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M.L. holds a postdoctoral Fellowship of the Spanish Ministry of Economy and Competitiveness (FPDI-2013-16409). JMB thanks the support by MINECO through research Grants BIO2013-44565R and BIO2016-77430R. MP, SGC, DC and MLO work was supported by the Universidad Politecnica de Madrid (COOP-XVII-02), Madrid Regional Government (TOPUS S2013/MIT-3024), the European Regional Development Funds, Amazon Web Services and Fundacion Renta Corporacion.

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Cuadrado, DanielAuthorLuengo-Oroz, MiguelAuthor
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Plasmodium species differentiation by non-expert on-line volunteers for remote malaria field diagnosis

Publicated to:Malaria Journal. 17 (54): 54- - 2018-01-30 17(54), DOI: 10.1186/s12936-018-2194-8

Authors: Ortiz-Ruiz, Alejandra; Postigo, Maria; Gil-Casanova, Sara; Cuadrado, Daniel; Bautista, Jose M.; Miguel Rubio, Jose; Luengo-Oroz, Miguel; Linares, Maria;

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SPOTLAB SL, C Gran Via 39,2, Madrid 28013, Spain. - Author

Abstract

Background: Routine field diagnosis of malaria is a considerable challenge in rural and low resources endemic areas mainly due to lack of personnel, training and sample processing capacity. In addition, differential diagnosis of Plasmodium species has a high level of misdiagnosis. Real time remote microscopical diagnosis through on-line crowdsourcing platforms could be converted into an agile network to support diagnosis-based treatment and malaria control in low resources areas. This study explores whether accurate Plasmodium species identification-a critical step during the diagnosis protocol in order to choose the appropriate medication-is possible through the information provided by non-trained on-line volunteers. Methods: 88 volunteers have performed a series of questionnaires over 110 images to differentiate species (Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax, Plasmodium malariae, Plasmodium knowlesi) and parasite staging from thin blood smear images digitalized with a smartphone camera adapted to the ocular of a conventional light microscope. Visual cues evaluated in the surveys include texture and colour, parasite shape and red blood size. Results: On-line volunteers are able to discriminate Plasmodium species (P. falciparum, P. malariae, P. vivax, P. ovale, P. knowlesi) and stages in thin-blood smears according to visual cues observed on digitalized images of parasitized red blood cells. Friendly textual descriptions of the visual cues and specialized malaria terminology is key for volunteers learning and efficiency. Conclusions: On-line volunteers with short-training are able to differentiate malaria parasite species and parasite stages from digitalized thin smears based on simple visual cues (shape, size, texture and colour). While the accuracy of a single on-line expert is far from perfect, a single parasite classification obtained by combining the opinions of multiple on-line volunteers over the same smear, could improve accuracy and reliability of Plasmodium species identification in remote malaria diagnosis.

Keywords
crowdsourcingmalaria species identificationAdolescentAdultChildCrowdsourcingGametocyte carriageHematologic testsHumansInfantMalariaMalaria species identificationMicroscopyParasitologyPlasmodiumRemote diagnosisReproducibility of resultsSurveys and questionnairesTanzaniaVolunteers

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Malaria Journal due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2018, it was in position 4/21, thus managing to position itself as a Q1 (Primer Cuartil), in the category Tropical Medicine.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 3.27, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Apr 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-04-26, the following number of citations:

  • WoS: 7
  • Scopus: 14
  • Europe PMC: 6
  • OpenCitations: 16
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-04-26:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 135.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 135 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 6.1.
  • The number of mentions on the social network X (formerly Twitter): 5 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.