Marcio follows newly diagnosed patients to gather data on their illness.
“My name is Marcio Madussa and I am the Research Study Coordinator at APOPO’s Tuberculosis (TB) research project in Maputo, Mozambique. I collect data from 5 of the 20 collaborating health clinics in partnership with APOPO. Once the HeroRATs identify new TB cases by re-evaluating patients’ sputum samples, I follow the patients for at least two years to see when, and if, their TB becomes active. So far, I am tracking 277 participants who will receive free consultation, blood tests, X-ray tests, and quarterly transport payments. It has been challenging since the general public is not interested in taking part in research and there is a stigma around TB being associated with HIV/AIDS.
TB in Mozambique is a very serious disease, statistically the country is one of the worst in terms of incidence; a quarter of the population are likely carriers of TB (latent). The overcrowded public transport system, open public markets, and the multigenerational and extended families in a home leads to high transmission once TB is active. In 2019, incidence of TB in Mozambique was estimated at 361 cases per 100,000 people. The same year, 1.4 million people died from TB globally, and TB is frequently the first cause of death in HIV patients. HIV and TB form a lethal combination, each speeding the other’s progress.
When a patient gets confirmed with TB, the reaction is often fear or denial. As for treatment, the priority here is to identify people as early as possible, so that diagnosed patients can start treatment and stop transmitting to others. My work is to collect data that verifies if the HeroRATs positively identified TB in a sample, even though the microscopic result was a “false negative”. I then trace the development of active TB cases, collaborating and sharing my findings with other researchers and community health workers at APOPO’s partner organization – Kenguelekezé Association. I hope to publish my research findings once the study is completed. This work also supports my Masters’ work in Microbiology relating to Tuberculosis (TB).
Before I started working at APOPO, I worked in a Military Hospital of Maputo in biochemistry and microbiology. Based on this experience, I know that human lab technicians can take a long time to test a small number of presumptive TB-patient samples. while the African giant pouched rat, aka HeroRATs, are very fast at identifying TB. One rat can screen 100 samples in just 20 minutes. This could take a lab technician up to four days! All rat-indicated samples are of course confirmed in APOPO’s lab before we notify the clinic – but we save on so much time, meaning more patients can get on treatment and stop the spread of this disease.
While I once associated these rats with disease and saw them as rodent scavengers; I am now very impressed by the HeroRATs. Once I got to know them, I saw what they could do with their incredible sense of smell advancing the important work of medical science in eradicating tuberculosis. I’ve even grown quite fond of them! I am proud of APOPO’s HeroRATs and share my work with all of my friends!
My hope is that APOPO can continue to collaborate with health facilities all across Mozambique and even Africa, provide support, and find patients that otherwise would have been “false negatives” and link them to care. This is how, together, we can stop the spread of this disease.”