ADAPTIVE FRAMEWORK FOR DIAGNOSIS AND TREATMENT OF

TUBERCULOSIS
1
Ateko Busayo C., 2Oyetunji Olumayowa O.,3Babafemi Olushola F., Onyeka Ndidi C.,5Lawal
Moshood O.
*Department of Computer Science, Federal Polytechnic, Ede

Author’s Corresponding Email: ayclara16@gmail.com,

Abstract

Tuberculosis is amongst the world’s leading causes of death from a single infectious disease.
Medical professionals are faced with a lot of challenges in delivering good health-care with
unassisted automation in hospitals where there are several patients who need the doctor's
attention. The main problem is the problem of certainty and also there is a critical need in
employing computerized technologies to assist in diagnosis and accessing related information.
Different expert systems have been designed to diagnosis tuberculosis but none has been
designed to recommend treatment. General objective is to design an automated system for the
doctors and also the patients to diagnose and treat tuberculosis.

Keywords: Tuberculosis, Expert System, Fuzzy Logic

1.0 Introduction

Tuberculosis (TB) is a global health problem, it is estimated that about one billion individuals are
infected worldwide with tuberculosis, with 10 million new cases and over 3 million deaths per
year (Taura et al., 2008). Tuberculosis is amongst the world’s leading causes of death from a
single infectious disease. Medical professionals are faced with a lot of challenges in delivering
good health-care with unassisted automation in hospitals where there are several patients who
need the doctor's attention. Tuberculosis is still a major public-health difficulty in the tropics.
The combination of inadequate expertise and sometimes the complexity of medical practices
exponentially increase the morbidity and mortality rates of tuberculosis patients. The task of
arriving at an accurate medical diagnosis may sometimes become very complex and
cumbersome. TB most commonly affects the lungs but can also involve any organ of the body.
Tuberculosis has been known under a variety of names during the course of history. It has been a
difficult disease to diagnose and has been confused with many other diseases. The actual name
"Tuberculosis" was introduced during the first half of the nineteenth century. It refers to the
diseased condition caused by infectious agents known as mycobacterium tuberculosis or tubercle
bacilli (Neil and Janet, 2005). The disease has also been known under other names, such as
phthisis, Scrofula, tabes, bronchitis, and inflammation of the lungs, hectic fever, gastric fever,
and lupus (Neil and Janet, 2005). It was also known as the great white plague or “consumption”
(Medicine Net, 2005).

Fuzzy logic provides a means for representing and manipulating data that are not precise, but
rather fuzzy, Fuzzy logic technology provides a simple way to arrive at a definite conclusion
from vague, imprecise and ambiguous medical data (Zadeh, 1965). Fuzzy logic presents an
inference morphology that enables appropriate human reasoning capabilities to be applied to
knowledge-based systems. The theory of fuzzy logic encompasses a mathematical strength to
capture the uncertainties associated with human cognitive processes.

1.1 Aim and Objectives

The aim of this paper is to develop a fuzzy based expert system framework to diagnose and treat
tuberculosis
The objectives of the study includes: -
 To provide a decision support platform to tuberculosis researchers, physicians and other
healthcare practitioners in the tropics
 To ascertain the degree to which fuzzy methodology represents the exact diagnosis of the
patient and prescribe possible treatment as compared with those of medical doctors.
 To use a set of clinical findings such as sign, symptoms and laboratory data to produce a
ranked list of diagnoses which might explain (or be associated with) the clinical
manifestations of the disease.
2.0 Literature Review

As a result of diagnosing and treatment of tuberculosis, growing number of authors who have
done research in tuberculosis, are being discussed:

(Ojeme, 2014) present a paper titled “Fuzzy Expert System for Malaria Diagnosis” base on the
work, the fuzzy logical AND is used to evaluate the composite firing strength of the rules. In
practice, the fuzzy rules sets usually have several antecedents that are combined using fuzzy
logical operators, such as AND, OR and NOT, though their definitions tend to vary: AND simply
uses minimum weight of all the antecedents, while OR uses the maximum value. There is also
the NOT operator that subtracts a membership function from 1 to give the “complementary”
function. The degree of truth (R) of the rules are determined for each rule by evaluating the
nonzero minimum values using the AND operator. The inference engine for the research work
evaluated all the rules in the rules base and combined the weighted consequences of all the
relevant (fired) into a single fuzzy set. In their work, an attempt was made to design a fuzzy
expert system for the diagnosis of malaria. According to their research it is one of the best ways
to deal with the vagueness and imprecision in the health care sector, and no doubt will exploit
tolerance for imprecision, uncertainty and partial truth to achieve tractability, robustness, low
solution cost and better report with reality in medical diagnosis of this major illness. It was
recorded that it will reduce mortality rate in cases where a limited medical doctors are available,
as it provides very rapid method of diagnosis with so much accuracy and reduces the hours spent
by patients in the hospital.

(Fateme et al., 2013), presented a paper titled “designing an expert system for diagnosis of
tuberculosis”, the method used in the paper is prototype method where the system that are not
yet fully ready are presented to the operators for necessary feedback and then the system is
modified. This method consists of three phases of analysis, design, and implementation. And
also the design was fulfilled using vp-expert shell and after the experiment it was discovered that
the designed system show that the expert system collects data through the user’s questions and
answers, and ultimately informs the user of the decision it has arrived at. The expert person’s
behavior is simulated. The limitation identified in this research is that the system is flawless and
cannot recognize wrong answer given by users, the system cannot recommend treatment.
(Dr. M. S. Ali et al., 2013) presented a paper titled “A Fuzzy Expert System For Pathological
Investigation And Diagnosis Of Jaundice” the paper describes design of fuzzy expert system for
the pathological investigation and diagnosis of Jaundice, which can be used by the doctors for
the jaundice treatment. The system design is based on membership functions, input, output
variables and the rule base. In this system fuzzy logic enhance the reasoning in dealing with
fuzzy data and the expert system uses the rules designed by the domain expert to diagnose
patient’s illness based on the pathological tests. Combination of expert system and fuzzy logic
could increase the performance. They now suggested that in future the system can be applied for
the other liver diseases.

