Browsing by Author "Valverde, E."
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Item Accuracy of giant African pouched rats for diagnosing tuberculosis: comparison with culture and Xpert W MTB/RIF(Researchgate, 2017) Mulder, C.; Mgode, G. F.; Ellis, H.; Valverde, E.; Beyene, N.; Cox, C.; Reid, S. E.; Van’t Hoog, A. H.; Edwards, T. L.S E T T I N G : Enhanced tuberculosis (TB) case finding using detection rats in Tanzania. O B J E C T I V E S : To assess the diagnostic accuracy of detection rats compared with culture and Xpert w MTB/ RIF, and to compare enhanced case-finding algorithms using rats in smear-negative presumptive TB patients. D E S I G N : A fully paired diagnostic accuracy study in which sputum of new adult presumptive TB patients in Tanzania was tested using smear microscopy, 11 detection rats, culture and Xpert. R E S U LT S : Of 771 eligible participants, 345 (45%) were culture-positive for Mycobacterium tuberculosis, and 264 (34%) were human immunodeficiency virus (HIV) positive. The sensitivity of the detection rats was up to 75.1% (95%CI 70.1–79.5) when compared with cul- ture, and up to 81.8% (95%CI 76.0–86.5) when compared with Xpert, which was statistically signifi- cantly higher than the sensitivity of smear microscopy. Corresponding specificity was 40.6% (95%CI 35.9– 45.5) compared with culture. The accuracy of rat detection was independent of HIV status. Using rats for triage, followed by Xpert, would result in a statistically higher yield than rats followed by light- emitting diode fluorescence microscopy, whereas the number of false-positives would be significantly lower than when using Xpert alone. C O N C L U S I O N : Although detection rats did not meet the accuracy criteria as standalone diagnostic or triage testing for presumptive TB, they have additive value as a triage test for enhanced case finding among smear- negative TB patients if more advanced diagnostics are not availableItem Active tuberculosis detection by pouched rats in 2014: more than 2,000 new patients found in two countries(2016 Society for the Experimental Analysis of Behavior, 2016) Poling, A.; Beyene, N.; Valverde, E.; Mulder, C.; Cox, C.; Mgode, G.; Edwards, T. L.Tuberculosis (TB) is a major problem in poor countries because sensitive diagnostic tools are unavail- able. In 2014, our pouched rats evaluated sputum from 21,600 Tanzanians and 9,048 Mozambicans whose sputum had previously been evaluated by microscopy, the standard diagnostic for TB. Evalua- tion by the rats revealed 1,412 new patients with active TB in Tanzania and 645 new patients in Mozambique, increases of 39% and 53%, respectively, when compared to detections by microscopy alone. These results provide further support for the applied use of scent-detecting rats.