Research heralds leprosy diagnosis via a smartphone

Pioneering research is taking place which could see the world’s oldest disease diagnosed by a smartphone.

Despite there being a cure for leprosy since the 1980s, there remains more than 200,000 cases of leprosy diagnosed and treated each year. The treated cases are just the tip of the iceberg. Research suggests that for every person treated there are a hidden 20 who need the cure.

If left untreated, leprosy causes nerve damage which can lead to permanent disability, including blindness. It thrives in areas of poverty where there is malnutrition and poor living conditions. The Leprosy Mission’s work involves telling people about the disease and quashing prejudice surrounding it. By doing so it is hoped that people come forward for treatment before they develop disabilities.

Dr Arie de Kruijff heads up The Leprosy Mission Mozambique, which works in remote communities in the troubled northern Cabo Delgado province.

Arie explained that community volunteers, people who have often been cured of leprosy themselves, talk to their communities about the disease and make them aware of the early signs, including skin lesions.

He said: “For people affected by leprosy the road to an early diagnosis and a cure without disabilities is a long one. At The Leprosy Mission Mozambique we are seeking a better road to a better future for people affected by leprosy.

“The biggest problem that volunteers face is how to find someone with enough clinical skill, time and patience to make a correct diagnosis among the myriad of skin diseases that could appear like leprosy.”

Every year The Leprosy Mission trains thousands of health workers and volunteers to diagnose leprosy. However, diagnosis can be tricky as leprosy may be confused with other skin diseases.

Often health workers do not have adequate clinical skills, especially when dealing with early cases of leprosy. In such instances, the patient is given a skin smear or biopsy to confirm a diagnosis. But in areas such as rural Mozambique, where Arie and his team works, there are no such facilities.

So when Arie and Dr Deanna Hagge, Senior Research Advisor at TLM International, learned of groundbreaking research at the University of Latvia diagnosing skin abnormalities through multi-spectral screening, they reached out to forge a partnership with Professor Janis Spigulis.

Professor Spigulis and his team are specialists in multi-spectral screening (specifically the absorption and scattering of light) of skin lesions and the development of mobile screening devices.

Spectral screening has been used successfully to detect melanoma, the deadliest form of skin cancer. Digital technology has meant that suspect lesions can be immediately screened against a database. The database provides scoring factors that significantly increase accuracy of initial clinician decisions.

A one-year research project is now underway at The Leprosy Mission’s Anandaban Hospital in Nepal to test the efficacy of multi-spectral screening on leprosy lesions. A baseline scoring of digital images of leprosy classifications can then be developed and cross-referenced with other common skin conditions, such as dermatitis.

The next step is to apply a screening device to a smartphone. This will enable volunteers and health workers to have in their hands the ability to diagnose a leprosy lesion in minutes.

The project has secured funding from the Neglected Tropical Disease Innovation Prize and The Leprosy Mission New Zealand. A £5,479 grant from St Francis Leprosy Guild will enable the research project to be completed.

Sian Arulanantham, Head of Programmes and Policy at The Leprosy Mission England and Wales said: “Pioneering diagnostic tools such as in-situ multi-spectral screening are desperately needed to quickly and accurately diagnose leprosy in the remote areas of Asia and Africa where we work.

“There are so many communities that don’t have access to hospital-based skin smears and biopsies, which are also costly and invasive.

“A health worker armed with the technology to more accurately diagnose leprosy with a scanner on a smartphone is such an exciting prospect. A person with leprosy can be treated immediately and spared a lifetime of disability.

“Such a device would be an immensely valuable tool in our mission to end leprosy. We are incredibly grateful to St Francis Leprosy Guild for funding this groundbreaking research.”

Clare McIntosh, Director of St Francis Leprosy Guild, which has cared for people affected by leprosy for 125 years, said: “We are delighted to be supporting this exciting research project. An easy-to-use, field diagnostic is the vital tool that we need to find the many people affected by leprosy and stop its transmission."