(K.Soundararajan et al., 2012) presented a paper titled “Diagnostics Decision Support System
for Tuberculosis using Fuzzy Logic” the paper present an application of fuzzy logic for the
development of decision support system in medicine. Fuzzy logic is a highly suitable and
applicable basis for developing knowledge based systems in medicine. The system is mainly
specialized for the pulmonary physicians that are focusing on tuberculosis and for patients
already diagnosed with tuberculosis.

(Mir Anamul Hasan et al., 2010) presented a paper titled “Human Disease Diagnosis Using a
Fuzzy Expert System” the paper aim at developing a web-based fuzzy expert system for
diagnosing human diseases. Now a days fuzzy systems are being used successfully in an
increasing number of application areas; they use linguistic rules to describe systems. The project
focused on the research and development of a web-based clinical tool designed to improve the
quality of the exchange of health information between health care professionals and patients.
Practitioners can also use this web-based tool to corroborate diagnosis. The system is
experimented on various scenarios in order to evaluate its performance. The knowledge based
online diagnosis system can play a vital role for the users of the system. The system facilitates
the users to determine his probable diseases very quickly with the aid of a knowledge based
expert system. As the knowledge base is created based on the feedback from expert and
specialist doctors, users can also rely on it.

From the past research, the limitation recorded was that the Expert System built was unable to
diagnosed all types of tuberculosis and also all the past research on tuberculosis could not
recommend treatment for tuberculosis patient. In this research we design a system that diagnosis
general tuberculosis and the system also recommend treatment for each patient diagnosed.

3.0 Research Methodology

3.1 Data Collection
The following method of data collection was used in writing this research:

i. Interview
ii. Observation
iii. Review of procedure or existing system or procedural manual
iv. Evaluation of forms

3.2 Fuzzy Expert System

An expert system is a computer system that emulates the decision-making ability of a human
expert. Expert systems are designed to solve complex problems by reasoning about knowledge
like an expert, and not by following the procedure of a developer like in conventional system. To
run an expert system, the engine reasons about the knowledge base like human.

Input Parameter (Crisp)

Fuzzification

Knowledge Base
Fuzzy logic
Inference (root sum Fuzzy Rules
square)
Database

Defuzzification

Output Parameter (crisp)

Figure1. System Architecture of Fuzzy Expert System

The development system involves fuzzification, inference engine and defuzzification. The
designed system is a rule based system that uses fuzzy logic rather that Boolean logic. It was
developed based on the following key components:
 Knowledge-Base component
 Fuzzification Component
 Inference Engine Component
 Defuzzification Component

4.0 Result and Discussion

4.1 Application Interfaces

Various interfaces involved in the development of Fuzzy Expert System to Diagnosis

Tuberculosis are categorized into three sections, comprising user, admin and database section.

4.2 User Interface

The first Introduction page the user decides on operation to perform; whether to register as a new
patient or to log in as an existing patient. User views existing information by launching the
application and go to specific information he intends to view as shown in Figure 4.1, then the
information displayed base on clicked item. This home page comprises of file, patient and edit
links
 Figure 2: User Login Page

4.3 New Patient Link

This is the page where the new patient registered, where all the data of the new patient will be
given for proper Record in case the patient is coming back.

Figure 3: Registration Page

4.4 Medical Diagnosis Menu

After the new patient registration, the new patient proceeds to medical diagnosis page where the
database will be filled and the list of records after which the patient can proceed to diagnosis.

Figure 4: Medical Diagnosis Page

4.5 Diagnosis Page

This is where the patients get diagnosed after he has filled the database and the list of records
then the patient will input appropriate value and click proceed to diagnose.

Figure 5: Diagnosis Page

4.6 Diagnosis Result and Treatment Page

The diagnosis result is being display here whether the patient is positive or negative. If a patient
is negative then the patient can exit the diagnosis page but if the patient result is positive then
there are procedures to follow.

 Prescription
 6months treatment
 Check up

Figure 6: Result Page

5.0 Recommendation and Conclusion

5.1 Conclusion

This study shows that accurate medical diagnosis is one of the major ways to sustain good health
and long live. In this work, an attempt has been made to design a fuzzy expert system for the
diagnosis and treatment of tuberculosis. This is one of the best ways to deal with the vagueness
and imprecision in the health care sector, and no doubt will exploit tolerance for imprecision,
uncertainty and partial truth to achieve tractability, robustness, low solution cost and better report
with reality in medical diagnosis and treatment of this major disease. This will in turn reduce
mortality rate in cases where a limited medical doctors are available, as it provides very rapid
method of diagnosis and treatment with so much accuracy and reduces the hours spent by
patients in the hospital.

5.2 Recommendation
The developed system provides decision support platform to assist TB researchers, physicians
and other health practitioners in TB endemic regions. The authors believe that the approach
proposed in this study, if used intelligently, could be an effective technique for diagnosing TB.

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