Hi, My advise to you on this is to contact experts who can advise you. Since you would wish to link up and perform your tests with an already established system, the person you need must be the head of an institution who would agree to participate based on his own ethical-judgment only. It is however unethical to involve people who do not- at inception understands design and objectives of the study, but it appears to me that you would like to test if your model works first. Also, I hope you understand issues related to intellectual property right, so that the latter may not come up as an end to its means. Science is complex and needs true spirit, not those developed on quick-sand. Meanwhile, please find out if you could contact Professors Collins or Ofulla of Maseno University. These are experts whom I know and trust; operates/research on Malaria in endemic areas,  with wide knowledge of the aforementioned subject. Their contacts should be available from international library.

Thanks for the inputs.

Chandra, the model we are proposing can be based anywhere. It is not restrictive in particular regions, and therefore whose research on Malaria is based in any country may join.

Gabriel, you have a very good advise and indeed useful. I will take all ideas you have suggested into considerations.

I'm in a malaria endemic zone-Western Kenya Kisumu county. Trained in malaria microscopy from waltereed Kisumu branch. Currently working on alternative methods of controlling malaria vectors through ICIPE salarmal project. Can we talk!!?

It is good to think a new diagnostic method but same time so many thing required to do. It seems the experience and the publication of the author is not that  to replace the technology. To replacing a diagnosing system your product should be cost effective, time saving essay to handle validation by specificity and sensitivity and so many things.

Before collaborating you should do all these ground work and call for a partner.

Hi, that is a good research proposal. Pls consider the advice of Gabriel and Prakash. Am currently on a different area of research. Good luck!

Dear Baraka,

I think this topic has been given interest before. You have to be careful not to breach others' rights because I see that you reported that as a novel idea. You can read the following article published in Malaria Journal: "Reliable enumeration of malaria parasites in thick blood films using digital image analysis". Therefore, image analysis of malaria parasites for the sake of enumerating them is not a new idea. I do not know whether you have read about "Cellscope" or cell-phone microscope, which has been designed for image analysis for the diagnosis of certain diseases, including malaria. I do not want to discourage you, but just to make you re-orient your idea in a more suitable manner. I advise you because I have a manuscript about virtual microscopy (currently under review) and have read a lot about the topic. I wish you all the best with your idea and may our paths cross at some point.

Kind regards,

Rashad

Dear Rashad,

Thanks much for the ideas and caution you have raised. However, if you carefully read my comments above, I have not said that the idea I am trying to propose stands on its own as novel. I am well-informed that automatic methods for Malaria detection have been proposed by several authors, and now the research has even moved further into trying to use a mobile phone and other similar portable devices to diagnose Malaria (like theLifeLensProject, Matibabu (Kenya, Uganda), and what you have already mentioned). I think you may agree with me that the existing automatic methods still face some challenges, especially in the context of Accuracy, Speed, Reliability, Adaptability, Robustness, and Cost. These are all research opportunities that are open for researchers in the field. The details I have given above was just meant to capture the attention of the volunteers to join the group, and I think are not complete to describe the design considerations of the system.

As you said, I think we may intersect at one point. Malaria detection is a multidisciplinary subject - combining researchers from all angles.

Dear Baraka,

I admire your enthusiasm to do something helpful. However, one has to go with steady steps starting with comprehensive literature reviewing. I do not know whether you considered the following points:

- Making spot field images would not be accurate as parasite density has to be counted against millions of RBCs (or against 200 WBCs). To make a virtual slide representing a significant section of the slide, millions of images are needed; a process that requires the use of high-resolution virtual slide scanners followed by stitching of these images together. Price of such scanners is so expensive that they does not fit routine diagnosis.

- Humans still have to be involved in reading the results to differentiate whether the enumerated parasites are truly as such or just artifacts. Frequently, it is very difficult, even for experienced microscopist, to differentiate ring stages from stain precipitates. How will your approach be fully automated and can be independently used by the patient?

- Validation of technologies can never be performed on "retrospective" samples. These samples might be read by microscopists of varying experience levels, and quality control guidelines might not have been followed. Moreover, precise determination of RBC count has to be based on the examination of fresh whole blood samples, taking into consideration the variant thickness of blood films, which is usually uneven on the same section of the same blood film (clumping or spacing of RBCs).

