World Health Organization. Bench Aids for the Diagnosis of Intestinal Parasites 2nd Edn (World Health Organization, 2019)."},{"key":"7309_CR11","doi-asserted-by":"publisher","first-page":"e0009032","DOI":"10.1371\/journal.pntd.0009032","volume":"15","author":"F Bosch","year":"2021","unstructured":"Bosch, F. et al. Diagnosis of soil-transmitted helminths using the Kato-Katz technique: what is the influence of stirring, storage time and storage temperature on stool sample egg counts? PLoS Negl. Trop. Dis. 15, e0009032 (2021).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR12","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3390\/tropicalmed5020093","volume":"5","author":"M Mbong Ngwese","year":"2020","unstructured":"Mbong Ngwese, M. et al. Diagnostic techniques of soil-transmitted helminths: impact on control measures. Trop. Med. Infect. Dis. 5, 93 (2020).","journal-title":"Trop. Med. Infect. Dis."},{"key":"7309_CR13","doi-asserted-by":"publisher","first-page":"e0010500","DOI":"10.1371\/journal.pntd.0010500","volume":"16","author":"P Ward","year":"2022","unstructured":"Ward, P. et al. Affordable artificial intelligence-based digital pathology for neglected tropical diseases: a proof-of-concept for the detection of soil-transmitted helminths and Schistosoma mansoni eggs in Kato-Katz stool Thick smears. PLoS Negl. Trop. Dis. 16, e0010500 (2022).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR14","doi-asserted-by":"publisher","first-page":"e0012041","DOI":"10.1371\/journal.pntd.0012041","volume":"18","author":"J Lundin","year":"2024","unstructured":"Lundin, J. et al. Diagnosis of soil-transmitted helminth infections with digital mobile microscopy and artificial intelligence in a resource-limited setting. PLoS Negl. Trop. Dis. 18, e0012041 (2024).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR15","doi-asserted-by":"publisher","first-page":"e0007577","DOI":"10.1371\/journal.pntd.0007577","volume":"13","author":"A Yang","year":"2019","unstructured":"Yang, A. et al. Kankanet: an artificial neural network-based object detection smartphone application and mobile microscope as a point-of-care diagnostic aid for soil-transmitted helminthiases. PLoS Negl. Trop. Dis. 13, e0007577 (2019).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR16","doi-asserted-by":"publisher","first-page":"e211740","DOI":"10.1001\/jamanetworkopen.2021.1740","volume":"4","author":"O Holmstr\u00f6m","year":"2021","unstructured":"Holmstr\u00f6m, O. et al. Point-of-care digital cytology with artificial intelligence for cervical cancer screening in a resource-limited setting. JAMA Netw. Open. 4, e211740 (2021).","journal-title":"JAMA Netw. Open."},{"key":"7309_CR17","doi-asserted-by":"publisher","first-page":"102802","DOI":"10.1016\/j.media.2023.102802","volume":"88","author":"F Shamshad","year":"2023","unstructured":"Shamshad, F. et al. Transformers in medical imaging: a survey. Med. Image Anal. 88, 102802 (2023).","journal-title":"Med. Image Anal."},{"key":"7309_CR18","doi-asserted-by":"publisher","unstructured":"Dacal, E. et al. Mobile microscopy and telemedicine platform assisted by deep learning for quantification of Trichuris trichiura infection. Preprint at (2021). https:\/\/doi.org\/10.1101\/2021.01.19.426683","DOI":"10.1101\/2021.01.19.426683"},{"key":"7309_CR19","doi-asserted-by":"publisher","first-page":"e0012492","DOI":"10.1371\/journal.pntd.0012492","volume":"18","author":"N Cure-Bolt","year":"2024","unstructured":"Cure-Bolt, N. et al. Artificial intelligence-based digital pathology for the detection and quantification of soil-transmitted helminths eggs. PLoS Negl. Trop. Dis. 18, e0012492 (2024).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR20","doi-asserted-by":"publisher","first-page":"1337325","DOI":"10.1080\/16549716.2017.1337325","volume":"10","author":"O Holmstr\u00f6m","year":"2017","unstructured":"Holmstr\u00f6m, O. et al. Point-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium. Glob Health Action. 10, 1337325 (2017).","journal-title":"Glob Health Action"},{"key":"7309_CR21","doi-asserted-by":"publisher","first-page":"4212","DOI":"10.1002\/mp.14352","volume":"47","author":"Q Li","year":"2020","unstructured":"Li, Q. et al. Automated detection of visible components in human feces using deep learning. Med. Phys. 47, 4212\u20134222 (2020). FecalNet.","journal-title":"Med. Phys."