<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN"
  "https://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd">
<article xmlns:xlink="http://www.w3.org/1999/xlink"
         xmlns:mml="http://www.w3.org/1998/Math/MathML"
         article-type="research-article"
         dtd-version="1.2">

  <!-- ============================================================ FRONT -->
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IJLTEMAS</journal-id>
      <journal-title-group>
        <journal-title>International Journal of Latest Technology in Engineering, Management &amp; Applied Science (IJLTEMAS)</journal-title>
        <abbrev-journal-title abbrev-type="publisher">IJLTEMAS</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="epub">2278-2540</issn>
      <publisher>
        <publisher-name>IJLTEMAS</publisher-name>
      </publisher>
    </journal-meta>

    <article-meta>
      <!-- IDs -->
      <article-id pub-id-type="publisher-id">537</article-id>
            <article-id pub-id-type="doi">10.51583/IJLTEMAS.2026.151000018</article-id>
      
      <!-- Categories -->
            <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Machine Learning</subject>
        </subj-group>
      </article-categories>
      
      <!-- Title -->
      <title-group>
        <article-title>Ensemble Learning-Based Non-Invasive Anemia Detection Using Conjunctival Image Analysis</article-title>
      </title-group>

      <!-- Authors -->
      <contrib-group>
                <contrib contrib-type="author">
                    <name>
            <surname>P V</surname>
            <given-names>Sona</given-names>
          </name>
                              <aff>
            St. Thomas College (Autonomous), Thrissur                        <country>India</country>
                      </aff>
                    
        </contrib>
                <contrib contrib-type="author">
                    <name>
            <surname>Anil George K</surname>
            <given-names>Dr.</given-names>
          </name>
                              <aff>
            St. Thomas College (Autonomous), Thrissur                        <country>India</country>
                      </aff>
                    
        </contrib>
              </contrib-group>

      <!-- Volume / Issue / Pages -->
            <volume>15</volume>
                  <issue>10</issue>
                        <fpage>190</fpage>
            <lpage>200</lpage>
            
      <!-- Dates -->
      <history>
                <date date-type="received">
          <day>12</day>
          <month>10</month>
          <year>2026</year>
        </date>
                        <date date-type="accepted">
          <day>17</day>
          <month>10</month>
          <year>2026</year>
        </date>
              </history>

            <pub-date pub-type="epub">
        <day>30</day>
        <month>10</month>
        <year>2026</year>
      </pub-date>
      
      <!-- DOI Self-URI -->
            <self-uri xlink:href="https://doi.org/10.51583/IJLTEMAS.2026.151000018"/>
      
      <!-- Keywords -->
            <kwd-group kwd-group-type="author">
                <kwd>Anemia detection</kwd>
                <kwd>machine learning</kwd>
                <kwd>ensemble learning</kwd>
                <kwd>stacking</kwd>
                <kwd>conjunctival images</kwd>
                <kwd>Random Forest</kwd>
                <kwd>XGBoost</kwd>
                <kwd>Extra Trees</kwd>
                <kwd>medical image classification</kwd>
              </kwd-group>
      
    </article-meta>
  </front>

  <!-- ============================================================ BODY (Abstract) -->
  <body>
        <sec>
      <title>Abstract</title>
      <p>Anemia is a global health issue characterized by low hemoglobin levels, leading to reduced oxygen transport in the body. Traditional diagnosis relies on invasive blood tests, which can be costly and inaccessible. This study proposes a machine learning-based ensemble framework for non-invasive anemia detection using conjunctival images. Various classifiers, including SVM, Random Forest (RF), XGBoost, and ANN, were trained and evaluated. Ensemble learning techniques such as bagging, boosting, stacking, and voting were applied, with the stacking ensemble (RF + ANN + XGB) achieving the highest accuracy (95.77%). Extra Trees emerged as the best-performing individual model with 96.48% accuracy. The results confirm that ensemble models significantly improve classification performance over individual classifiers. Future work should integrate multi-modal approaches to further enhance diagnostic accuracy. This study highlights the potential of ensemble learning for scalable, non-invasive anemia detection in clinical settings.</p>
    </sec>
      </body>

