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Comment by maxklein | Hacker News Reader

The sad part is: This app is basically useless. Malaria has very distinct symptoms. Malaria also has a 3-day pre-roll period where you know you are about to get malaria, but you are not yet in bed. Also, Malaria is the #1 drug every chemist stocks in malaria-infested areas. Furthermore, taking a malaria pill even if you don't have malaria has no side effect.

What this means is that if all the criteria of bad luck come together:

1. Person does not know the symptoms for malaria

2. There is no chemist around who stocks malaria pills

3. The illness for some reason instantly hits the person without the pre-roll period

...then the person for whom all these criteria comes into question is about 99.99% not likely to have an Android phone around. And 100% not likely to have a lifelens attached to the phone.

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This is from Wikipedia:

The mainstay of malaria diagnosis has been the microscopic examination of blood. Although blood is the sample most frequently used to make a diagnosis, both saliva and urine have been investigated as alternative, less invasive specimens.

Areas that cannot afford laboratory diagnostic tests often use only a history of subjective fever as the indication to treat for malaria. Using Giemsa-stained blood smears from children in Malawi, one study showed that when clinical predictors (rectal temperature, nailbed pallor, and splenomegaly) were used as treatment indications, rather than using only a history of subjective fevers, a correct diagnosis increased from 2% to 41% of cases, and unnecessary treatment for malaria was significantly decreased.

It certainly sounds as there is use for diagnostics tools.

You still don't get it. It's not neccessary to diagnose for malaria via blood. Malaria patients know they have malaria in almost all cases, because they are familiar with the disease. As soon as the symptoms show, they take the tablets. If the problem is not fixed, then it was not malaria. But if you live in a malaria area and you have the typical malaria fever, 99.9% of the time it will be malaria.

Blood diagnosis is unnecessary and expensive. Just take the pills.

I'm no expert. I don't claim to be. My point is that people actually appear to do testing. Now maybe you should relay your message to these testers, but it doesn't appear to be uncommon.

In fact, there's a whole Wikipedia page dedicate to Malaria testing:

http://en.wikipedia.org/wiki/Malaria_antigen_detection_tests

And they note more than 20 commercial products for sale that test for Malaria.

Here's a paper from the NIH on the importance and state of rapid Malaria diagnosis:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2223842/

Here's another NIH paper talking about an Malaria eradication, and a big part of their plan is diagnosis:

http://www.ncbi.nlm.nih.gov/pubmed/21311583

Again, I'm not expert (or even novice), but looking at the literature and what people in the field are working on -- it looks like they make use of diagnostic tools for Malaria. I've certainly seen no papers saying that diagnostics isn't useful in 99.99% of all cases, just pop a pill. Not saying that that's not what should be done, but I find the evidence thus far lacking.

The people who need to diagnose it are in a hospital, where they can just use one of many methods. They don't need to to peer through an android lens. Laymen rarely need to diagnose malaria because the symptoms are very very clear.

From the other poster, this is from WHO:

"Clinical diagnosis, the most widely used approach, is unreliable because the symptoms of malaria are very non-speciﬁc."

From the last NIH paper I referenced, "Many of malaria's signs and symptoms are indistinguishable from those of other febrile diseases."

Here's a paper from the Lancet about Malaria misdiagnosis:

http://www.ncbi.nlm.nih.gov/pubmed/15555670

From the above: "Effective and affordable treatment is recommended for all cases of malaria within 24 h of the onset of illness. Most cases of "malaria" (ie, fever) are self-diagnosed and most treatments, and deaths, occur at home. The most ethical and cost-effective policy is to ensure that newer drug combinations are only used for true cases of malaria. Although it is cost effective to improve the accuracy of malaria diagnosis, simple, accurate, and inexpensive methods are not widely available, particularly in poor communities where they are most needed."

Additionally people apparently can build up a resistance to the Malaria treatment. See:

http://www.irinnews.org/Report.aspx?ReportId=78014

“When people are sick in Mali, the doctor will usually tell them they have malaria whether or not they test for it,” said Fatou Faye, an infectious diseases researcher and trainer at a privately funded medical laboratory, the Charles Merieux Centre in Bamako.

“The patients then buy anti-malarial drugs in the street and build up a resistance to treatment.”

As a result, according to research by Dr. Imelda Bates at the Malaria Knowledge Project (MKP), part of the Liverpool University School of Tropical Medicine, this means people miss other causes of feverish illness such as pneumonia and meningitis, which can cause further illness and even death.

Again, I'm not saying your wrong necessarily, but everything I read seems to point to the fact that low-cost accurate Malaria diagnosis would be useful.

