title: The remote diagnosis of malaria using telemedicine or e-mailed images.
abstract: We determined the ability of blinded remote expert microscopy to identify malaria parasites through transmission of malaria smear images via telemedicine and as e-mail attachments. Protocols for malaria smear transmission included: (1) transmission of sender-selected televised smears at various bandwidths (Bw), (2) transmission of remote reader-directed televised smears at various Bw, and (3) transmission of digital photomicrographs as e-mail attachments. Twenty (14%) of 147 sender-selected, and 13 (6%) of 221 reader-directed, images were deemed unreadable by slide readers. The presence or absence of malaria was correctly identified in 98% of the remaining images. Sixty-four (34%) of 190 digital microphotographs were deemed unreadable, while the presence or absence of malaria was correctly identified in 100% of the remaining images. Correct speciation ranged from 45% to 83% across various transmission methods and Bw. The use of telemedicine and e-mail technology shows promise for the remote diagnosis of malaria.
authors.affiliation: Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA. Clinton.Murray@amedd.army.mil
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: Rupal M
authors.initials: RM
authors.lastname: Mody
authors.forename: David P
authors.initials: DP
authors.lastname: Dooley
authors.forename: Duane R
authors.initials: DR
authors.lastname: Hospenthal
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Horvath
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Moran
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Muntz
mesh_terms: D000818:Animals; D034742:Electronic Mail; D005240:Feasibility Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008288:Malaria / Q000469:parasitology / Q000473:pathology*; D008853:Microscopy / Q000379:methods*; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification; D019114:Remote Consultation; D013045:Species Specificity; D013781:Texas; D014481:United States