ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Diagnostic Accuracy of Molecular Testing on Saliva and Oral Swabs for Pulmonary Tuberculosis.
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. Cited by 1 paper.
What it found
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Who cites it
1 citing paper in PubMed.
- Impact of sputum quality on Xpert MTB/RIF Ultra test results for tuberculosis: A multi-country study.medRxiv : the preprint server for health sciences · 2026Article
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Authors and funding
12 authors.
Funding
Abstract
backgroundRapid, accurate, nonsputum tests are needed to close gaps in tuberculosis (TB) detection. We evaluated the diagnostic performance of molecular testing on saliva and oral swabs.
methodsWe conducted a nested case-control study with 1:1 incidence-density sampling within a prospective cohort of adults and children undergoing evaluation for pulmonary TB at primary care centers in Colombia (July 2023-August 2024). Participants provided a sputum sample for liquid mycobacterial culture and paired saliva and nylon-flocked oral swabs for storage at -80°C. A microbiologist blinded to clinical and culture data performed Xpert MTB/RIF Ultra on thawed saliva and on swab eluate, each mixed 1:1 with sample reagent. We calculated the sensitivity and specificity of saliva and swab against sputum culture and compared them using McNemar's test.
resultsAmong 648 enrolled participants, we tested saliva and swabs from all 95 individuals with culture-confirmed TB and 95 matched culture-negative controls (n = 190). Saliva sensitivity was 90.5% (95% confidence interval [CI], 82.8-95.6), and specificity was 95.8% (95% CI, 89.6-98.8). Swab sensitivity was 71.6% (95% CI, 61.4-80.4), and specificity was 99% (95% CI, 94.3-100). Saliva sensitivity exceeded that of swab by an absolute difference of 18.9% (95% CI, +10.0 to +27.9, P < .001), but there was no significant difference in specificity (-3.2%, 95% CI, -7.7 to +1.4, P = .25). Over 95% of participants found saliva and swab collection procedures acceptable.
conclusionsBoth saliva and swabs were highly sensitive and specific for culture-confirmed pulmonary TB. Saliva sensitivity exceeded the World Health Organization's ≥80% target for a low-complexity, nonsputum TB diagnostic test.
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