Friday November 22, 2019

Now Rats may help in Detecting Tuberculosis

The rats learn to recognize the presence of TB in samples of mucus that is coughed up from the patient's lower airways.

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Rats and treatment of Tuberculosis
FILE - An African Giant Pouch rat is seen before a training session where the rats will learn to detect tuberculosis (TB) at a laboratory in Sokoine University for Agriculture in Morogoro, Tanzania, Jan. 31, 2006. VOA

London, November 16,2017:

Giant rats are probably not the first thing that come to mind to tackle tuberculosis but scientists hope their sniffing skills will speed up efforts to detect the deadly disease in major cities across the world.

Tuberculosis, which is curable and preventable, is one of the world’s deadliest infectious diseases, according to the World Health Organization (WHO), killing 1.7 million people in 2016 and infecting 10.4 million others.

African Giant Pouched Rats, trained by Belgian charity APOPO, are known for sniffing out landmines in countries from Angola to Cambodia and for detecting TB cases in East Africa.

Over the next few years, APOPO plans to fight tuberculosis at the source by launching TB-detection rat facilities in major cities of 30 high-risk countries including Vietnam, India and Nigeria.

Rats can play a role in containing Tuberculosis
Dr. Simon Angelo (L) examines Iman Steven suffering from tuberculosis, held by her mother (R) at the hospital of Doctors Without Borders (MSF), June 15, 2016, at the Protection of Civilians (PoC) site in Malakal, South Sudan. VOA

“One of the best ways to fight TB at source is in major cities that draw a lot of people from the rural areas,” James Pursey, APOPO spokesman, told the Thomson Reuters Foundation.

“It is a vicious circle. You can be reinfected. To fight TB, you have to hit it hard,” he said by phone from Zimbabwe.

Many people get infected in big, densely populated cities and spread the disease to rural areas, according to Pursey.

The rats learn to recognize the presence of TB in samples of mucus that is coughed up from the patient’s lower airways.

In Tanzania, people in communities where TB is most common, including in prisons, often fail to show up for screening because of a lack of money or awareness, placing a huge burden on health authorities, health experts said.

“TB is a disease of poverty,” said Pursey. “If nothing changes it can only get worse.”

The APOPO has seen the TB detection rate increase by 40 percent in clinics it has worked with in Tanzania and Mozambique, according to Pursey, who said that using rats to screen did not negate the need for proper diagnostic testing.

While a technician may take four days to detect a case of TB, a trained rat can screen 100 samples in 20 minutes, and a rat screening costs as little as 20 US cents, APOPO said.

Next Story

New Tuberculosis Treatment for 150 Countries Including India and South Africa to Cost $1,040

BPaL is an oral treatment which promises a shorter, more convenient option to existing TB treatment options, which use a cocktail of antibiotic drugs

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Tuberculosis, Treatment, Countries
A tuberculosis patient receives treatment at the TB Hospital in Gauhati, India, March 24, 2012. VOA

A newly approved three-drug treatment for tuberculosis will be available in 150 countries including India and South Africa, priced at $1,040 for a complete regimen, more than twice the cost proposed in the past by advocacy groups for other treatments.

The United Nations-backed Stop TB Partnership said on Monday that BPaL would be obtainable in eligible countries through the Global Drug Facility (GDF), a global provider of TB medicines created in 2001 to negotiate lower prices for treatments.

Tuberculosis was responsible for 1.5 million deaths in 2018.

BPaL is an oral treatment which promises a shorter, more convenient option to existing TB treatment options, which use a cocktail of antibiotic drugs over a period of up to two years.

Tuberculosis, Treatment, Countries
The United Nations-backed Stop TB Partnership said on Monday that BPaL would be obtainable in eligible countries through the Global Drug Facility (GDF), a global provider. Pixabay

The new cocktail, which will treat extensively drug-resistant strains of the illness, consists of drug developer TB Alliance’s newly-approved medicine pretomanid, in combination with linezolid and Johnson & Johnson’s bedaquiline.

Pretomanid, which will be available at $364 per treatment course, is only the third new medicine for drug-resistant tuberculosis to be approved in about 40 years, after J&J’s bedaquiline and Otsuka Pharmaceutical Co Ltd’s delamanid.

Criticism

Advocacy groups have long criticized the cost for bedaquiline and delamanid. Not-for-profit Medecins Sans Frontieres (MSF) has waged a running battle in public with J&J over its $400 price tag for a six-month course for bedaquiline.

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MSF has argued that bedaquiline could be produced and sold at a profit for 25 cents per day, and that the price of treatments for drug-resistant TB should be no higher than $500 for a complete treatment course.

Leena Menghaney, the South-Asia head for MSF’s Access Campaign, said it was a cause of concern that pretomanid was priced just below the price of bedaquiline.

But Stop TB Partnership says costs of other regimens for extremely drug-resistant TB range from $2,000 to $8,000 — for courses of at least 20 months.

Drugmakers

Tuberculosis, Treatment, Countries
Tuberculosis was responsible for 1.5 million deaths in 2018. Pixabay

TB Alliance in April granted a license to U.S. drugmaker Mylan NV to manufacture and sell pretomanid as part of certain regimens in high-income markets, as well as a non-exclusive license for low-income and middle-income countries, where most tuberculosis cases occur.

Stop TB Partnership said it would start supplying the regimen following World Health Organization’s guidance on using the drug. Mylan, however, said it will also sell the drug directly to countries.

Prices in low-income countries would be in-line with the price offered through GDF, but would be decided on a case by case basis where the drug is not supplied through GDF, it said.

The drug will be available in bottles of 26 tablets, with a six-month treatment requiring seven bottles.

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India-based Macleods Pharmaceuticals Ltd has also been granted a non-exclusive license to make pretomanid as part of the BPaL regimen, TB Alliance said Monday.

The maker of generic drugs will market the treatment in about 140 countries with high tuberculosis rates. (VOA)