Tuberculosis (TB) was declared a national emergency in Mozambique in March 2006. APOPO supports the country’s Ministry of Health TB control program. Our integrated TB detection approach in Maputo helps identifying additional TB cases by collecting and re-evaluating patient sputum samples from partner clinics and or providing molecular testing services. Results are returned within 24 hours so that newly diagnosed patients can start treatment early.
Background
Mozambique is ranked by the World Health Organization as a global ‘high TB-burden country’ that faces one of the highest TB incidence rates in the world. APOPO’s TB project in Mozambique was designed to replicate the successful research use of the TB detection rats in Tanzania. It contributes to the Mozambican National TB Control Program by effectively increasing the number of identified TB patients in the city of Maputo.
APOPO in Mozambique
APOPO refurbished and equipped a TB detection rat facility in partnership with the Veterinary School of the Eduardo Mondlane University in Maputo in 2012. The facility is situated on the University grounds and has been operational since 2013. It expanded further in early 2018, now using two 16-module GeneXpert machine for rapid molecular diagnostic of TB offering a testing capacity of 96 samples a day. This investment was crucial to align with the country’s efforts to roll out molecular testing as the first diagnostic tool for TB. APOPO has progressively began providing more molecular testing services.
Ariound 17 health centers in Maputo city are now collaborating with the project by providing sputum samples from patients with presumptive TB. The confirmed additional positive results are then communicated back to the health centers and to partner organization CCS (Centro para Colaboração em Saúde) and its contracted community-based associations, allowing their community health workers to trace the patients back and get them on treatment.
24 Hour Results
Since October 2015, APOPO has been accelerating sample collection and laboratory testing which has allowed APOPO to deliver test results to partner clinics within 24 hours. The aim being to increase treatment initiation and reduce time and effort in patient tracking to deliver results after patients have left the clinics. And it has been successful.
APOPO maintains a 24-hour result turnaround when using Xpert MTB/Rif as confirmation test since the acquisition of the high-throughput GeneXpert platform.
Beyond Tuberculosis
With the established diagnostic infrastructure and smooth work flow from sample collection to testing and result reporting ; in early 2020 APOPO began a new collaboration with Population Services International (PSI) for testing Human Papillomavirus (HPV) using its molecular platforms.
APOPO was awarded a new grant by the Government of Flanders in October 2020 to continue detecting TB but also to begin testing for SARS-CoV-2. The team will builds on its solid field experience, making use of the available molecular testing capacity to continue testing TB and HPV samples, but also supporting the National Health Institute (INS) in the country’s response to Coronavirus disease (COVID-19).
Over the next 15 months APOPO will test about 6,000 samples for TB and extend its coverage from Maputo city to Matola and Marracuene to collect and test up to 20,000 samples for SARS-CoV-2. Based on APOPO’s rapid and reliable testing capacity, defined priority groups include health staff, in-patients and most-at-risk patients (elderly, diabetes, chronic diseases. APOPO will maintain its results delivery in 24 hours.
Future plans
APOPO plans to continue increasing the number of collaborating health centers, not only in the city of Maputo but also in the neighboring city of Matola, in order to offer access to enhanced TB diagnostics to as many people in need as possible.
