Design of a Novel Low Cost Point of Care Tampon (POCkeT) Colposcope for Use in Resource Limited Settings.

Abstract

INTRODUCTION: Current guidelines by WHO for cervical cancer screening in low- and middle-income countries involves visual inspection with acetic acid (VIA) of the cervix, followed by treatment during the same visit or a subsequent visit with cryotherapy if a suspicious lesion is found. Implementation of these guidelines is hampered by a lack of: trained health workers, reliable technology, and access to screening facilities. A low cost ultra-portable Point of Care Tampon based digital colposcope (POCkeT Colposcope) for use at the community level setting, which has the unique form factor of a tampon, can be inserted into the vagina to capture images of the cervix, which are on par with that of a state of the art colposcope, at a fraction of the cost. A repository of images to be compiled that can be used to empower front line workers to become more effective through virtual dynamic training. By task shifting to the community setting, this technology could potentially provide significantly greater cervical screening access to where the most vulnerable women live. The POCkeT Colposcope's concentric LED ring provides comparable white and green field illumination at a fraction of the electrical power required in commercial colposcopes. Evaluation with standard optical imaging targets to assess the POCkeT Colposcope against the state of the art digital colposcope and other VIAM technologies. RESULTS: Our POCkeT Colposcope has comparable resolving power, color reproduction accuracy, minimal lens distortion, and illumination when compared to commercially available colposcopes. In vitro and pilot in vivo imaging results are promising with our POCkeT Colposcope capturing comparable quality images to commercial systems. CONCLUSION: The POCkeT Colposcope is capable of capturing images suitable for cervical lesion analysis. Our portable low cost system could potentially increase access to cervical cancer screening in limited resource settings through task shifting to community health workers.

Department

Description

Provenance

Subjects

Adolescent, Adult, Aged, Cervix Uteri, Colposcopes, Colposcopy, Equipment Design, Female, Humans, Image Processing, Computer-Assisted, Middle Aged, Pilot Projects, Point-of-Care Systems, Uterine Cervical Neoplasms, Young Adult

Citation

Published Version (Please cite this version)

10.1371/journal.pone.0135869

Publication Info

Lam, Christopher T, Marlee S Krieger, Jennifer E Gallagher, Betsy Asma, Lisa C Muasher, John W Schmitt and Nimmi Ramanujam (2015). Design of a Novel Low Cost Point of Care Tampon (POCkeT) Colposcope for Use in Resource Limited Settings. PLoS One, 10(9). p. e0135869. 10.1371/journal.pone.0135869 Retrieved from https://hdl.handle.net/10161/10961.

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Scholars@Duke

Muasher

Lisa Coates Muasher

Assistant Professor of Obstetrics and Gynecology
Schmitt

John Wilson Schmitt

Medical Professor in the Department of Obstetrics and Gynecology
Ramanujam

Nimmi Ramanujam

Robert W. Carr, Jr., Distinguished Professor of Biomedical Engineering

Nirmala (“Nimmi”) Ramanujam is the Robert W. Carr Professor of Biomedical Engineering and Professor of Cancer Pharmacology, Cancer Biology, and Global Health and founder of the Center for Global Women’s Health Technologies (GWHT) at Duke University. Her work addresses access gaps across the cancer care continuum both locally and globally. Her group develops low-cost imaging, artificial intelligence, and digital health platforms to decentralize the early detection of cervical cancer, and immune-based injectables and metabolic biomarkers for breast cancer treatment. Across both programs, she addresses access in different ways—expanding prevention where healthcare infrastructure is limited and improving access to treatment where therapies are available, yet lengthy and prohibitively expensive. She founded Calla Health to translate women’s health technologies into practice and co-developed The (In)visible Organ, a documentary that raises awareness and addresses stigma as barriers to care. She also leads experiential STEM initiatives that train students in systems-based, equity-centered technology development and she has authored a textbook, Biomedical Engineering and Global Health. She is a Fellow of the National Academy of Engineering and the National Academy of Inventors, a Fulbright Scholar, and recipient of a number of awards, notably of the Department of Defense Breast Cancer Innovator Award, the IEEE Biomedical Engineering Technical Field Award and the Anita B social impact award.


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