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


CONCLUSIONS
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 of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Christopher T
CT
Lam
Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America; Center for Global Women's Health Technologies, Duke University, Durham, North Carolina, United States of America; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Marlee S
MS
Krieger
Department of Surgery, Duke University, Durham, North Carolina, United States of America.
Jennifer E
JE
Gallagher
Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Betsy
B
Asma
Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, United States of America.
Lisa C
LC
Muasher
Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, United States of America.
John W
JW
Schmitt
Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America; Center for Global Women's Health Technologies, Duke University, Durham, North Carolina, United States of America; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Nimmi
N
Ramanujam
D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology; D020681:Colposcopes / Q000191:economics*; D003127:Colposcopy / Q000191:economics* / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D010865:Pilot Projects; D019095:Point-of-Care Systems / Q000191:economics*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult