Evaluation of Giant African Pouched Rats for Detection of Pulmonary Tuberculosis in Patients from a High-Endemic Setting

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Oct 8

PMID 26445086

Citations 9

Authors

Klaus Reither

Levan Jugheli

Tracy R Glass

Mohamed Sasamalo

Francis A Mhimbira

Bart J Weetjens

Christophe Cox

Timothy L Edwards

Christiaan Mulder

Negussie W Beyene

Amanda Mahoney

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Machine Learning for Prediction of Tuberculosis Detection: Case Study of Trained African Giant Pouched Rats.

Jonathan J, Barakabitze A, Fast C, Cox C Online J Public Health Inform. 2024; 16:e50771.

PMID: 38625737 PMC: 11061786. DOI: 10.2196/50771.

Remote Medical Scent Detection of Cancer and Infectious Diseases With Dogs and Rats: A Systematic Review.

Bauer P, Leemans M, Audureau E, Gilbert C, Armal C, Fromantin I Integr Cancer Ther. 2022; 21:15347354221140516.

PMID: 36541180 PMC: 9791295. DOI: 10.1177/15347354221140516.

Visual Analytics of Tuberculosis Detection Rat Performance.

Jonathan J, Sanga C, Mwita M, Mgode G Online J Public Health Inform. 2021; 13(2):e12.

PMID: 34659646 PMC: 8500793. DOI: 10.5210/ojphi.v13i2.11465.

Breath can discriminate tuberculosis from other lower respiratory illness in children.

Bobak C, Kang L, Workman L, Bateman L, Khan M, Prins M Sci Rep. 2021; 11(1):2704.

PMID: 33526828 PMC: 7851130. DOI: 10.1038/s41598-021-80970-w.

Rats sniff out pulmonary tuberculosis from sputum: a diagnostic accuracy meta-analysis.

Kanaan R, Farkas N, Hegyi P, Soos A, Hegyi D, Nemeth K Sci Rep. 2021; 11(1):1877.

PMID: 33479276 PMC: 7820466. DOI: 10.1038/s41598-021-81086-x.

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