Rats, Butterflies, Sponges & More

TB in Tidbits News Scan

I smell a rat…who smells TB

The Telegraph has a fascinating piece on HeroRAT, an inventive and highly impactful TB screening initiative being run by Belgian NGO APOPO. The program taps into the superior olfactory capabilities of 50 giant African pouched rats, who technicians use to help sniff out potential false negatives from regionally sourced TB samples.

“The rats take turns sniffing around 100 tiny trays of mucus each, which takes them just 20 minutes. The rodents pace up and down, and hover over samples they detect as positive for approximately three seconds. Those results are then verified by human technicians – but the rats are almost always right, with a 90 per cent accuracy rate.”

The collective efforts of these rats serve as a vital “second-line defense,” by identifying tuberculosis cases potentially missed by traditional screening techniques, like spectrum smear microscopies. Since the HeroRAT TB program began in 2008, its rodents have smelled their way through half a million samples in three countries – Tanzania, Mozambique and Ethiopia – and have helped detect over 30,000 false negative cases.

Butterfly effect

A powerful new mural at the National Institute of Pneumology in Bucharest, Romania, is bringing attention to the ongoing battle against tuberculosis (TB). Created by art student Theia Catrina Mirodot and her team, the mural, entitled “Tuberculosis & Pollution,” is helping draw attention to the links between air pollution and TB in Romania, a country which accounts for nearly a quarter of reported cases in the WHO European Region.

The signature butterfly, which sits towards the center right side of the piece, represents the transformation and recovery of TB patients. Replicas of the mural are also being used as part of a broader campaign aimed at raising awareness in Romania’s more polluted metropolitan areas. (Photo Credit: World Health Organization)

Cause for optimism

In an opinion piece for the New York Times, USAID’s Atul Gawande makes a strong argument in favor of increasing support for global TB initiatives, leveraging some of his own compelling, on-the-ground observations of patients’ experiences:

“I spoke to a group of teenage boys standing in line outside an open-air tent, waiting to get digitally screened for TB. I asked them why they had come. One boy said he had a cough, and he was worried it was TB. The others said they were worried they’d caught it from him. Did they have family? No, the boy with the cough said. They looked after one another. They’d been kicked out of their homes for using drugs. They didn’t want to say what kind. I asked if the drugs scared them. No, they said. But TB did.”

Despite the grim realities many TB patients face, Gawande argues that recent advancements and innovations with the ecosystem are a reason to be optimistic:

“During the past couple of years….we have seen advances in every aspect of TB control… [which] make it possible to greatly accelerate the reduction of TB globally. For screening, digital chest X-ray equipment has shrunk in cost and size to the point that it can be carried in a backpack and delivered in primary health care clinics. Artificial intelligence software now can read — instantly — chest X-rays for indications of TB or other conditions as accurately as radiologists can. For treatment and prevention, newer drug regimens are also shorter, more effective and less toxic.”

The minder of Mushin

Writing for VaccinesWork, Chioma Umeha profiles Zainab Danjaki, a contact tracer who, for the past three years, has been working tirelessly to increase tuberculosis awareness and reduce TB-related stigma in Mushin, Lagos. In the article, Umeha notes the substantial impact Danjaki has already made:

“She can count more than 70 patients on the list of people she has helped to recover from TB in the last three years. All from Mushin, Lagos, many of them are drawn from the high-risk population of persons with disabilities, people living with HIV or people struggling with drug addiction. During a visit to some of the communities Danjaki serves in Mushin, VaccinesWork discovered that she is not just a household name among residents, but that she is celebrated as a ‘nurse,’ because of her valued role as a caregiver.”

Despite these successes, Danjaki also shared with Umeha some of the many challenges her team of community health workers have faced:

“’During our contact-tracing efforts, we faced both welcoming and hostile reactions from families. But I will never forget one encounter where a man threatened us with a cutlass and questioned the importance of our visit. The situation escalated to the point where we had to flee to avoid harm, as they also attempted to loose a dog to attack us,’ she said.”

Hometown matters

A pivotal study from Harvard Medical School researchers shines a light on an interesting tuberculosis transmission dynamic that could shape future approaches to TB prevention and treatment. Summarizing the key findings, HMS’s Jake Miller writes:

“For some forms of tuberculosis, the chances that an exposed person will get infected depend on whether the individual and the bacteria share a hometown, according to a new study comparing how different strains move through mixed populations in cosmopolitan cities. Results of the research…provide the first hard evidence of long-standing observations that have led scientists to suspect that pathogen, place, and human host collide in a distinctive interplay that influences infection risk and fuels differences in susceptibility to infection.”

Later in the piece, Miller explains the impact these findings could have on public health responses:

“While this experiment was not designed to capture insights about the mechanism underlying the affinity between human and TB populations sharing geographic backgrounds, it highlights the importance of using multiple strains of TB and cells from diverse populations to inform treatment and prevention.”

Sea relatives

Researchers from the Doherty Institute for Infection and Immunity have recently uncovered a new bacterium on a sponge that shares 80 percent of its genetic makeup with M. tuberculosis. The bacterium, called Mycobacterium spongiae, was discovered during an unrelated scientific expedition off the Great Barrier Reef, near Cookstown, Australia.

While initial vaccine experiments in mice did not show a comparative advantage over existing BCG vaccines, experts hope additional research could help scientists to develop more innovative treatments to combat TB in the future.