Leprosy Screening Based on Artificial Intelligence: Development of a Cross-Platform App.

BACKGROUND: According to the World Health Organization, achieving targets for control of leprosy by 2030 will require disease elimination and interruption of transmission at the national or regional level. India and Brazil have reported the highest leprosy burden in the last few decades, revealing the need for strategies and tools to help health professionals correctly manage and control the disease. OBJECTIVE: The main objective of this study was to develop a cross-platform app for leprosy screening based on artificial intelligence (AI) with the goal of increasing accessibility of an accurate method of classifying leprosy treatment for health professionals, especially for communities further away from major diagnostic centers. Toward this end, we analyzed the quality of leprosy data in Brazil on the National Notifiable Diseases Information System (SINAN). METHODS: Leprosy data were extracted from the SINAN database, carefully cleaned, and used to build AI decision models based on the random forest algorithm to predict operational classification in paucibacillary or multibacillary leprosy. We used Python programming language to extract and clean the data, and R programming language to train and test the AI model via cross-validation. To allow broad access, we deployed the final random forest classification model in a web app via shinyApp using data available from the Brazilian Institute of Geography and Statistics and the Department of Informatics of the Unified Health System. RESULTS: We mapped the dispersion of leprosy incidence in Brazil from 2014 to 2018, and found a particularly high number of cases in central Brazil in 2014 that further increased in 2018 in the state of Mato Grosso. For some municipalities, up to 80% of cases showed some data discrepancy. Of a total of 21,047 discrepancies detected, the most common was "operational classification does not match the clinical form." After data processing, we identified a total of 77,628 cases with missing data. The sensitivity and specificity of the AI model applied for the operational classification of leprosy was 93.97% and 87.09%, respectively. CONCLUSIONS: The proposed app was able to recognize patterns in leprosy cases registered in the SINAN database and to classify new patients with paucibacillary or multibacillary leprosy, thereby reducing the probability of incorrect assignment by health centers. The collection and notification of data on leprosy in Brazil seem to lack specific validation to increase the quality of the data for implementations via AI. The AI models implemented in this work had satisfactory accuracy across Brazilian states and could be a complementary diagnosis tool, especially in remote areas with few specialist physicians.

Avaliação das ações de controle da hanseníase no município de Governador Valadares, Brasil, no período de 2001 a 2006 / Assessment of actions for the control of leprosy in the municipality of Governador Valadares, Brazil, the period of 2001/2006

A hanseníase é uma doença infecto-contagiosa de evolução crônica que se manifesta principalmente através de sinais e sintomas dermatoneurológicos: lesões na pele e nos nervos periféricos. O objetivo deste trabalho é avaliar a situação epidemiológica e operacional do controle da hanseníase no município de Governador Valadares/MG no período de 2001 a 2006. Trata-se de um estudo epidemiológico, de natureza descritiva, do tipo transversal. Os altos coeficientes de detecção geral e em menores de 15 anos encontrados no município de Governador Valadares entre 2001 e 2006 mantêm o município como hiperendêmico para hanseníase. Apesar do predomínio de adultos jovens, a quantidade de pessoas com menos de 15 anos diagnosticadas ainda é alta sinalizando a necessidade de ações de prevenção nesta faixa etária. Há uma tendência de melhora com relação ao tipo de alta com um aumento dos casos de cura e diminuição dos índices de abandono a partir de 2005. Governador Valadares vem apresentando melhora em suas ações de controle ao longo dos anos, porém há um grande desafio pela frente no controle da hanseníase no município. É necessário a intensificação da vigilância epidemiológica e adoção de ações efetivas de controle para que o município alcance as metas de eliminação da doença enquanto problema de saúde pública.

Leprosy is an infectious and contagious disease of chronic evolution manifested primarily through signs and dermato-neurological symptoms: skin and peripheral nerve lesions. The aim of this study is to evaluate the epidemiological and operational control of leprosy in the city of Governador Valadares/MG in the period 2001 to 2006. This is an epidemiological, descriptive, and transversal study. The high detection rates in general and in children under 15 found in the city of Governador Valadares between 2001 and 2006's characterized the municipality as hyperendemic for leprosy. Despite the predominance of young adults, the amount of people under 15 years diagnosed is still high indicating the need for preventive actions in this age group. There is a trend of improvement with respect to the type of discharge, with an increase in cases of healing and reduction of dropout rates from 2005. Governador Valadares has shown improvement in their control actions over the years, but there is a big challenge in the control of leprosy in the district. It is necessary to intensify surveillance and adoption of effective control so that the council reaches the goals of eliminating the disease as a public health problem.

Transmissao e controle da hanseniase no Municipio de Governador Valadares/MG - Periodo de 1990 a 2000 / Transmission and control of leprosy in the municipality of Governador Valadares/MG - Period 1990 / 2000

Este estudo tem como objeto a transmissao e controle da hanseniase em Governador Valadares, tendo em vista analisar indicadores epidemiologicos e operacionais, delimitar areas de risco e formular estrategias para controle e eliminacao da hanseniase como problema de saude publica. Trata-se de um estudo epidemiologico de natureza descritiva, de tipo operacional. Os resultados indicam que Governador Valadares situa-se na categoria de municipio hiperendemico (prevalencia de 16,2/10.00 habitantes e deteccao de 10,22/10.00 habitantes em 2000). Aumento da deteccao em menores de 15 anos contraria a descendencia da deteccao geral verificada no periodo. Dos casos novos, 14% foram detectados com alguma incapacidade, indicando diagnostico tardio e prevelencia oculta. A implantacao do Programa de Saude da Familia, a partir de 1998, nao alterou o quadro endemico da doenca. Concluimos qua a endemia esta em expansao no municipio. Sugerimos a intensificacao das estrategias de controle atraves de Plano de Eliminacao baseado em diretrizes politicas e epidemiologicas, tais como: construcao de sustentabilidade economica, politica e social para a eliminacao; descentralizacao das acoes de controle de hanseniase atraves do Programa de Saude da Familia; busca ativa de casos; e investigacao de eventos-sentinela para hanseniase em "areas silenciosas".