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The World Health Organization's (WHO) Global Strategy to reduce harmful use of alcohol sets a voluntary target of reducing the harmful use of alcohol by 10% in about 10 years. Using the WHO criteria, this paper critically assesses the alcohol control policy of the Federal Democratic Republic of Ethiopia and sets out recommendations for major improvement for protecting the health of the population.

The first COVID-19 case was reported in Ethiopia on 13th March 2020 and series of announcements of set of measures, proclamation and directives have been enacted to fight the coronavirus pandemic. These have implications for the regular health services including the TB control program. This brief communication assesses the impact of the COVID-19 response on the TB control activities of Addis Ababa health centers based on research project data. We compared the patient flows in pre-COVID-19 period (quarter 1, Q1) and during COVID-19 (quarter 2, Q2 and quarter 3, Q3) of 2020 at 56 health centers in Addis Ababa from all 10 sub-cities per sub-city. The patient flow declined from 3,473 in Q1 to 1,062 in Q2 and 1,074 in Q3, which is a decrease by 62-76% and 52-80% in Q2 and Q3 respectively as compared to that of Q1. In Q2, Kolfe keranio and Kirkos sub-cities recorded the biggest decline (76 and 75% respectively) whereas Yeka sub-city had the least decline (62%). In Q3, Kirkos sub-city had the biggest decline (80%) and Addis ketema sub-city had the lowest (52%). We conclude that the series of measures, state of emergency proclamation and government directives issued to counter the spread of COVID-19 and the public response to these significantly affected the TB control activities in Addis Ababa city as attested by the decrease in the patient flow at the clinics. Health authorities may inform the public that essential health services are still available and open to everyone in need of these services.

It9s time… to find and treat all patients with TB. Rats may have a say in research towards better diagnostic tests.http://bit.ly/2Rioa9N

Tuberculosis (TB) is a major problem in poor countries because sensitive diagnostic tools are unavailable. In 2014, our pouched rats evaluated sputum from 21,600 Tanzanians and 9,048 Mozambicans whose sputum had previously been evaluated by microscopy, the standard diagnostic for TB. Evaluation by the rats revealed 1,412 new patients with active TB in Tanzania and 645 new patients in Mozambique, increases of 39% and 53%, respectively, when compared to detections by microscopy alone. These results provide further support for the applied use of scent-detecting rats.

SETTING: Enhanced tuberculosis (TB) case finding using detection rats in Tanzania. OBJECTIVES : To assess the diagnostic accuracy of detection rats compared with culture and Xpert (R) MTB/RIF, and to compare enhanced case-finding algorithms using rats in smear-negative presumptive TB patients. DESIGN: A fully paired diagnostic accuracy study in which sputum of new adult presumptive TB patients in Tanzania was tested using smear microscopy, 11 detection rats, culture and Xpert. RESULTS : Of 771 eligible participants, 345 (45%) were culture-positive for Mycobacterium tuberculosis, and 264 (34%) were human immunodeficiency virus (HIV) positive. The sensitivity of the detection rats was up to 75.1% (95% CI 70.1-79.5) when compared with culture, and up to 81.8% (95% CI 76.0-86.5) when compared with Xpert, which was statistically significantly higher than the sensitivity of smear microscopy. Corresponding specificity was 40.6% (95% CI 35.9-45.5) compared with culture. The accuracy of rat detection was independent of HIV status. Using rats for triage, followed by Xpert, would result in a statistically higher yield than rats followed by light-emitting diode fluorescence microscopy, whereas the number of false-positives would be significantly lower than when using Xpert alone. CONCLUSION: Although detection rats did not meet the accuracy criteria as standalone diagnostic or triage testing for presumptive TB, they have additive value as a triage test for enhanced case finding among smear-negative TB patients if more advanced diagnostics are not available

Pouched rats can detect Mycobacterium tuberculosis, which causes tuberculosis, in human sputum. Historically, a phosphate-buffered saline solution was added to sputum in the belief that doing so improved rats’ detection of M. tuberculosis, but no relevant data were available. Experiment 1 evaluated rats’ performance on samples with and without phosphate-buffered saline solution added. There was no difference in detection accuracy. Adding the solution slows sample processing and will not be done in future operational applications. Experiment 2 compared the performance of rats trained on sputum samples with low versus high concentrations of M. tuberculosis. Training on low-concentration samples improves sensitivity on that sample type. Unfortunately, it is impractical to arrange low-concentration training in the current operational setting, where the rats are used for the second-line screening of samples initially evaluated by microscopy.