  <!-- ============================================================ BACK (References) -->
    <back>
    <ref-list>
      <title>References</title>
            <ref id="ref1">
        <label>1</label>
        <mixed-citation>Kassebaum, N. J., Jasrasaria, R., Naghavi, M., et al. (2014). A systematic analysis of global anemia burden from 1990 to 2010. Blood, 123(5), 615-624. https://doi.org/10.1182/blood-2013-06-508325</mixed-citation>
      </ref>
            <ref id="ref2">
        <label>2</label>
        <mixed-citation>McLean, E., Cogswell, M., Egli, I., Wojdyla, D., &amp; de Benoist, B. (2009). Worldwide prevalence of anemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutrition, 12(4), 444-454. https://doi.org/10.1017/S1368980008002401</mixed-citation>
      </ref>
            <ref id="ref3">
        <label>3</label>
        <mixed-citation>von Schenck, H., Falkensson, M., &amp; Lundberg, B. (1986). Evaluation of “HemoCue,” a new device for determining hemoglobin. Clinical Chemistry, 32(3), 526-529.</mixed-citation>
      </ref>
            <ref id="ref4">
        <label>4</label>
        <mixed-citation>https://doi.org/10.1093/clinchem/32.3.526</mixed-citation>
      </ref>
            <ref id="ref5">
        <label>5</label>
        <mixed-citation>Asare, J. W., Appiahene, P., Donkoh, E. T., &amp; Dimauro, G. (2023). Detection of anemia using conjunctiva images: A smartphone application approach. Informatics in Medicine Unlocked, 40, 101283. https://doi.org/10.1016/j.imu.2023.101283</mixed-citation>
      </ref>
            <ref id="ref6">
        <label>6</label>
        <mixed-citation>Asare, J., Appiahene, P., Donkoh, E., &amp; Dimauro, G. (2023). Iron deficiency anemia detection using machine learning models: A comparative study of fingernails, palm, and conjunctiva of the eye images. Engineering Reports, 5(11), e12667. https://doi.org/10.1002/eng2.12667</mixed-citation>
      </ref>
            <ref id="ref7">
        <label>7</label>
        <mixed-citation>Appiahene, P., Dogbe, S. S. D., Kobina, E. E. Y., Dartey, P. S., Afrifa, S., Donkoh, E. T., &amp; Asare, J. W. (2023). Application of ensemble models approach in anemia detection using images of the palpable palm. Medicine in Novel Technology and Devices, 20, 100269.</mixed-citation>
      </ref>
            <ref id="ref8">
        <label>8</label>
        <mixed-citation>https://doi.org/10.1016/j.medntd.2023.100269</mixed-citation>
      </ref>
            <ref id="ref9">
        <label>9</label>
        <mixed-citation>GBD 2021 Anaemia Collaborators. (2023). Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990–2021: findings from the Global Burden of Disease Study 2021. The Lancet Haematology, 10(8), e574-e586. https://doi.org/10.1016/S2352-3026(23)00160-6</mixed-citation>
      </ref>
            <ref id="ref10">
        <label>10</label>
        <mixed-citation>Asare, Justice Williams; Appiahene, Peter; Donkoh, Emmanuel. (2023). CP-AnemiC (A Conjunctival Pallor) Dataset from Ghana. Mendeley Data, V1. https://doi.org/10.17632/m53vz6b7fx.1</mixed-citation>
      </ref>
            <ref id="ref11">
        <label>11</label>
        <mixed-citation>Collings, S., Ellingson, K. D., Keeler, C., et al. (2016). Non-invasive detection of anaemia using digital photographs of the conjunctiva. PLoS One, 11(4), e0153286.</mixed-citation>
      </ref>
            <ref id="ref12">
        <label>12</label>
        <mixed-citation>https://doi.org/10.1371/journal.pone.0153286</mixed-citation>
      </ref>
            <ref id="ref13">
        <label>13</label>
        <mixed-citation>Appiahene, P., Chaturvedi, K., Asare, J. W., Donkoh, E. T., &amp; Prasad, M. (2023). CP-AnemiC: A conjunctival pallor dataset and benchmark for anemia detection in children. Medicine in Novel Technology and Devices, 18, 100244. https://doi.org/10.1016/j.medntd.2023.100244</mixed-citation>
      </ref>
            <ref id="ref14">
        <label>14</label>
        <mixed-citation>Dimauro, G., Bevilacqua, V., Colizzi, L., et al. (2021). A machine learning approach for anemia detection based on conjunctiva images. Computer Methods and Programs in Biomedicine, 200, 105911. https://doi.org/10.1016/j.cmpb.2020.105911</mixed-citation>
      </ref>
            <ref id="ref15">
        <label>15</label>
        <mixed-citation>Mannino, R. G., Myers, D. R., Tyburski, E. A., et al. (2018). Smartphone app for non-invasive detection of anemia using only patient-sourced photos. Nature Communications, 9(1), 4924.</mixed-citation>
      </ref>
            <ref id="ref16">
        <label>16</label>
        <mixed-citation>https://doi.org/10.1038/s41467-018-07262-2</mixed-citation>
      </ref>
            <ref id="ref17">
        <label>17</label>
        <mixed-citation>Shao, J., Wong, J. Y., Poljak, M., et al. (2017). HemaApp: Noninvasive blood screening of hemoglobin using smartphone cameras. Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies, 1(3), 97. https://doi.org/10.1145/3130952</mixed-citation>
      </ref>
            <ref id="ref18">
        <label>18</label>
        <mixed-citation>Muljono, S. A., Wulandari, H. A., Azies, M., Naufal, W. A., Prasetyanto, F. A., &amp; Zahra, F. A. (2024). Breaking boundaries in diagnosis: Non-invasive anemia detection empowered by AI. IEEE Access, 12, 9292-9307. https://doi.org/10.1109/ACCESS.2024.3353788</mixed-citation>
      </ref>
            <ref id="ref19">
        <label>19</label>
        <mixed-citation>Asare, Justice Williams; Appiahene, Peter; Donkoh, Emmanuel. (2023). CP-AnemiC (A Conjunctival Pallor) Dataset from Ghana. Mendeley Data, V1. https://doi.org/10.17632/m53vz6b7fx.1</mixed-citation>
      </ref>
            <ref id="ref20">
        <label>20</label>
        <mixed-citation>Ali, M. A., Dornaika, F., Cherry, A., et al. (2024). Advancing medical image processing: A comparative analysis of ‘Naturalize’ and traditional augmentation techniques for enhanced diagnostic accuracy. IC2SPM, 138–143. https://doi.org/10.1109/ic2spm62723.2024.10841335</mixed-citation>
      </ref>
          </ref-list>
  </back>
  
</article>
