Browsing by Author "Jubitana, M"
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Item Ability of Cricetomys rats to detect Mycobacterium tuberculosis and discriminate it from other microorganisms(2011-11-26) Mgode, G.F; Weetjens, B; Cox, C; Jubitana, M; Machang’u, R; Lazar, D; Weiner, J; Geertruyden, J.P; Kaufmann, STrained African giant pouched rats (Cricetomys gambianus) have potential for diagnosis of tuberculosis (TB). These rats target volatile compounds of Mycobacterium tuberculosis (Mtb) that cause TB. Mtb and nontuberculous mycobacteria (NTM) species are related to Nocardia and Rhodococcus spp., which are also acid-fast bacilli and can be misdiagnosed as Mtb in smear microscopy. Diagnostic performance of C. gambianus on in vitro-cultured mycobacterial and related pulmonary microbes is unknown. This study reports on the response of TB detection rats to cultures of reference Mtb, clinical Mtb, NTM, Nocardia; Rhodococcus; Streptomyces; Bacillus; and yeasts. Trained rats significantly discriminated Mtb from other microbes (p < 0.008, Fisher’s exact test). Detection of Mtb cultures was age-related, with exponential and early stationary phase detected more frequently than early log phase and late stationary phase (p < 0.001, Fisher’s test) (sensitivity ¼ 83.33%, specificity ¼ 94.4%, accuracy ¼ 94%). The detection of naturally TB-infected sputum exceeded that of negative sputum mixed with Mtb, indicating that C. gambianus are conditioned to detect odours of TB-positive sputum better than spiked sputum. Although further studies on volatiles from detectable growth phases of Mtb are vital for identification of Mtb-specific volatiles detected by rats, our study underline the potential of C. gambianus for TB diagnosis.Item African pouched rats for the detection of pulmonary tuberculosis in sputum samples(2009) Weetjens, B.J; Mgode, G.F.; Machang’u, R.S; Kazwala, R; Mfi nanga, G; Lwilla, F; Cox, C; Jubitana, M; Kanyagha, H; Mtandu, R; Kahwa, A; Mwessongo, J; Makingi, G; Mfaume, S; Steenberge, J.V; Beyene, N.W; Billet, M; Verhagen, RSETTING: Resource-limited settings in sub-Saharan African countries. OBJECTIVE: To utilise African giant pouched rats (Cricetomys gambianus) for the diagnosis of tuberculosis (TB) in human sputum. DESIGN: A specially designed cage with 10 sniffi ng holes and cassette-carrier was used. The sputum samples were put in the sample cassette, containing 10 samples in line, placed under matching sniffi ng holes. Rats were trained to sniff each consecutive sample, and indicate TB positives by fi xing their nose for 5 seconds at the sniffi ng hole. This behaviour was maintained by food reinforcement upon correct indications. A total of 3416 samples were used. RESULTS: Of the 20 trained rats, 18 were able to discriminate positive from negative sputum samples, with average daily sensitivities ranging from 72% to 100%, and average daily false-positives ranging from 0.7% to 8.1%. The use of multiple rats signifi cantly increased sensitivity and negative predictive value. CONCLUSION: Utilising trained sniffer rats for TB detection is a potentially faster screening method and is at least as sensitive as smear microscopy. This method could therefore be suitable for active case fi nding, especially where large numbers of samples are to be analysed in resource-limited settings, to complement existing diagnostic techniques.Item APOPO’s tuberculosis research agenda: achievements, challenges and prospects(2012-04) Beyene, N; Mahoney, A; Cox, C; Weetjens, B; Making, G; Mgode, G; Durgin, A; Kuipers, D; Jubitana, M; Egwaga, S; Kamala, D; Lwila, F; Mfinanga, S; Kahwa, A; Machangu, R; Kazwala, R; Reither, K; Kaufmann, S; Poling, AThis article describes Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) recent use of specially trained African giant pouched rats as detectors of pulmonary tuberculosis in people living in Tanzania. It summarizes the achievements and challenges encountered over the years and outlines future prospects. Since 2008, second-line screening by the rats has identified more than 2000 tuberculosis-positive patients who were missed by microscopy at Direct Observation of Treatment – Short Course centres in Tanzania. Moreover, data that are reviewed herein have been collected with respect to the rats’ sensitivity and specificity in detecting tuberculosis. Findings strongly suggest that scent-detecting rats offer a quick and practical tool for detecting pulmonary tuberculosis and within the year APOPO’s tuberculosis-detection project will be extended to Mozambique. As part of its local capacity building effort, APOPO hires and trains Tanzanians to play many important roles in its TB detection project and provides research and training opportunities for Tanzanian students.Item Diagnosis of tuberculosis by trained African Giant Pouched Rats and confounding impact of pathogens and microflora of the respiratory tract(American Society for Microbiology, 2012-11-30) Mgode, G; Weetjens, B; Nawrath, T; Cox, C; Jubitana, M; Machang’u, R; Cohen-Bacrie, S; Bedotto, M; Drancourt, M; Schulz, S; Kaufmanna, STrained African giant-pouched rats (Cricetomys gambianus) can detect Mycobacterium tuberculosis and show potential for the diagnosis of tuberculosis (TB). However, rats’ ability to discriminate between clinical sputum containing other Mycobacterium spp. and nonmycobacterial species of the respiratory tract is unknown. It is also unknown whether nonmycobacterial species produce odor similar to M. tuberculosis and thereby cause the detection of smear-negative sputum. Sputum samples from 289 subjects were analyzed by smear microscopy, culture, and rats. Mycobacterium spp. were isolated on Lowenstein-Jensen medium, and nonmycobacterial species were isolated on four different media. The odor from nonmycobacterial species from smear- and M. tuberculosis culture-negative sputa detected by >2 rats (“rat positive”) was analyzed by gas chromatographymass spectrometry and compared to the M. tuberculosis odor. Rats detected 45 of 56 confirmed cases of TB, 4 of 5 suspected cases of TB, and 63 of 228 TB-negative subjects (sensitivity, 80.4%; specificity, 72.4%; accuracy, 73.9%; positive predictive value, 41.7%; negative predictive value, 93.8%). A total of 37 (78.7%) of 47 mycobacterial isolates were M. tuberculosis complex, with 75.7% from rat-positive sputa. Ten isolates were nontuberculous mycobacteria, one was M. intracellulare, one was M. avium subsp. hominissuis, and eight were unidentified. Rat-positive sputa with Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus spp., and Enterococcus spp. were associated with TB. Rhodococcus, Nocardia, Streptomyces, Staphylococcus, and Candida spp. from rat-positive sputa did not produce M. tuberculosis-specific volatiles (methyl nicotinate, methyl para-anisate, and ortho-phenylanisole). Prevalence of Mycobacterium-related Nocardia and Rhodococcus in smear-negative sputa did not equal that of smear-negative mycobacteria (44.7%), of which 28.6% were rat positive. These findings and the absence of M. tuberculosis-specific volatiles in nonmycobacterial species indicate that rats can be trained to specifically detect M. tuberculosis.Item Using giant African pouched rats to detect tuberculosis in human sputum samples: 2010 findings(2011-07-17) Mahoney, A.M; Weetjens, B.J; Cox, C; Beyene, N; Mgode, G; Jubitana, M; Kuiper, D; Kazwala, R; Mfinanga, G.S; Durgin, A; Poling, AGiant 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.