Schistoscope: Towards a locally producible smart diagnostic device for Schistosomiasis in Nigeria

Schistosomiasis is a treatable and preventable neglected tropical disease of Public Health importance affecting over 250 million people worldwide while Nigeria is one of the high burden countries. Currently available diagnoses are cumbersome, low in sensitivity and not field-adaptable given the high skill required that are not available in the rural settings where the diseases are majorly prevalent. Democratizing access to diagnosis with a rapid, easy-to-use, accurate diagnosis is critical in currently stepped-up control, pre-elimination and elimination strategies for urinary schistosomiasis. In this paper, we describe the design process of a low-cost smartphone-based microscope for rapid diagnosis of urinary Schistosomiasis. Field research conducted in Nigeria with the active involvement of key stakeholders in the research and development (R&D) process validated our assumptions and enabled the development of our proof-of-concept into a working prototype in three iterative designs steps. Through this design process, we investigated the local development of technical optics for good quality imaging and explored the simplification of sample preparation techniques using commonly available materials. Starting from the first iteration, the output of each design step was used as the input to the subsequent iterations to optimize our system design. Insightful results and input from the field demonstrated that an adaptive design approach was needed to facilitate the rapid development and deployment of point-of-care diagnostic devices for use in low-resource settings. It is our goal that these devices will be locally manufactured in Nigeria to expand access to the test given her huge population and high disease burden, quick repairs, and easy maintenance on the field.