By Dr. Gregory Simon

In an ever increasing technological world, the use of mobile technology in disease surveillance and program evaluation has been demonstrated to be a powerful tool. Disease mapping with apps using Google Maps allows implementers to target programs to people with the greatest disease burden. SMS allows for real-time communications for supply chain of drugs and equipment to community level hospitals. And mobile phone cameras allow for photographs to be taken and sent anywhere around the world for diagnosis of diseases.

Recently, a new study was published in the American Journal of Tropical Medicine and Hygiene that looked at a novel way to identify children infected with intestinal worms. Scientists used a mobile phone mounted with a makeshift microscope to diagnose  the worms. This method was significantly cheaper than using a conventional microscope for identification, running only about $15 rather than $200.

The study used the microscope to evaluate stool samples from almost 200 children in Pemba, Tanzania, alongside conventional light microscope to measure the effectiveness of different intestinal worm treatments. The mobile phone microscope correctly identified 69.4 percent of the worm infections and avoided false negatives 61.5 percent of the time.

The study demonstrated another example of how mobile technology can help health care workers in the most remote areas of the world. The proof of concept of a first-generation mobile phone light microscope for the point-of-care diagnosis of soil-transmitted helminth infections among school-aged children shows the power of simple methods that can have great impacts on the lives of those affected.

However, there are still some issues that need to be resolved before this technology can be used more widely. While the sensitivity for diagnosing any soil-transmitted helminth egg with the mobile phone microscope was close to 70 percent, it would need to be increased to above 80 percent to be an acceptable diagnostic tool. This could be accomplished through better optics or applications that assist with identification. Another concern is that the cost of the phones themselves is often prohibitive.  This study used the iPhone 4S which cost US$250 at the time of the study. In order to be brought to scale, the prices will need to decline.

While this first-generation mobile phone microscope had modest results in its first major trial; it demonstrates that there is potential for a technology that is quick, inexpensive and portable to diagnose disease in the field. As its development is refined, the application could have great impacts on the populations affected by these diseases.