},{"key":"7309_CR22","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/j.ijpara.2014.05.009","volume":"44","author":"B Nikolay","year":"2014","unstructured":"Nikolay, B., Brooker, S. J. & Pullan, R. L. Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard. Int. J. Parasitol. 44, 765\u2013774 (2014).","journal-title":"Int. J. Parasitol."},{"key":"7309_CR23","doi-asserted-by":"publisher","first-page":"e1201","DOI":"10.1371\/journal.pntd.0001201","volume":"5","author":"B Levecke","year":"2011","unstructured":"Levecke, B. et al. A comparison of the sensitivity and fecal egg counts of the McMaster egg counting and Kato-Katz Thick smear methods for soil-transmitted helminths. PLoS Negl. Trop. Dis. 5, e1201 (2011).","journal-title":"PLoS Negl. Trop. Dis."},{"key":"7309_CR24","doi-asserted-by":"publisher","first-page":"e012799","DOI":"10.1136\/bmjopen-2016-012799","volume":"6","author":"JF Cohen","year":"2016","unstructured":"Cohen, J. F. et al. STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. BMJ Open. 6, e012799 (2016).","journal-title":"BMJ Open."},{"key":"7309_CR25","doi-asserted-by":"publisher","unstructured":"He, K., Zhang, X., Ren, S. & Sun, J. Deep residual learning for image recognition. in IEEE Conference on Computer Vision and Pattern Recognition (CVPR) 770\u2013778 (2016). 770\u2013778 (2016). (2016). https:\/\/doi.org\/10.1109\/CVPR.2016.90","DOI":"10.1109\/CVPR.2016.90"},{"key":"7309_CR26","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1109\/TMI.2016.2535302","volume":"35","author":"N Tajbakhsh","year":"2016","unstructured":"Tajbakhsh, N. et al. Convolutional neural networks for medical image analysis: fine tuning or full training? IEEE Trans. Med. Imaging. 35, 1299\u20131312 (2016).","journal-title":"IEEE Trans. Med. Imaging"},{"key":"7309_CR27","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1080\/00365510701666031","volume":"68","author":"A Trajman","year":"2008","unstructured":"Trajman, A. & Luiz, R. R. McNemar \u03c72 test revisited: comparing sensitivity and specificity of diagnostic examinations. Scand. J. Clin. Lab. Invest. 68, 77\u201380 (2008).","journal-title":"Scand. J. Clin. Lab. Invest."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-07309-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-07309-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-07309-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T21:03:29Z","timestamp":1751403809000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-07309-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["7309"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-07309-7","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,27]]},"assertion":[{"value":"26 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JL and ML are founders and co-owners of Aiforia technologies Plc. JL and AS reported having a patent for Mobile Microscope pending (no.WO2017037334A1; the invention is related to the use of fluorescence imaging filters combined with inexpensive plastic lenses; all rights are with the University of Helsinki) and JL having a patent for a slide holder for an optical microscope pending (no.WO2015185805A1; related to motorization of regular microscopes).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Ethical approval for the study was obtained from the Technical University of Mombasa Scientific and Ethics Review Committee (TUM ERC EXT\/001\/2020(RA), 19.4.2021) accredited by the National Commission for Science, Technology and Innovation (NACOSTI) Kenya. To be included in the study, assent from the study participant and informed written consent (in Swahili and English) from their legal guardian were required. It was emphasized that participation in the study was voluntary, and it was possible to withdraw consent at any stage. In addition, written consent was obtained from the primary school headmasters. All children participating in the study were offered a single oral dose of albendazole 400\u00a0mg by a designated clinician, according to national guidelines. Infected participants were also examined and monitored by a clinician in collaboration with the National NTD Program management. Furthermore, families of children with positive Kato-Katz smears were contacted and offered deworming treatment by the designated clinician.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"20332"}}