Evidence map›Paper›PMID 42046222›Full record

ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2026

Tongue swab Xpert MTB/RIF Ultra testing for TB using a revised consensus protocol.

B Ajide, C A Moe, J Barrameda, M Chirwa, L Rockman, P de Haas, M de Vos, M Kato-Maeda, B Tasca, J Bimba and 7 more

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Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

B AjideZankli Research Center, Bingham University, Karu, Nigeria.
C A MoeDivision of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Orange, CA, USA;, Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA.
J BarramedaDe La Salle Medical and Health Sciences Institute, Cavite, Philippines.
M ChirwaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
L RockmanDSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
P de HaasKNCV Tuberculosis Foundation, the Hague, the Netherlands.
M de VosDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.
M Kato-MaedaCenter for Tuberculosis, University of California San Francisco, San Francisco, CA, USA.
B TascaKNCV Tuberculosis Foundation, the Hague, the Netherlands.
J BimbaZankli Research Center, Bingham University, Karu, Nigeria.
C YuDe La Salle Medical and Health Sciences Institute, Cavite, Philippines.
C M DenkingerDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany;, German Centre for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany.
K KremerKNCV Tuberculosis Foundation, the Hague, the Netherlands.
P NahidCenter for Tuberculosis, University of California San Francisco, San Francisco, CA, USA;, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.
A CattamanchiDivision of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Orange, CA, USA;, Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA.
G TheronDSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
M MuyoyetaCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<sec><title>BACKGROUND</title>Tongue swabs are a promising specimen type for TB diagnosis. In a previous study, using a consensus protocol, tongue swabs tested with Xpert MTB/RIF Ultra outperformed sputum smear microscopy, but a substantial proportion (6.1%) of results were non-actionable (e.g., invalid/error). We evaluated a revised protocol for tongue swab Xpert Ultra testing in four high-burden countries.</sec><sec><title>METHODS</title>Participants aged ≥12 years with presumptive TB were enrolled from outpatient clinics in the Philippines, South Africa, Nigeria, and Zambia. Tongue swabs were processed using Sample Reagent (SR, Cepheid, USA) diluted 2:1 with phosphate buffer or phosphate-buffered saline and tested with Xpert Ultra. Diagnostic performance was assessed against culture-based microbiological reference standard and compared to sputum tests.</sec><sec><title>RESULTS</title>From March to November 2024, 1,168 participants were enrolled (median age 37 [IQR: 28-48] years; 46.7% female; 21.8% living with HIV; 18.5% culture-confirmed TB). The proportion of non-actionable tongue swab results was 5.6% overall, but <4% in all countries except South Africa (15.4%). Tongue swab sensitivity was 66.0% (95% CI: 59.0-72.5); specificity was 99.6% (95% CI: 98.9-99.9).</sec><sec><title>CONCLUSION</title>The revised protocol yielded low error rates at most sites and moderate sensitivity, supporting tongue swabs as an alternative specimen for Xpert Ultra testing when sputum is unavailable.</sec>.

Indexed as

Mycobacterium tuberculosisSpecimen HandlingTongueTuberculosisAdultBacilloscopyConsensusFemaleHumansMaleMiddle AgedNigeriaPhilippinesRapid Diagnostic TestsSensitivity and SpecificitySouth Africa

Identifiers

PMID42046222

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.