APOPO uses trained African Giant Pouched Rats, nicknamed “HeroRATs,” to detect tuberculosis (TB) by scent in clinical samples in Tanzania and Mozambique.APOPO is assessing the sensitivity, specificity, and cost-effectiveness of detection rats as a triage tool when paired with GeneXpert, a highly accurate but relatively expensive DNA diagnostic tool endorsed by the World Health Organization.
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The results from this study will be used to determine the cost-effectiveness of detection rats as a triage tool. We hypothesize that TB detection rats are a very cost-effective diagnostic tool, given their evaluation speed, the low evaluation and maintenance costs, and their promising diagnostic accuracy.

We propose a oneyear multisite study in Tanzania and Mozambique, in which 2,500 prison inmates, new entrants and remandees of prisons located in the respective countries will be examined for TB. The cost-effectiveness of a screening algorithm including TB detection rats as a triage tool will be rigorously assessed alongside the proposed project by using decision analytic modeling. Preliminary findings confirm that TB detection rats indeed are more cost-effective than competing triage tools.