ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Diagnostic Yield of Tongue Swab- Compared to Sputum-Based Molecular Testing for Tuberculosis in Four High-Burden Countries.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Towards ending tuberculosis in South Africa: an uncertainty analysis of the programmes and factors most critical to future declines.Global health action · 2026Article
- Diagnostic Performance of the Pluslife MiniDock MTB and Molbio MTB Ultima Assays to Detect Tuberculosis From Tongue and Sputum Swabs Among Outpatients and in Active Case Finding in Cameroon.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Article
- Diagnostic Accuracy and Usability of the PluslifeDiagnostics (Basel, Switzerland) · 2026Article
- A public-private partnership for facility-based tuberculosis screening using chest radiographs, Viet Nam.Bulletin of the World Health Organization · 2026Article
- Rapid molecular detection of TB drug resistance from swab samples: a proof of concept study.IJTLD open · 2026Article
- Tongue swab-based Targeted Universal Tuberculosis Testing in people living with HIV in KwaZulu-Natal, South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Diagnostic accuracy of Pluslife MiniDock MTB on tongue swabs in sputum scarce people with presumptive TB: a retrospective analysis.Research square · 2026Article
- Development of a Rapid Automated Point-of-Care Test formedRxiv : the preprint server for health sciences · 2026Article
Corrections and comments
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- Erratum issued
Authors and funding
12 authors.
Funding
Abstract
backgroundTongue swabs are a promising alternative specimen for tuberculosis (TB) diagnosis. Although test specificity exceeds 98%, sensitivity is lower than sputum-based molecular testing. We investigated whether the use of tongue swabs could increase sample availability, resulting in similar diagnostic yield.
methodsIn this cross-sectional study (July 2024-January 2025), we screened consecutive people with presumptive TB at health centers in the Philippines, Vietnam, Uganda, and Zambia. Participants were asked to provide tongue swabs and referred for routine sputum collection. Tongue swabs were tested in research laboratories using the MiniDock MTB Test (Guangzhou Pluslife Biotech Co., Ltd., China); sputum was tested using WHO-recommended molecular testing per national guidelines. We compared diagnostic yield, defined as proportion of positive test results among all participants, between tongue swab- and sputum-based molecular testing with a prespecified 3.0% non-inferiority margin.
resultsOf 1639 participants, 851 (51.9%) were female, 415 (25.3%) were diagnosed with HIV, and 132 (8.1%) were children <5 years. All provided tongue swabs, but only 1389 (84.7%) produced sputum. Diagnostic yield was 3.8% (63/1639) for tongue swabs and 4.1% (68/1639) for sputum-based (68/1639, 4.1%) molecular testing. The difference (0.3%, 95% CI -0.6 to +1.2) was within the prespecified non-inferiority margin. Results were consistent across countries and key subgroups (age, sex, and HIV status).
conclusionsTongue swab-based molecular testing with MiniDock MTB achieved non-inferior diagnostic yield compared with sputum-based molecular testing. These findings support scale-up of swab-based platforms as a cost-efficient alternative, particularly where sputum collection is challenging or smear microscopy remains the primary diagnostic method.
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