Deep learning model meets community-based surveillance of acute flaccid paralysis

Acute flaccid paralysis (AFP) case surveillance is pivotal for the early detection of potential poliovirus, particularly in endemic countries such as Ethiopia. The community-based surveillance system implemented in Ethiopia has significantly improved AFP surveillance. However, challenges like delayed detection and disorganized communication persist. This work proposes a simple deep learning model for AFP surveillance, leveraging transfer learning on images collected from Ethiopia's community key informants through mobile phones. The transfer learning approach is implemented using a vision transformer model pretrained on the ImageNet dataset. The proposed model outperformed convolutional neural network-based deep learning models and vision transformer models trained from scratch, achieving superior accuracy, F1-score, precision, recall, and area under the receiver operating characteristic curve (AUC). It emerged as the optimal model, demonstrating the highest average AUC of 0.870 ± 0.01. Statistical analysis confirmed the significant superiority of the proposed model over alternative approaches (P < 0.001). By bridging community reporting with health system response, this study offers a scalable solution for enhancing AFP surveillance in low-resource settings. The study is limited in terms of the quality of image data collected, necessitating future work on improving data quality. The establishment of a dedicated platform that facilitates data storage, analysis, and future learning can strengthen data quality. Nonetheless, this work represents a significant step toward leveraging artificial intelligence for community-based AFP surveillance from images, with substantial implications for addressing global health challenges and disease eradication strategies.