Peter M. Small

George P. Kafentzis, Stephane Tetsing, Joe Brew et al.

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis and primarily affects the lungs, as well as other body parts. TB is spread through the air when an infected person coughs, sneezes, or talks. Medical doctors diagnose TB in patients via clinical examinations and specialized tests. However, coughing is a common symptom of respiratory diseases such as TB. Literature suggests that cough sounds coming from different respiratory diseases can be distinguished by both medical doctors and computer algorithms. Therefore, cough recordings associated with patients with and without TB seems to be a reasonable avenue of investigation. In this work, we utilize a very large dataset of TB and non-TB cough audio recordings obtained from the south-east of Africa, India, and the south-east of Asia using a fully automated phone-based application (Hyfe), without manual annotation. We fit statistical classifiers based on spectral and time domain features with and without clinical metadata. A stratified grouped cross-validation approach shows that an average Area Under Curve (AUC) of approximately 0.70 $\pm$ 0.05 both for a cough-level and a participant-level classification can be achieved using cough sounds alone. The addition of demographic and clinical factors increases performance, resulting in an average AUC of approximately 0.81 $\pm$ 0.05. Our results suggest mobile phone-based applications that integrate clinical symptoms and cough sound analysis could help community health workers and, most importantly, health service programs to improve TB case-finding efforts while reducing costs, which could substantially improve public health.

Alexander Philip, Sanya Chawla, Lola Jover et al.

Chest X-ray is a commonly used tool during triage, diagnosis and management of respiratory diseases. In resource-constricted settings, optimizing this resource can lead to valuable cost savings for the health care system and the patients as well as to and improvement in consult time. We used prospectively-collected data from 137 patients referred for chest X-ray at the Christian Medical Center and Hospital (CMCH) in Purnia, Bihar, India. Each patient provided at least five coughs while awaiting radiography. Collected cough sounds were analyzed using acoustic AI methods. Cross-validation was done on temporal and spectral features on the cough sounds of each patient. Features were summarized using standard statistical approaches. Three models were developed, tested and compared in their capacity to predict an abnormal result in the chest X-ray. All three methods yielded models that could discriminate to some extent between normal and abnormal with the logistic regression performing best with an area under the receiver operating characteristic curves ranging from 0.7 to 0.78. Despite limitations and its relatively small sample size, this study shows that AI-enabled algorithms can use cough sounds to predict which individuals presenting for chest radiographic examination will have a normal or abnormal results. These results call for expanding this research given the potential optimization of limited health care resources in low- and middle-income countries.

Rediet Abebe, Shawndra Hill, Jennifer Wortman Vaughan et al.

The lack of comprehensive, high-quality health data in developing nations creates a roadblock for combating the impacts of disease. One key challenge is understanding the health information needs of people in these nations. Without understanding people's everyday needs, concerns, and misconceptions, health organizations and policymakers lack the ability to effectively target education and programming efforts. In this paper, we propose a bottom-up approach that uses search data from individuals to uncover and gain insight into health information needs in Africa. We analyze Bing searches related to HIV/AIDS, malaria, and tuberculosis from all 54 African nations. For each disease, we automatically derive a set of common search themes or topics, revealing a wide-spread interest in various types of information, including disease symptoms, drugs, concerns about breastfeeding, as well as stigma, beliefs in natural cures, and other topics that may be hard to uncover through traditional surveys. We expose the different patterns that emerge in health information needs by demographic groups (age and sex) and country. We also uncover discrepancies in the quality of content returned by search engines to users by topic. Combined, our results suggest that search data can help illuminate health information needs in Africa and inform discussions on health policy and targeted education efforts both on- and offline.