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Tackling Tuberculosis in Megacities

Tanzania is one of the world's 22 high-TB burden countries. The case detection rate is low due to the lack of adequate diagnostic methods. Like most developing countries, Tanzania's government clinics rely on microscopy that has a low sensitivity of about 20-60%, meaning many positives are missed. This is made worse by challenging factors such as inadequate funding for training and equipment, power and water cuts, and lack of staff. As a result, only about half of the visiting patients with active TB are diagnosed, leading to further infections and fatalities.


The TB detection program in Tanzania was launched in mid-2007 as a partnership with four government clinics. It has since expanded to 28 collaborating clinics in Dar es Salaam, Coast region and the city of Morogoro. APOPO collects sputum samples that have already been tested by microscopy in the partner clinic labs and retests them using HeroRATs.  Since 2007, the HeroRATs screened more than 310,000 sputum samples, thereby identifying over 8,015 positive TB samples that were initially missed by conventional diagnostics like microscopy.


In order to support the process of tracking and treating patients who were found TB positive with the help of the HeroRATs, APOPO established a partnership with two Tanzanian organisations: MKUTA (Mapambano ya Kifua Kikuu na Ukimwi Tanzania) and PASADA (Pastoral Activities and Services for people with AIDs in Dar Es Salaam ARchiocese). Both organisations are composed of volunteers, many of them former TB patients or living with HIV.

Lulu and claudi-pillsLulu works as a MKUTA volunteer and makes sure TB patients start and complete treatment

Once APOPO tells the clinic who they diagnosed with TB, the MKUTA and PASADA volunteers carry out an active search of the patients, including visits to people's homes when they are not reachable by phone. When people with symptoms indicative of TB show up at a clinic, the volunteers make sure they provide a reliable telephone number and physical address that facilitates a later follow-up. Apart from that, they sensitize communities about TB, dispelling stigma and explaining that a fast diagnosis is important to remain healthy and to avoid further infecting family and colleagues.

New TB Center in Dar es Salaam Opening End 2016

Dar es Salaam contributes to more than 20% of the Tanzanian national TB burden. APOPO utilizes its innovative detection technology for the containment of the deadly disease in this emerging African megacity. A HeroRAT can screen 100 sputum samples in just 20 minutes, which would take a skilled lab technician in a public clinic up to 4 days. 

Earlier this year, APOPO in partnership with the Tanzanian Veterinary Laboratory Agency (TVLA) began the process of transitioning its TB detection program from a 4-5 day diagnostic timeline to a 24-hour timeline by building APOPO’s new TB center in Dar es salaam with a top-notch lab, brand new rat facilities and TB detection rooms. The resulting change will greatly increase the amount of newly diagnosed patients starting treatment, ultimately enhancing the life saving impact of APOPO.  We are expecting to officially open the new TB lab in November 2016.

APOPO's HeroRATs in Tanzania are currently screen around 150 samples a day from clinics in Dar es Salaam at its operational headquarters in Morogoro, a 4 hour drive away from Dar. The new lab in Dar es Salaam will allow APOPO to deliver results to the clinics within 24 hours. This in turn means that all the confirmed patients who return to the clinics for their results the day after their initial appointment will be put on treatment. APOPO will also be allowed to expand to cover more than the 28 clinics it currently works with.

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APOPO collaborates with the National Tuberculosis and Leprosy Program (NTLP) and its Central Tuberculosis Reference Laboratory (CTRL) to implement stringent quality control measures and to provide refresher training for laboratory personnel. Our donors to the TB program in Tanzania include the UBS Optimus Foundation, the Carraresi Foundation, USAID, and the government of Liechtenstein.

Lulu, former TB patient and MKUTA volunteer

Lulu, former TB patient and MKUTA volunteer

Lulu's TB was missed by the clinics but detected by the HeroRATs. She has since joined volunteer group MKUTA to help raise TB awareness

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