Remote analysis of sputum smears for mycobacterium tuberculosis quantification using digital crowdsourcing

PLoS One. 2022 May 19;17(5):e0268494. doi: 10.1371/journal.pone.0268494. eCollection 2022.

Abstract

Worldwide, TB is one of the top 10 causes of death and the leading cause from a single infectious agent. Although the development and roll out of Xpert MTB/RIF has recently become a major breakthrough in the field of TB diagnosis, smear microscopy remains the most widely used method for TB diagnosis, especially in low- and middle-income countries. This research tests the feasibility of a crowdsourced approach to tuberculosis image analysis. In particular, we investigated whether anonymous volunteers with no prior experience would be able to count acid-fast bacilli in digitized images of sputum smears by playing an online game. Following this approach 1790 people identified the acid-fast bacilli present in 60 digitized images, the best overall performance was obtained with a specific number of combined analysis from different players and the performance was evaluated with the F1 score, sensitivity and positive predictive value, reaching values of 0.933, 0.968 and 0.91, respectively.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Crowdsourcing*
  • Humans
  • Mycobacterium tuberculosis*
  • Sensitivity and Specificity
  • Sputum / microbiology
  • Tuberculosis, Lymph Node*
  • Tuberculosis, Pulmonary* / diagnosis
  • Tuberculosis, Pulmonary* / microbiology

Grants and funding

This research was partially funded by the project H2020-MSCA-RISE-2018 INNOVA4TB (EU), CDTI NEOTEC SNEO-20171197, RTI2018- 098682-B-I00 (MCIU/AEI/FEDER, EU) from the Spanish Ministry of Science, Innovation and Universities (MJLC, AS, LGD) and IND2019/TIC-17167 from Comunidad de Madrid (MALO,MJLC). CISM is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID) (MG,SB,QB,AGB). Spotlab provided support in the form of salaries for authors MP, DC, AMM. The funders did not have any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.