APOPO, an international organization that trains African Giant Pouched Rats to sniff out landmines and tuberculosis (TB), has been awarded a Development Innovation Ventures grant by the U.S. Agency for International Development’s (USAID) U.S. Global Development Lab.
The USAID DIV award will enable APOPO to study the effectiveness of its tuberculosis detection rats to proactively screen patients in high TB prevalence prisons in Mozambique and Tanzania. If successful APOPO hopes to scale up the program to other high prevalence communities, including crowded and poorly ventilated work places, and slum dwellings.
Often for a variety of reasons including lack of financial resources and lack of awareness around TB, individuals from high prevalence communities, including prisons, do not present themselves for testing. This creates a cycle of transmission that can potentially be curbed by pro-active screening of community members. However, until now, there have been no existing screening systems capable of the accuracy, speed, and cost-efficiency required to scale proactive screening programs in high TB-burden countries.
APOPO’s detection technology can fill this gap. Rats are trained by behavioral reinforcement to smell the presence of TB in sputum samples (mucus that comes from the lungs, which is the traditional medium used to diagnosis TB). The rats are presented with a row of 10 suspect TB sputum samples. When TB is detected the rat hovers over the sample for 3 seconds. APOPO TB detection rat technology is so fast and has such low variable costs, that it has the potential to greatly lower the total costs of proactive screening for TB in low resource countries. A tuberculosis detection rat screens a hundred samples in 20 minutes, a task which would take a lab technician four days. A rat screening can cost as low as 20 US cents when APOPO’s operations are running near capacity.
The speed, low variable costs and accuracy of the TB detection rats is a proven aspect of APOPO’s current TB detection programs executed in partnership with The National Tuberculosis Programs of Tanzania and Mozambique since 2008 and 2013 respectively. The current operational program uses the same operational procedures that the proactive screening program will use, but is done with samples from sick patients that have presented themselves to clinics for testing. APOPO’s current programs have screened over 340,000 TB samples, resulting in a 40% increase in TB detection at partner clinics. Over 9,000 TB patients initially missed by clinics have been found and over 36,000 further potential infections have been halted.
“APOPO is thrilled to be working for the first time with USAID through its Development Innovation Ventures program,” said Charlie Richter, APOPO’s US director based in Washington DC. “We believe our unique TB Detection Rat technology will prove itself as an effective mass-screening tool. We then aim to expand the program to all prisons, shantytowns, factories and other settings in Tanzania, Mozambique and other high TB-burden countries, as well as in high-risk groups such as those individuals living with HIV/AIDS. This will improve and save lives all over the globe at a low cost”.