{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:17:06Z","timestamp":1783480626376,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases at the US National Institutes of Health","doi-asserted-by":"publisher","award":["R21AI174129"],"award-info":[{"award-number":["R21AI174129"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center of the National Institutes of Health","doi-asserted-by":"publisher","award":["D43TW006589"],"award-info":[{"award-number":["D43TW006589"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rapid, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nested case\u2013control 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\u2013August 2024). Participants provided a sputum sample for liquid mycobacterial culture and paired saliva and nylon-flocked oral swabs for storage at \u221280\u00b0C. 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 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\u201395.6), and specificity was 95.8% (95% CI, 89.6\u201398.8). Swab sensitivity was 71.6% (95% CI, 61.4\u201380.4), and specificity was 99% (95% CI, 94.3\u2013100). Saliva sensitivity exceeded that of swab by an absolute difference of 18.9% (95% CI, +10.0 to +27.9, P &amp;lt; .001), but there was no significant difference in specificity (\u22123.2%, 95% CI, \u22127.7 to +1.4, P = .25). Over 95% of participants found saliva and swab collection procedures acceptable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both saliva and swabs were highly sensitive and specific for culture-confirmed pulmonary TB. Saliva sensitivity exceeded the World Health Organization's \u226580% target for a low-complexity, nonsputum TB diagnostic test.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag055","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T12:46:11Z","timestamp":1770295571000},"page":"e1313-e1321","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic Accuracy of Molecular Testing on Saliva and Oral Swabs for Pulmonary Tuberculosis"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6575-1919","authenticated-orcid":false,"given":"Deninson Alejandro","family":"Vargas","sequence":"first","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM) , Cali ,","place":["Colombia"]},{"name":"Universidad Icesi , Cali 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,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8135-596X","authenticated-orcid":false,"given":"Jairo","family":"Palomares Velosa","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM) , Cali ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-6707","authenticated-orcid":false,"given":"Alvaro Mauricio","family":"Lasso","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM) , Cali ,","place":["Colombia"]},{"name":"Universidad Icesi , Cali ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2318-1783","authenticated-orcid":false,"given":"Amanda J","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health , New Haven, Connecticut ,","place":["USA"]},{"name":"Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5641-2392","authenticated-orcid":false,"given":"Alvaro J","family":"Martinez-Valencia","sequence":"additional","affiliation":[{"name":"Centro Internacional de Entrenamiento e Investigaciones M\u00e9dicas (CIDEIM) , Cali ,","place":["Colombia"]},{"name":"Universidad Icesi , Cali ,","place":["Colombia"]},{"name":"Centro de Investigaciones Cl\u00ednicas, Fundaci\u00f3n Valle del Lili , Cali ,","place":["Colombia"]},{"name":"Servicio de Enfermedades Infecciosas, Fundaci\u00f3n Valle del Lili , Cali 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