Tuberculosis (TB) is a major problem in poor countries because sensitive diagnostic tools are unavailable. In 2014, our pouched rats evaluated sputum from 21,600 Tanzanians and 9,048 Mozambicans whose sputum had previously been evaluated by microscopy, the standard diagnostic for TB. Evaluation by the rats revealed 1,412 new patients with active TB in Tanzania and 645 new patients in Mozambique, increases of 39% and 53%, respectively, when compared to detections by microscopy alone. These results provide further support for the applied use of scent-detecting rats.

A total of 5 giant African pouched rats detected 10- (95.3% sensitivity) and 100-fold dilutions (78.8% sensitivity) of broth from cultured Salmonella enterica serovar Saint Paul inoculated into dried horse feces. All rats demonstrated some generalization to more dilute concentrations and analyzed 50 samples in less than 20 minutes. These findings suggest that further research examining the use of pouched rats to detect Salmonella is merited.

Many species have sensitive chemical-detection systems. For millennia, dogsr exquisite sense of smell has assisted human beings in hunting and in thwarting intruders. Trained dogs have detected landmines and other explosives, illicit drugs, pipeline leaks, and melanomas (Furton a Myers, 2001). Although Canis familaris is far and away the species whose chemical-detection abilities most often benefit humans, a few other species have been used (Habib, 2007). For example, personnel of...

Despite its characteristically low sensitivity, sputum smear microscopy remains the standard for diagnosing tuberculosis (TB) in resource-poor countries. In an attempt to develop an alternative or adjunct to microscopy, researchers have recently examined the ability of pouched rats to detect TB-positive human sputum samples and the microbiological variables that affect their detection. Ten published studies, reviewed herein, suggest that the rats are able to detect the specific odor of Mycobacterium tuberculosis, which causes TB, and can substantially increase new-case detections when used for second-line TB screening following microscopy. Further research is needed to ascertain the rats' ability to detect TB in children and in HIV-positive patients, to detect TB when used for first-line screening, and to be useful in broad-scale applications where cost effectiveness is a major consideration.

Giant African pouched rats recently have been used as mine-detection animals in Mozambique. To provide an example of the wide range of problems to which operant conditioning procedures can be applied and to illustrate the common challenges often faced in applying those procedures, this manuscript briefly describes how the rats are trained and used operationally. To date, the rats have performed well and it appears they can play a valuable role in humanitarian demining.

In recent years, operant discrimination training procedures have been used to teach giant African pouched rats to detect tuberculosis (TB) in human sputum samples. This article summarizes how the rats are trained and used operationally, as well as their performance in studies published to date. Available data suggest that pouched rats, which can evaluate many samples quickly, are sufficiently accurate in detecting TB to merit further investigation as a diagnostic tool.

This article describes Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling (APOPO) recent use of specially trained African giant pouched rats as detectors of pulmonary tuberculosis in people living in Tanzania. It summarizes the achievements and challenges encountered over the years and outlines future prospects. Since 2008, second-line screening by the rats has identified more than 2000 tuberculosis-positive patients who were missed by microscopy at Direct Observation of Treatment – Short Course centres in Tanzania. Moreover, data that are reviewed herein have been collected with respect to the rats’ sensitivity and specificity in detecting tuberculosis. Findings strongly suggest that scent-detecting rats offer a quick and practical tool for detecting pulmonary tuberculosis and within the year APOPO’s tuberculosis-detection project will be extended to Mozambique. As part of its local capacity building effort, APOPO hires and trains Tanzanians to play many important roles in its TB detection project and provides research and training opportunities for Tanzanian students.

