Optical Scanning of Sputum Smears to Detect Tubercle Bacilli

The fastest growing technology in the field of pathology and lab medicine is digital imaging and, tangentially, the use of algorithms in the interpretation of digital images. This latter technology is commonly used in connection with IHC and FISH-stained slides to quantify a previously subjective interpretation. Now it turns out that image analysis and algorithms may also be of value in the identification of tubercle bacilli in microbiology labs in developing countries (see: Technology: For Nations That Lack the Expertise, an Automated System for Detecting TB):

One of the difficulties of diagnosing tuberculosis is that there is no simple blood or urine test. Instead, a laboratory technician must take a sample of sputum coughed up from the lungs, stain it and inspect it under a microscope for the telltale bacteria, which resemble long-grain rice. It takes expertise that is often rare in poor countries. Guardian Technologies, a Virginia company that was started to help airport X-ray scanners distinguish explosives in luggage from innocuous plastics and liquids, has developed a system that automatically scans microscope slides for the bacillus. The company’s software algorithms can spot distinctive shapes, colors and densities that untrained eyes may miss. In a recent test in South Africa, which has some of the highest TB rates in the world, the technology was 93 percent accurate in detecting the bacillus on microscope slides and had a false positive rate of less than 2 percent, the company said. The original Guardian system fit a digital camera to a standard microscope. Now, it is making an automated version that can hold 50 slides and work all night while no one is in the lab. New technologies like Guardian’s hold great promise for poor countries with inadequate laboratories, said [a company spokesperson].

One of the major advantages of globalization, from the perspective of healthcare, is that various technologies requiring less trained personnel and lower capital investment are now being developed for use in developing countries. One example is ultrasound imaging (see: Ultrasound in Developing Countries - Photos). Part of the incentive for developing hand-held ultrasound imaging devices is for the deployment in such countries (see: Compact Ultrasound for Improving Maternal and Perinatal Care in Low-Resource Settings). Such devices will also soon be carried by some physicians in addition to their stethoscopes (see: Advances in Portable Ultrasound Devices).  One of the ironies of this emerging global strategy is that these technologies are frequently appropriate in U.S. settings as in the case of free clinics in poor neighborhoods and smaller public health laboratories. These sites don't constitute an initial attractive market for the instrument manufacturers. However, once developed for developing countries, they can then be purchased and deployed in the U.S..

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