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DeWeerdt S. Could rats and dogs detect disease better than the finest lab equipment? Nature 2024:10.1038/d41586-024-01751-9. [PMID: 38898249 DOI: 10.1038/d41586-024-01751-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
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Pollock TY, Odom John AR. Thinking Small, Stinking Big: The World of Microbial Odors. J Infect Dis 2024; 229:1254-1255. [PMID: 37738417 PMCID: PMC11095540 DOI: 10.1093/infdis/jiad405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Affiliation(s)
- Tzvi Y Pollock
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Audrey R Odom John
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Agizew TB, Soka J, Fast CD, Mwimanzi S, Mwesiga G, Edward N, Stephen M, Kondo R, Burny R, Cox C, Beyene N. Increased tuberculosis case detection in Tanzanian children and adults using African giant pouched rats. BMC Infect Dis 2024; 24:401. [PMID: 38622527 PMCID: PMC11017552 DOI: 10.1186/s12879-024-09313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/10/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND African giant pouched rats, trained by Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO), have demonstrated their ability to detect tuberculosis (TB) from sputum. We assessed rat-based case detection and compared the mycobacterium bacillary load (MTB-load) in children versus adults. METHODS From January-December 2022, samples were collected prospectively from 69 Directly Observed Therapy (DOT) facilities' presumed TB patients. Using an average of five rats, APOPO re-evaluated patients with bacteriologically negative (sputum-smear microscopy or Xpert MTB/RIF) results. Rat-positive samples were tested using concentrated smear light-emitting diode microscopy to confirm TB detection before treatment initiation. The rats' identification of pulmonary TB is based on smelling TB-specific volatile organic compounds (VOCs) in sputum. Using STATA, Chi-square for odds ratio and confidence interval was calculated and evaluated: (1) the yield of rat-based TB detection compared to that of the health facilities; (2) rat-based TB detection in children versus adults; and (3) rats' ability to detect TB across MTB-loads and between children and adults. RESULTS From 35,766 patients, 5.3% (1900/35,766) were smear-positive and 94.7% (33,866/35,766) were smear or Xpert-negatives at DOTS facility. Of those with negative results, 2029 TB cases were detected using rats, contributing to 52% (2029/3929 of total TB identified), which otherwise would have been missed. Compared to DOT facilities, rats were six-fold more likely to detect TB among Acid Fast Bacilli (AFB) 1+/scanty [90% (1829/2029) versus 60% (1139/1900), odds ratio, OR = 6.11, 95% confidence interval, CI: 5.14-7.26]; twice more likely to identify TB cases among children [71% (91/129) versus 51% (1795/3542), OR = 2.3, 95% CI: 1.59-3.42]; and twice more likely to identify TB cases among children with AFB 1+/scanty than adults with the same MTB-load [5% (86/1703) versus 3% (28/1067), OR = 2.0, 95% CI: 1.28-3.03]. CONCLUSIONS Rats contributed over half of the TB cases identified in program settings, and children, especially those with a lower MTB-load, were more likely to be diagnosed with TB by rats. The chemical signatures, VOCs, were only available for adults, and further research describing the characteristics of VOCs in children versus adults may pave the way to enhance TB diagnosis in children.
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Affiliation(s)
- Tefera B Agizew
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania.
- Department of Biology, University of Antwerp, Antwerp, Belgium.
| | - Joseph Soka
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Cynthia D Fast
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
- Department of Biology, University of Antwerp, Antwerp, Belgium
| | - Stephen Mwimanzi
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Gilbert Mwesiga
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Nashon Edward
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Marygiven Stephen
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Reheme Kondo
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Robert Burny
- APOPO, TB Detection Program, Eduardo Mondlane University, Maputo, Mozambique
| | - Christophe Cox
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
- Department of Biology, University of Antwerp, Antwerp, Belgium
| | - Negussie Beyene
- Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) Tuberculosis Department, Sokoine University of Agriculture, Morogoro, Tanzania
- Department of Biology, University of Antwerp, Antwerp, Belgium
- APOPO TB Research Project, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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Bauër P, Leemans M, Audureau E, Gilbert C, Armal C, Fromantin I. Remote Medical Scent Detection of Cancer and Infectious Diseases With Dogs and Rats: A Systematic Review. Integr Cancer Ther 2022; 21:15347354221140516. [PMID: 36541180 PMCID: PMC9791295 DOI: 10.1177/15347354221140516] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Remote medical scent detection of cancer and infectious diseases with dogs and rats has been an increasing field of research these last 20 years. If validated, the possibility of implementing such a technique in the clinic raises many hopes. This systematic review was performed to determine the evidence and performance of such methods and assess their potential relevance in the clinic. METHODS Pubmed and Web of Science databases were independently searched based on PRISMA standards between 01/01/2000 and 01/05/2021. We included studies aiming at detecting cancers and infectious diseases affecting humans with dogs or rats. We excluded studies using other animals, studies aiming to detect agricultural diseases, diseases affecting animals, and others such as diabetes and neurodegenerative diseases. Only original articles were included. Data about patients' selection, samples, animal characteristics, animal training, testing configurations, and performances were recorded. RESULTS A total of 62 studies were included. Sensitivity and specificity varied a lot among studies: While some publications report low sensitivities of 0.17 and specificities around 0.29, others achieve rates of 1 sensitivity and specificity. Only 6 studies were evaluated in a double-blind screening-like situation. In general, the risk of performance bias was high in most evaluated studies, and the quality of the evidence found was low. CONCLUSIONS Medical detection using animals' sense of smell lacks evidence and performances so far to be applied in the clinic. What odors the animals detect is not well understood. Further research should be conducted, focusing on patient selection, samples (choice of materials, standardization), and testing conditions. Interpolations of such results to free running detection (direct contact with humans) should be taken with extreme caution. Considering this synthesis, we discuss the challenges and highlight the excellent odor detection threshold exhibited by animals which represents a potential opportunity to develop an accessible and non-invasive method for disease detection.