Setting. Tanzania.Objective. To compare microscopy as conducted in direct observation of treatment, short course centers to pouched rats as detectors ofMycobacterium tuberculosis.Design. Ten pouched rats were trained to detect tuberculosis in sputum using operant conditioning techniques. The rats evaluated 910 samples previously evaluated by smear microscopy. All samples were also evaluated through culturing and multiplex polymerase chain reaction was performed on culture growths to classify the bacteria.Results. The patientwise sensitivity of microscopy was 58.0%, and the patient-wise specificity was 97.3%. Used as a group of 10 with a cutoff (defined as the number of rat indications to classify a sample as positive forMycobacterium tuberculosis) of 1, the rats increased new case detection by 46.8% relative to microscopy alone. The average samplewise sensitivity of the individual rats was 68.4% (range 61.1–73.8%), and the mean specificity was 87.3% (range 84.7–90.3%).Conclusion. These results suggest that pouched rats are a valuable adjunct to, and may be a viable substitute for, sputum smear microscopy as a tuberculosis diagnostic in resource-poor countries.

Giant African pouched rats previously have detected tuberculosis (TB) in human sputum samples in which the presence of TB was not initially detected by smear microscopy. Operant conditioning principles were used to train these rats to indicate TB-positive samples. In 2010, rats trained in this way evaluated 26,665 sputum samples from 12,329 patients. Microscopy performed at DOTS centers found 1,671 (13.6%) of these patients to be TB-positive. Detection rats identified 716 additional TB-positive patients, a 42.8% increase in new-case detection. These previously unreported data, which extend to over 20,000 the number of patients evaluated by pouched rats in simulated second-line screening, suggest that the rats can be highly valuable in that capacity.Key words: Giant pouched rats, Tuberculosis detection, disease, operant conditioning, Africa

We used giant African pouched rats (Cricetomys gambianus) as land mine-detection animals in Mozambique because they have an excellent sense of smell, weigh too little to activate mines, and are native to sub-Saharan Africa, and therefore are resistant to local parasites and diseases. In 2009 the rats searched 93,400 m(2) of land, finding 41 mines and 54 other explosive devices. Humans with metal detectors found no additional mines. On average, the rats emitted 0.33 false alarm for every 100 m(2) searched, which is below the threshold given by International Mine Action Standards for accrediting mine-detection animals. These findings indicate that Cricetomys are accurate mine-detection animals and merit continued use in this capacity.

Background This study established evidence about the diagnostic performance of trained giant African pouched rats for detecting Mycobacterium tuberculosis in sputum of well-characterised patients with presumptive tuberculosis (TB) in a high-burden setting. Methods The TB detection rats were evaluated using sputum samples of patients with presumptive TB enrolled in two prospective cohort studies in Bagamoyo, Tanzania. The patients were characterised by sputum smear microscopy and culture, including subsequent antigen or molecular confirmation of Mycobacterium tuberculosis, and by clinical data at enrolment and for at least 5-months of follow-up to determine the reference standard. Seven trained giant African pouched rats were used for the detection of TB in the sputum samples after shipment to the APOPO project in Morogoro, Tanzania. Results Of 469 eligible patients, 109 (23.2%) were culture-positive for Mycobacterium tuberculosis and 128 (27.3%) were non-TB controls with sustained recovery after 5 months without anti-TB treatment. The HIV prevalence was 46%. The area under the receiver operating characteristic curve of the seven rats for the detection of culture-positive pulmonary tuberculosis was 0.72 (95% CI 0.66–0.78). An optimal threshold could be defined at ≥2 indications by rats in either sample with a corresponding sensitivity of 56.9% (95% CI 47.0–66.3), specificity of 80.5% (95% CI 72.5–86.9), positive and negative predictive value of 71.3% (95% CI 60.6–80.5) and 68.7% (95% CI 60.6–76.0), and an accuracy for TB diagnosis of 69.6%. The diagnostic performance was negatively influenced by low burden of bacilli, and independent of the HIV status. Conclusion Giant African pouched rats have potential for detection of tuberculosis in sputum samples. However, the diagnostic performance characteristics of TB detection rats do not currently meet the requirements for high-priority, rapid sputum-based TB diagnostics as defined by the World Health Organization.