Guest Post: David Stoker, BYU MPH Alum, Ashoka
The other day at work I met with one of our Fellows
, Bart Weetjens
. He has a creative and successful strategy that is not taught in most public health courses: he is training giant African rats
to identify tuberculosis bacteria in human suptum samples. I was struck by both his innovation and the incredible speed and cost efficiency of his solution. Taken from his website:
“In 2002, 2 million people died worldwide from TB. The WHO prospects lethal cases to increase to 8 million by 2015. In sub- Sahara Africa, the combination of TB and HIV result in the highest casualty rate per capita, worldwide. The low detection rate of TB cases, which is reportedly only about 1/3rd, is one of the main factors of the spread of TB. The main reason for this low detection rate is the lack of a cheap and reliable diagnostic tool that can handle big volumes of samples.
Trained sniffer rats may offer a solution. A rat can evaluate 40 samples in 10 minutes, equal to what a skilled lab technician, using microscopy, will do in one day. Without requiring sophisticated instruments, this method is non invasive and can handle a high volume of samples, all very important factors in a pro-active screening approach.
APOPO started this pilot research in 2003. The outcome was positive, and the project was awarded by the World Bank for further investigation. In partnership with the leading national TB programs, APOPO set up a sample collection program in several regional DOTS centers. About 900 sputum samples are collected on a weekly base from six health centers in Dar Es Salaam and one in Morogoro. These samples are double checked as a reference for comparative testing, and cultured for training.
The new technology is now thoroughly tested and compared with existing methods. In a next phase, APOPO plans to focus on TB detection in an early stage of development, as well as on improvement of the sample and collection method.”
Here is a video of the rats in action, unfortunately there is not a voice over to explain what is going on, but basically there are ten samples in each batch and there is a hole corresponding to each location, the keeper opens and closes the vents, allowing the rat to smell each sample individually, you will see the rat scratch on the second sample and be rewarded.
You can find out more on their website about the evaluative research conducted by European and American universities. You can also read more about Bart’s main work which involves a fleet of rats that have been trained to identify land mines, there is a great video produced by Animal Planet but there is not a direct link, you must navigate to it in their press room.
Another interesting Ashoka Fellow that came through the office recently with a public health focus was Dr. Gladys Kalema-Kikusoka, founder of Conservation Through Public Health. She is working towards conservation of the mountain gorilla population in Uganda but her strategy is a community-owned public health initiative in the communities surrounding the national park. Another innovative model.