{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T19:33:34Z","timestamp":1774035214819,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"US Civilian Research and Development Foundation","award":["DAA3-17-63192-1"],"award-info":[{"award-number":["DAA3-17-63192-1"]}]},{"name":"Department of Science and Innovation"},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"South African Department of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Tuberculosis (TB) diagnosis remains difficult in children under 5 years of age (under-5s), who have high TB morbidity and mortality rates. In a high-burden TB setting, we investigated the diagnostic characteristics of Xpert MTB\/RIF Ultra testing of tongue swabs (TS-XU) collected from under-5s.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a masked, prospective, observational study, tongue swabs were collected from enrolled hospitalized under-5s deemed high risk for TB disease who were categorized into 1 of the following: confirmed, unconfirmed, or unlikely TB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 201 enrolled under-5s, 11 (5.5%) had confirmed TB, 53 (26.4%) unconfirmed TB, and 137 (68.2%) unlikely TB. TS-XU testing reported \u201cMtb detected\u201d in 116 (57.7%) of 201 under-5s: positive results were \u201ctrace\u201d (90\/116, 77.6%), \u201cvery low\u201d (21\/116, 18.1%), and \u201clow\u201d or \u201cmedium\u201d (4\/116 [3.4%] and 1\/116 [0.8%], respectively). There were no \u201chigh\u201d TS-XU results. When trace results were presumed negative, TS-XU sensitivity was 17.2% (95% CI, 7.9%\u201326.4%) and specificity 89.1% (95% CI, 83.8%\u201394.3%), and TS-XU detected Mtb in 15 (10.9%) of 137 children with unlikely TB. Our data showed that TS-XU, in addition to routine TB testing, increased TB detection rates by 19.2%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite the difficulty of interpreting trace-positive results, TS-XU testing increased TB detection rates in hospitalized under-5s with presumptive TB.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf474","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T11:28:52Z","timestamp":1755689332000},"source":"Crossref","is-referenced-by-count":2,"title":["Performance of Tongue Swabs for Tuberculosis Diagnosis in Hospitalized Children Under 5 Years of Age"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9964-513X","authenticated-orcid":false,"given":"Sanjay G","family":"Lala","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child 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