ArticleBMC health services research2026
"That is why I trust": a qualitative study on acceptability and feasibility of novel tongue swab diagnostics to assess people presenting with tuberculosis symptoms in Viet Nam and Zambia.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 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
- Predicted Preferences for Tuberculosis Point-of-Care Tests Among Tuberculosis-Affected Individuals in 5 High Burden Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Centralized molecular testing of community-collected tongue swabs for tuberculosis screening among household contacts: a cross-sectional diagnostic performance, yield, and implementation study.medRxiv : the preprint server for health sciences · 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
- Preferences for tongue swab versus sputum collection for TB testing: a multi-country survey.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2026Article
- Preferences for tongue swab-based versus sputum-based testing in the context of TB care: a best-worst scaling exercise in Vietnam and Zambia.BMJ global health · 2025Article
- Informing People-Centered Target Product Profiles for TB Diagnostics: A Multi-Country Qualitative Study.medRxiv : the preprint server for health sciences · 2025Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundMillions of tuberculosis (TB) cases are estimated to be undiagnosed and unreported annually. Sputum has been the primary approach for diagnostic testing, but tongue swabs are being investigated as an alternative to expand testing. To understand potential uptake and implementation, we explored the acceptability, usability, and feasibility of tongue swab-based TB testing from the perspectives of healthcare workers, people undergoing TB screening, and caregivers in Viet Nam and Zambia.
methodsWe interviewed people with symptoms of TB, caregivers of children undergoing TB evaluation, and healthcare workers who collected tongue swabs (n = 76 participants) between September 2023 and February 2024. Interviews were analyzed using framework analysis to elucidate preferences, experiences, and acceptability of tongue swabs vs. sputum. Findings were further organized according to acceptability and feasibility to understand barriers and facilitators to uptake.
resultsMost participants preferred tongue swab to sputum collection. The perceived usability and feasibility of tongue swabs were high. Key themes that influenced the acceptability of tongue swabs included ease of use, diagnostic accuracy, diagnostic yield, hygiene, risk of TB transmission during sample collection, time to test result, and trust in healthcare workers and the health system. Across interviews, many participants described tongue swabs as a comfortable and easy way to test for TB, compared to the physical discomfort and difficulty expectorating sputum. Participants described tongue swabs as suitable for everyone, yet perceived diagnostic accuracy was crucial in shaping test preference.
conclusionTongue swab-based testing for TB is likely to be highly acceptable and feasible if incorporated into TB diagnostic guidelines. Future integration of tongue swabs in facilities and communities should target drivers of acceptability.
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