OocystMeter, a machine-learning algorithm to count and measure Plasmodium oocysts, reveals clustering patterns in the...

We present OocystMeter, a machine learning-based software developed to automate the segmentation of malaria oocysts from images of mosquito midguts stained with mercurochrome. Existing bioimage analysis tools, including machine learning-based ones, often struggle with the unique staining patterns, complex midgut backgrounds, and variable morphology of oocysts, making the determination of oocyst size and numbers cumbersome. To overcome these challenges, we curated a high-quality dataset comprised of 11,178 Plasmodium falciparum oocysts in Anopheles gambiae midguts annotated by expert parasitologists. Using this dataset, we fine-tuned a Mask R-CNN object detection model to achieve segmentation accuracy comparable to human parasitologists (Spearman's correlation of 0.998 for oocyst counts and 0.978 for size measurements). Applying this tool in conjunction with spatial analysis, we uncovered a non-random, clustered spatial distribution of oocysts independent of the midgut's anatomical regions or geometric axes, particularly in infections with fewer than 75 oocysts/midgut. Our workflow significantly accelerates malaria oocyst intensity and size analysis, reduces human bias, and provides spatial coordinates for advanced parasitology studies. OocystMeter is freely available at https://github.com/duopeng/OocystMeter, and as a web tool at http://Oocystmeter.org/, offering a valuable resource for researchers investigating the oocyst stage of malaria development.