Kind regards,

Rashad

Dear Rashan,

Thanks for very constructive ideas, and indeed useful ones. Being multidisciplinary, this research needs both engineers and medical doctors to collaborate together to make something useful, and that was my initial idea to look for some people in the medical field to collaborate with. Perhaps the comments in my initial post may be questionable for a person in the medical field, and at that point it is where collaboration is essential to compliment one another and make something concrete. I have a mental map of what is supposed to be done, may be rough at the moment but already tested in the simulation and seems working.

One of the nice points you have introduced is cost, and this is exactly what my research is trying to address. Other parameters we will address are robustness and adaptability. From the literature review I have done, these aspects are usually not considered in these automatic methods for Malaria detection.

I am taking into consideration the nice comments you have given. Others which are more technical may need someone in the medical field to translate and implement in part of the system. I am an Engineer, and my expertise is image /video processing and analysis.

Kind regards,

Baraka Maiseli.

Dear Baraka,

Glad to help! Although I have no interest in being directly involved, I am very willing to help regarding malaria with NO need to be a collaborator. The points raised are just to give you a closer view, but not to underestimate your idea or discourage you. I did not want to send my comments privately as I sought to enrich the discussion by others. I think you may need to consider the following points:

- A thorough literature review on image analysis for malaria diagnosis (What has been done? What is missed? What can be further improved? Any pitfalls? etc.

- A sound study design that considers several components such as parasite density, type of staining used for comparing the new approach with the traditional one (Which is better to use routine stains or fluorescent ones? Will there be a difference? etc.). What is the appropriate sample size (Should you increase the proportion of low density infections included)? Which is better to perform the validation study on field samples or on serial dilutions of culture- adapted parasites for the sake of empirical study? One may think that the latter could be controlled better.

- You should consider what to do with submicroscopic infections. It is well-documented that these infections are largely underestimated and form the potential source of infection persistence in endemic areas. For your approach to address the current trend of malaria elimination, it may be necessary to deal with this point..

- Quality control of the whole process from sample preparation to analysis of resultant data (What are the Standard Operating Procedures that will be followed regarding patients, samples, reagents, procedures, personnel, etc. ?). External quality assessment would help strengthen your diagnostic approach, at least for a random subset of samples? You may ask for quality control blood films for assessing the accuracy and precision of your technique as well (I think that WHO can provide these films)?, and this will be better than searching for archived, uncontrolled blood films.

- You have to justify your approach compared to rapid diagnostic tests (RDTs), which are easy-to-use and highly sensitive and specific. One may say that these cannot be helpful for quantifying parasitemia, but you have consider that malaria has to be treated even if submicroscopic. From my experience, the intensity of colored lines of RTDs (faint or dark) can be roughly used to estimate parasite density. In the new approach, however, preparation and imaging of blood films are needed, eliminating the advantages of ease and rapidity. You should discuss the reasons that make it overweigh  RTDs. Additionally, RTDs proved very cost-effective, with sensitivities approaching those of molecular techniques. These can be easily used and interpreted by patients themselves without the need for specialized equipment or electricity.

These are some points I want to draw your attention to. Your insistence on success should be the goal for your excellent idea to reach maturity. I am sorry for intrusion but want to help. Please, feel free to contact me at ([email protected]) for any queries or assistance.

Kind regards,

Rashad

i am a biologist and work on malaria control.i can count rbc in blood and also wish to collaborate 

Dear Baraka Maiseli,

Your proposal it is very interesting, I have a team (3 researchers) with strong experience in microscopic diagnosis of malaria and count of infected RBCs (principally malaria falciparum and vivax). Thus, we were the authors of the Manual of Malaria Diagnosis and Treatment in Bolivia, that include modifications in the antimalarial drugs policies and normalization of malaria diagnosis procedures as (past) head of the National Reference Laboratory in Malaria. We have experience in “in vivo” surveillance of the antimalarial-resistance, malaria surveillance and other similar topics including molecular markers related to antimalarial-resistance. In this way, probably we have the characteristics to satisfy your specific requirements.

We need more information related possibilities to work in collaboration with you and other researchers. Preliminary, I confirm that we are very interested in your innovative proposal.

Sincerely,

Eddy Martinez

DIRECTOR

INSTITUTO DE INVESTIGACION EN SALUD Y DESARROLLO

FACULTAD DE MEDICINA

UNIVERSIDAD MAYOR DE SAN ANDRES

LA PAZ, BOLIVIA

PAST-COORDINATOR OF AMAZON MALARIA INITIATIVE /AMAZON NETWORK FOR SURVEILLANCE OF ANTIMALARIAL-DRUGS RESISTANCE (AMI/RAVREDA)

Interested. I have samples (collected for my PhD work; N=1600).