Again, I'm not saying your wrong necessarily...

Actually you're telling him that he's acting exactly like people commonly do in malarial areas, and are informing him that simply taking that course of action breeds worse varieties of malaria, and causes people to die of unrelated diseases that could have been treated.

This strongly suggests that he has practical experience with malaria. And is useful information for him about how the advice he has based on experience is suboptimal.

Medicine is a game of probability. If you have malaria symptoms in a malaria area, the chance of you having malaria are around 99%. Every other disease with similar symptoms (e.g Typhoid) is pretty rare.

When it comes to peoples lives, people very quickly reach the optimal solution. It's what humans do best. This android solution is a theoretical solution from people who have never experienced malaria and don't even live in an area where malaria exists.

Yes, I have practical experience with malaria. I also have practical experience with android phones. I am actually qualified to make experience-based judgments on the feasibility of that tool, and quoting theoretical papers may win you arguments on the internet, but it will have little practical usage.

When there is a disease in an area that has existed for so long that people have built genetic resistance to it, at the cost of having occasionally sickly children, then trust me, modern methods that work will quickly be selected.

Modern methods that don't work (bed mosquito nets), will be selected away.

Armchair solutions for problems you only partially understand are pointless.

They were showing it on a Windows Phone 7, not Android.

http://whqlibdoc.who.int/hq/2000/WHO_CDS_RBM_2000.14.pdf

From WHO/USAID report on Malaria detection (executive summary):

"In malaria patients, a prompt and accurate diagnosis is the key to effective disease management. The two diagnostic approaches currently used most often, however, do not allow a satisfactory diagnosis of malaria. Clinical diagnosis, the most widely used approach, is unreliable because the symptoms of malaria are very non-speciﬁc. Microscopic diagnosis, the established method for laboratory conﬁrmation of malaria, presents technical and personnel requirements that often cannot be met, particularly in facilities at the periphery of the health care system. In addition, delays in the provision of the microscopy results to the clinician mean that decisions on treatment may be taken without the beneﬁt of the results. Thus, the recent introduction of rapid diagnostic tests (RDTs) for malaria is of considerable interest."

The report is completely disconnected from reality. Malaria patients often have very clear symptoms, and at the point where a diagnosis is necessary, a blood test WILL have to be done. Malaria is a very common disease, and there are very clear and available treatments, and the symptoms are very well known. The blood tests are also very available.

This android device is solving a solved problem.

Why do you keep calling it an Android device? The article clearly states it's a Windows 7 Mobile device-specific app.

I have had malaria twice. When you have it you definitely know you have the disease. Your legs shake from side to side. You can diagnose disease as well becuase your temperature goes in a zig zag patern over a 10 to 20 min cycle. none of these methods will tell you what kind of maleria you have, which is usefull to know what the best treatment is. Sometimes this is not necessary as there is only one kind in the region. It should not be under estimated how hard it is tell one type of maleria from the other. The last time I had it took 4 hours for a major hospital in London to identfy that I had 3 types of parasite in my blood.

Hopefully this sort of technology is expanded upon, with two directions possible. The first is creating more self-diagnosis tools for smartphones (more relevant to those who are likely to own one). The second is creating tools for those 99.999% not likely to have an Android phone around (and perhaps to help doctors/nurses/other aides).

CellScope, based in Berkeley, came up with a way to attach a smartphone to a microscope a few years ago in order to test for TB in remote places and have doctors elsewhere analyze results [ BBC story: http://news.bbc.co.uk/2/hi/technology/8161775.stm ].

Their next device is an otoscope that attaches to the iPhone so you can take pictures of ear infections [ see the CellScope profile on LAUNCH: http://lnch.is/qTqQK0 ].

Whether the malaria app works or not, I have no doubt we'll see more health-related hardware and apps for mobile phones.

Saying that Android penetration is small now means nothing regarding growth potential. Mobile phone usage in sub-Saharan Africa has exploded over the past decade and is responsible for greater mobile banking penetration than there is in the US (despite our incredible Android penetration).

The fact that this technology is being built means that mobile clinic operators can take advantage of faster, easier, cheaper, more accurate diagnostics in the field. When will an everyday consumer enjoy the ability to self-diagnose a blood-borne disease? When someone gets AIDs in the US, can they self-diagnose?

The need exists and this is a great step forward.

If the scan can be expanded to other blood-borne diseases, it could potentially be useful. But it's pointless for malaria.

Malaria is a bit unique among diseases in that it's a parasite and not a virus or bacteria. I'm not sure this method extends to non-parasitic diseases.

Maybe it can be modified to look for other diseases with distinct blood patterns.

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