{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T13:24:20Z","timestamp":1770729860210,"version":"3.49.0"},"posted":{"date-parts":[[2024,11,2]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":66,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T00:00:00Z","timestamp":1730505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,11,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Effective strategies are needed to facilitate early detection and diagnosis of tuberculosis (TB). The over-reliance on passive case detection, symptom screening, and collection of sputum, results in delayed or undiagnosed TB, which directly contributes to on-going TB transmission. We assessed the acceptability and feasibility of in-home, Targeted Universal TB Testing (TUTT) of household contacts using GeneXpert MTB\/RIF Ultra at point-of-care (POC) during household contact investigations (HCIs) and compared the feasibility of using sputum vs. tongue swab specimens.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Household contacts (HHCs) receiving in-home POC TUTT as part of the TB Home Study were asked to complete a post-test acceptability survey. The survey explored HHC\u2019s level of comfort, confidence in the test results, and the perceived appropriateness of in-home POC TUTT. We used the Metrics to Assess the Feasibility of Rapid Point-of-Care Technologies framework to assess the feasibility of using sputum and tongue swab specimens for in-home POC TUTT. Descriptive statistics were used to report participant responses and feasibility metrics.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 313 eligible HHCs, 267\/313 (85.3%) consented to in-home POC TUTT. Of those, 267\/267 (100%) provided a tongue swab and 46\/267 (17.2%) could expectorate sputum. All specimens were successfully prepared for immediate, in-home testing with Xpert Ultra on GeneXpert Edge. Of 164 tongue swab tests conducted, 160\/164 (97.6%) generated a valid test result compared to 44\/46 (95.7%) sputum-based tests. An immediate test result was available for 262\/267 (98.1%) individuals based on in-home swab testing, and 44\/46 (95.7%) based on in-home sputum testing. The mean in-home POC TUTT acceptability score (5=highly acceptable) was 4.5\/5 (SD= 0.2).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In-home, POC TUTT using either sputum or tongue swab specimens was highly acceptable and feasible. Tongue swab specimens greatly increase the proportion of HHCs tested compared to sputum. In-home POC TUTT using a combination of sputum and tongue swabs can mitigate shortcomings to case detection.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>KEY MESSAGE<\/jats:title>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>What is already known on this topic<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>TB transmission among household contacts of people with TB is a public health concern.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>The delivery of community-based diagnostic testing for TB is challenging and the reliance on sputum continue to hamper universal testing and result in diagnostic delay.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>What this study adds<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>This is the first study to assess the acceptability of universal in-home point-of-care TB testing of household contacts during household contact investigations.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>This study assesses the feasibility of different specimen types for immediate in-home point-of-care TB testing including tongue swabs and sputum.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>How this study might affect research, practice or policy<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>Household contacts perceived in-home targeted universal TB testing to be highly acceptable, prompting the need for further investigation into the cost-effectiveness of such strategies to improve early case detection.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>The use of tongue swabs as an additional or alternative sample type to sputum could increase testing and improve early case detection.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>","DOI":"10.1101\/2024.11.01.24316570","type":"posted-content","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T17:30:14Z","timestamp":1730568614000},"source":"Crossref","is-referenced-by-count":3,"title":["USING SPUTUM AND TONGUE SWAB SPECIMENS FOR IN-HOME POINT-OF-CARE TARGETED UNIVERSAL TESTING FOR TB OF HOUSEHOLD CONTACTS: AN ACCEPTABILITY AND FEASIBILITY ANALYSIS"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7545-6188","authenticated-orcid":false,"given":"Charl","family":"Bezuidenhout","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4986-4988","authenticated-orcid":false,"given":"Lawrence","family":"Long","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-4999","authenticated-orcid":false,"given":"Brooke","family":"Nichols","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0439-381X","authenticated-orcid":false,"given":"Gesine","family":"Meyer-Rath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew 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