Center for Health Market Innovations (CHMI)

Programs

APOPO

last updated Apr 19, 2013

Overview

Implementation Partner(s): 
The National Institute of Medical Research (NIMR), The National Tuberculosis and Leprosy Program (NTLP), The Central Tuberculosis Research Laboratory (CTRL), Sokoine University of Agriculture (SUA), Mapambano ya Kifua Kikuu na Ukimwi Tanzania (MKUTA), National Institute of Health (INS), National Tuberculosis Control program, National Tuberculosis Reference Laboratory, Maputo City Health Directorate, University of Eduardo Mondlane, Medecins Sans Frontieres- Belgium in Mozambique
Legal Status: 
Private (not-for-profit)
Year Launched: 
2000
Stage: 
Existing/expansion stage
Income Level of Target Population: 
All income levels

Funding

Primary Source of Funding: 
Government
Additional Source(s) of Funding: 
Donor, In-kind contributions
Funders: 
Ashoka Foundation, Cararesi Foundation, Johnson & Johnson CSR, Nature Trust Fund, NIH- USA, Skoll Foundation, The Province of Antwerp- Belgium, UBS Optimus Foundation, World Bank Development Marketplace

Technology

Technology Used: 
Computer

Scale

Personnel Employed: 
10-49
Number of Clients Served: 
3300 patients/month
Number of Facilities Operated/Networked: 
17 DOTS centers in Dar es Salaam and Morogoro, 8 DOTS centers in Maputo
Other Measures of Scale: 
39 rats evaluating sputum samples
Scope: 
Initially, APOPO used the giant rats to detect landmines. The TB detection program is an expansion of this first phase of the program.
Summary: 

APOPO is a social enterprise that researches, develops, and deploys detection rat technology for humanitarian purposes. APOPO's HeroRATs provide second-line screening of TB samples from collaborating DOTS Centers.

Program goals/rationale: 

Tuberculosis (TB) is a widespread disease. 1.7 million people die from TB each year. Only 50% of the patients with TB are diagnosed. Left untreated, a person with active TB can infect 10-15 new people each year. A faster, more accurate diagnostic technology is needed to help curb the spread of this deadly disease.

Key program components: 

Trained HeroRATs can quickly and accurately sniff out TB in human sputum samples. In Tanzania, APOPO offers second-line screening by rats to partner hospitals, which has increased new case detection rates by over 40 percent.

Trained rats can evaluate 40 sputum samples in just seven minutes, equal to what a skilled lab technician will do in a full day's work. Rats sniff a series of holes, under which human sputum samples are lined up for evaluation. They identify samples that contain TB bacteria by scratching at the hole. Their correct indications on known positive samples are rewarded with a food treat. Indications on unknown samples, if pinpointed by two rats or more, are confirmed by humans using microscopy. Samples that are in fact positive with TB are reported to the hospitals who then follow-up with the associated patient(s) for confirmation of diagnosis and treatment.

APOPO's TB detection program is in a research phase. Proof of principle has been established, and they're now working towards further validation of the technology before full implementation. In 2010, APOPO commenced work on a three-year research plan, which includes experiments that compare the rats to various other diagnostic technologies, and looks more closely at exactly how effective they are at detecting TB, as well as the costs involved per sample. Their aim for the next three years is to further optimize this disease detection technology and focus on implementation models for the future.

Program history: 

APOPO set up its operational base in Tanzania in 2000, after conducting initial research of its detection rats technology in Belgium. The move to East Africa allowed for training and testing of the rats in near-to-real conditions, and further product development in the cultural context. It also provided access to a regular supply of African giant pouched rats, a species indigenous to sub-Saharan Africa, which APOPO chose as the most suitable. Today, APOPO breeds and trains all of its HeroRATs in its Tanzanian headquarters, which are then deployed to their in-country programs as needed. Their headquarters includes research and training rooms, laboratory and sample preparation areas, kennels, outdoor play and breeding enclosures, a data processing room and office space.

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