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Affiliation(s)
- Pierre Bauër
- Institut Curie, Paris, France,Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA
| | - Michelle Leemans
- Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA,Michelle Leemans, Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA, 61 Av. du Général de Gaulle, 94000 Créteil, F-94010 Créteil, France.
| | | | - Caroline Gilbert
- Muséum National d’Histoire Naturelle, Brunoy, France,Ecole nationale vétérinaire d’Alfort, Maisons-Alfort cedex, France
| | | | - Isabelle Fromantin
- Institut Curie, Paris, France,Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA
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Mani-Varnosfaderani A, Gao A, Poch KR, Caceres SM, Nick JA, Hill JE. Breath biomarkers associated with nontuberculosis mycobacteriadisease status in persons with cystic fibrosis: a pilot study. J Breath Res 2022; 16:031001. [PMID: 35487186 DOI: 10.1088/1752-7163/ac6bb6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/29/2022] [Indexed: 11/11/2022]
Abstract
Pulmonary infections caused by mycobacteria cause significant mortality and morbidity in the human population. Diagnosing mycobacterial infections is challenging. An infection can lead to active disease or remain indolent with little clinical consequence. In patients with pulmonarynontuberculosis mycobacteria(PNTM) identification of infection and diagnosis of disease can take months to years. Our previous studies showed the potential diagnostic power of volatile molecules in the exhaled breath samples to detect active pulmonaryM. tuberculosisinfection. Herein, we demonstrate the ability to detect the disease status of PNTM in the breath of persons with cystic fibrosis (PwCF). We putatively identified 17 volatile molecules that could discriminate between active-NTM disease (n= 6), indolent patients (n= 3), and those patients who have never cultured an NTM (n= 2). The results suggest that further confirmation of the breath biomarkers as a non-invasive and culture-independent tool for diagnosis of NTM disease in a larger cohort of PwCF is warranted.
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Affiliation(s)
- Ahmad Mani-Varnosfaderani
- Department of Chemical and Biological Engineering, School of Biomedical Engineering, The University of British Columbia, Vancouver, Canada
| | - Antao Gao
- Department of Chemical and Biological Engineering, School of Biomedical Engineering, The University of British Columbia, Vancouver, Canada
| | - Katie R Poch
- Department of Medicine, National Jewish Health, Denver, CO, United States of America
| | - Silvia M Caceres
- Department of Medicine, National Jewish Health, Denver, CO, United States of America
| | - Jerry A Nick
- Department of Medicine, National Jewish Health, Denver, CO, United States of America
| | - Jane E Hill
- Department of Chemical and Biological Engineering, School of Biomedical Engineering, The University of British Columbia, Vancouver, Canada
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Ionescu S, Nicolescu AC, Madge OL, Marincas M, Radu M, Simion L. Differential Diagnosis of Abdominal Tuberculosis in the Adult-Literature Review. Diagnostics (Basel) 2021; 11:2362. [PMID: 34943598 PMCID: PMC8700228 DOI: 10.3390/diagnostics11122362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Tuberculosis (TB) is a public health issue that affects mostly, but not exclusively, developing countries. Abdominal TB is difficult to detect at first, with the incidence ranging from 10% to 30% of individuals with lung TB. Symptoms are non-specific, examinations can be misleading, and biomarkers commonly linked with other diseases can also make appropriate diagnosis difficult. As a background for this literature review, the method used was to look into the main characteristics and features of abdominal tuberculosis that could help with differentiation on the PubMed, Science Direct, and Academic Oxford Journals databases. The results were grouped into three categories: A. general features (the five forms of abdominal tuberculosis: wet and dry peritonitis, lymphadenopathy, lesions at the level of the cavitary organs, lesions at the level of the solid organs), B. different intra-abdominal organs and patterns of involvement (oesophageal, gastro-duodenal, jejunal, ileal, colorectal, hepatosplenic, and pancreatic TB with calcified lymphadenopathy, also with description of extraperitoneal forms), and C. special challenges of the differential diagnosis in abdominal TB (such as diagnostic overlap, the disease in transplant candidates and transplant recipients, and zoonotic TB). The study concluded that, particularly in endemic countries, any disease manifesting with peritonitis, lymphadenopathy, or lesions at the level of the intestines or solid organs should have workups and protocols applied that can confirm/dismiss the suspicion of abdominal tuberculosis.
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Affiliation(s)
- Sinziana Ionescu
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Octavia Luciana Madge
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
| | - Marian Marincas
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Madalina Radu
- Pathology Department, Bucharest Oncology Institute, 022328 Bucharest, Romania;
| | - Laurentiu Simion
- 1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania; (S.I.); (L.S.)
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
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