Frontiers in Parasitology · Published 2026-06-19 · DOI 10.3389/fpara.2026.1837310
Thomas F. Scherr, Pytsje T. Hoekstra, Theresia Abdoel, Carson P. Moore, Austin Hardcastle, Matthew Boisse, Boaz Mulonga, Kennedy Andiego, George Ogara, Gladys Odhiambo, Fredrick Rawago, Nicholas Spurlock, Alexandrea A. Howard, Megan E. Pask, Eline M. van Dam, Govert J. van Dam, Chris Ho, Goylette F. Chami, Frederick Haselton, Maurice R. Odiere, David Wright
IntroductionControl efforts against schistosomiasis are hampered by the subjective interpretation of the point-of-care circulating cathodic antigen (POC-CCA) urine test, which limits diagnostic consistency. We developed MEDSCAN (Mobile-Enabled Diagnostics for Schistosomiasis Control Analytics), a mobile application that uses smartphone imaging and computer vision to automate POC-CCA interpretation.MethodsIn a multi-site laboratory evaluation across the USA, the Netherlands, and Kenya, we compared MEDSCAN to visual G-Score interpretation and a benchtop lateral flow reader (LFR).ResultsAll three methods produced clear concentration–response relationships, with normalized machine-based metrics achieving AUROC ≥ 0.90. MEDSCAN demonstrated excellent inter-user reproducibility (intra-class correlation coefficients exceeding 0.94) and substantial agreement with both visual and LFR interpretations across sites. Some device-to-device variability was observed, attributable to differences in smartphone camera hardware and image processing; however, binary diagnostic outcomes remained robust across a heterogeneous set of smartphones.DiscussionThese results establish operational positivity thresholds for MEDSCAN—based on test-line signal alone or normalized metrics—suitable for direct implementation in field surveillance workflows. A large-scale field study is underway to evaluate MEDSCAN under routine POC-CCA surveillance conditions in endemic settings.
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Scherr, T., Hoekstra, P., Abdoel, T., et al. (2026). A multi-site laboratory evaluation of the MEDSCAN application for automated POC-CCA interpretation. Frontiers in Parasitology. https://doi.org/10.3389/fpara.2026.1837310