Reaching the unreached Tanzanian population: towards finding and testing all to end Tuberculosis (TB)

Contribute to ending TB (SDG3) through the decrease of the overall number of TB transmissions allowed by testing, tracking and treatment initiation of all TB patients, including usually neglected populations which are particularly at-risk and hard to reach (HIV+, children, urban poor, women). Tanzania is a Sub-Saharan African country with a high Tuberculosis (TB) and TB/HIV burden and despite a strong National TB Program (NTLP), the domestic budget to finance TB control remains small, and the World Health Organization (WHO) reports that only 59% of estimated cases are diagnosed. Reasons for missed cases include limited access to health care and performance of available diagnostic tests, and disconnected services alongside the cascade of care. Missing cases results in prolonged diagnostic delays, catastrophic costs faced by TB-affected families and continued TB spread in the communities. Children and people living with HIV are particularly vulnerable to TB and are often underdiagnosed. Left untreated, up to two thirds of TB patients will eventually die. A TB-positive patient can pass the pathogen to up to 15 other people within a year, creating a vicious cycle that is difficult to break. To End TB – as globally aspired – it is crucial to find and treat patients early. APOPO offers an innovative integrated approach based on animal scent detection, and has built crucial grassroots partnerships with community organizations to contribute to the global goal to Find & Treat All TB cases. The proposed program aims to curb TB in Dar Es Salaam, Morogoro and Dodoma regions through 1) provision of rapid, integrated TB diagnostic services for hard-to-reach populations, 2) treatment initiation of the newly diagnosed patients through linkage-to-care, 3) enhanced (passive) case finding through greater awareness on TB, capacity building and stigma decrease and 4) demonstration of APOPO’s technology efficiency, especially on neglected populations and integration of the technology within the national health policy. The proposed program will directly benefit at least 141,666 patients with presumptive TB, allowing 6,670 additional patients to be found and put on treatment, is likely to halt infections to hundred thousands of people in their communities.