Article of Basic Science Volume 84 | Number 1 | July 2018, pg. 99-103
BACKGROUND: Tuberculosis (TB) diagnosis in children is a
challenge with up to 94% of children with TB treated
empirically in TB high-burden countries. Therefore, new
diagnostic tests are needed for TB diagnosis. We determined
the performance of trained rats in the diagnosis of pediatric TB
and whether they can improve detection rate compared to
the standard of care.
METHODS: Presumptive TB patients in 24 TB clinics in
Tanzania were tested. Samples indicated as TB-positive by rats
underwent confirmation by concentrated smear microscopy.
TB yield of bacteriologically confirmed pediatric TB patients
(≤5 years) was compared with yield of standard of care.
RESULTS: Sputum samples from 55,148 presumptive TB
patients were tested. Nine hundred eighty-two (1.8%) were
the children between 1 and 5 years. Clinics detected 34
bacteriologically positive children, whereas rats detected
additional 23 children yielding 57 bacteriologically TB-
positive children. Rats increased pediatric TB detection by
67.6%. Among 1–14-year-old children, clinics detected 331
bacteriologically positive TB whereas rats found the additional
208 children with TB that were missed by clinics. Relative
increase in TB case detection by rats decreased with the
increase in age (Po0.0001).
CONCLUSION: Trained rats increase pediatric TB detection
significantly and could help address the pediatric TB diagnosis
challenges. Further determination of accuracy of rats involving
other sample types is still needed.