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Poling A.,Western Michigan University | Weetjens B.J.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | Cox C.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | Mgode G.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | And 4 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

In 2009, giant African pouched rats trained to detect tuberculosis (TB) evaluated sputum samples from 10,523 patients whose sputum had previously been evaluated by smear microscopy. Microscopists found 13.3% of the patients to be TB-positive. Simulated second-line screening by the rats revealed 620 new TB-positive patients, increasing the case detection rate by 44%. These data suggest that the rats may be useful for TB detection in developing countries, although further research is needed. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.


Mahoney A.M.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | Weetjens B.J.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | Cox C.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | Beyene N.,Anti Persoonsmijnen Ontmijnende Product Ontwikkeling APOPO | And 7 more authors.
Pan African Medical Journal | Year: 2011

Giant African pouched rats previously have detected tuberculosis (TB) in human sputum samples in which the presence of TB was not initially detected by smear microscopy. Operant conditioning principles were used to train these rats to indicate TB-positive samples. In 2010, rats trained in this way evaluated 26,665 sputum samples from 12,329 patients. Microscopy performed at DOTS centers found 1,671 (13.6%) of these patients to be TB-positive. Detection rats identified 716 additional TB-positive patients, a 42.8% increase in new-case detection. These previously unreported data, which extend to over 20,000 the number of patients evaluated by pouched rats in simulated second-line screening, suggest that the rats can be highly valuable in that capacity. © Amanda M Mahoney et al.


Reither K.,Swiss Tropical and Public Health Institute | Reither K.,University of Basel | Reither K.,Ifakara Health Institute | Jugheli L.,Swiss Tropical and Public Health Institute | And 15 more authors.
PLoS ONE | Year: 2015

Background: This study established evidence about the diagnostic performance of trained giant African pouched rats for detecting Mycobacterium tuberculosis in sputum of well-characterised patients with presumptive tuberculosis (TB) in a high-burden setting. Methods: The TB detection rats were evaluated using sputum samples of patients with presumptive TB enrolled in two prospective cohort studies in Bagamoyo, Tanzania. The patients were characterised by sputum smear microscopy and culture, including subsequent antigen or molecular confirmation of Mycobacterium tuberculosis, and by clinical data at enrolment and for at least 5-months of follow-up to determine the reference standard. Seven trained giant African pouched rats were used for the detection of TB in the sputum samples after shipment to the APOPO project in Morogoro, Tanzania. Results: Of 469 eligible patients, 109 (23.2%) were culture-positive for Mycobacterium tuberculosis and 128 (27.3%) were non-TB controls with sustained recovery after 5 months without anti- TB treatment. The HIV prevalence was 46%. The area under the receiver operating characteristic curve of the seven rats for the detection of culture-positive pulmonary tuberculosis was 0.72 (95% CI 0.66-0.78). An optimal threshold could be defined at ≥2 indications by rats in either sample with a corresponding sensitivity of 56.9% (95% CI 47.0-66.3), specificity of 80.5% (95% CI 72.5-86.9), positive and negative predictive value of 71.3% (95% CI 60.6-80.5) and 68.7%(95% CI 60.6-76.0), and an accuracy for TB diagnosis of 69.6%. The diagnostic performance was negatively influenced by low burden of bacilli, and independent of the HIV status. Conclusion: Giant African pouched rats have potential for detection of tuberculosis in sputum samples. However, the diagnostic performance characteristics of TB detection rats do not currently meet the requirements for high-priority, rapid sputum-based TB diagnostics as defined by the World Health Organization. Copyright: © 2015 Reither et al.

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