Schistosomiasis is a parasitic and neglected tropical disease, and affects <200-million people across the world, with school-aged children disproportionately affected. Here we present field-testing results of a handheld and cost effective smartphone-based microscope in rural Ghana, Africa, for point-of-care diagnosis of S. haematobium infection. In this mobile-phone microscope, a custom-designed 3D printed opto-mechanical attachment (~150g) is placed in contact with the smartphone camera-lens, creating an imaging-system with a half-pitch resolution of ~0.87µm. This unit includes an external lens (also taken from a mobile-phone camera), a sample tray, a z-stage to adjust the focus, two light-emitting-diodes (LEDs) and two diffusers for uniform illumination of the sample. In our field-testing, 60 urine samples, collected from children, were used, where the prevalence of the infection was 72.9%. After concentration of the sample with centrifugation, the sediment was placed on a glass-slide and S. haematobium eggs were first identified/quantified using conventional benchtop microscopy by an expert diagnostician, and then a second expert, blinded to these results, determined the presence/absence of eggs using our mobile-phone microscope. Compared to conventional microscopy, our mobile-phone microscope had a diagnostic sensitivity of 72.1%, specificity of 100%, positive-predictive-value of 100%, and a negative-predictive-value of 57.1%. Furthermore, our mobile-phone platform demonstrated a sensitivity of 65.7% and 100% for low-intensity infections (≤50 eggs/10 mL urine) and high-intensity infections (<50 eggs/10 mL urine), respectively. We believe that this cost-effective and field-portable mobile-phone microscope may play an important role in the diagnosis of schistosomiasis and various other global health challenges.
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