{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:54:44Z","timestamp":1772070884368,"version":"3.50.1"},"posted":{"date-parts":[[2025,7,5]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":7,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T00:00:00Z","timestamp":1751673600000},"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":[[2025,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sputum collection for tuberculosis (TB) diagnosis poses challenges for children, people living with HIV, and those who struggle with sputum production.<\/jats:p>\n                  <jats:p>Tongue swab-based molecular testing offers a promising non-invasive alternative, but person-centered research on acceptability is limited.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a pragmatic survey across eight countries (Vietnam, Philippines, South Africa, Nigeria, Zambia, India, Uganda, Peru) among people with presumptive TB attending primary care facilities. Participants provided both tongue swab and sputum samples, then completed a 5-10 minute survey about their collection preferences.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From October 2023 to July 2024, 1,297 participants were enrolled (median age 43 years, 45% female, 13% HIV-positive). Overall, 61% (95% CI: 58-64%) preferred tongue swab collection compared to 22% (95% CI: 20-25%) who preferred sputum collection and 17% (95% CI: 15-19%) with no preference. Preference for tongue swab was consistent across demographic and clinical subgroups, with country-level variation ranging from 47% in South Africa to 74% in Zambia and Nigeria.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Strong preference for tongue swab over sputum collection among individuals with presumptive TB supports this diagnostic innovation\u2019s potential to overcome barriers to timely TB testing, particularly for populations struggling with sputum production.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.07.04.25330895","type":"posted-content","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T17:40:33Z","timestamp":1751737233000},"source":"Crossref","is-referenced-by-count":2,"title":["Preferences for Tongue Swab versus Sputum Collection for Tuberculosis Testing: A Multi-Country Survey"],"prefix":"10.64898","author":[{"given":"Kingsley","family":"Manoj Kumar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Borkman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Crowder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bukola","family":"Ajide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"Al\u00ed-Francia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masuzyo","family":"Chirwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Kamulegeya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hien","family":"Le","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vu Ngoc","family":"Trung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rouxjeane","family":"Venter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Bimba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devasahayam J.","family":"Christopher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Dalay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen","family":"Van Hung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monde","family":"Muyoyeta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Nakiyingi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen","family":"Van Nhung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9216-2415","authenticated-orcid":false,"given":"Grant","family":"Theron","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Zamudio-Fuertes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Atim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5023-6658","authenticated-orcid":false,"given":"Andrew D.","family":"Kerkhoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0485-2919","authenticated-orcid":false,"given":"Maria del Mar","family":"Castro Noriega","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Payam","family":"Nahid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia M.","family":"Denkinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adithya","family":"Cattamanchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan E.","family":"Dorman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8556-1744","authenticated-orcid":false,"given":"Nora","family":"West","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025070804051058000_2025.07.04.25330895v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00469-2"},{"key":"2025070804051058000_2025.07.04.25330895v1.2","doi-asserted-by":"crossref","unstructured":"del Mar Castro, M. , Le, H. , Muzazu, S. , Pham, N. , Trinh, T. , Nyirenda, H. , et al. (2024). Preferences for tongue swab-versus sputum-based testing in the context of TB care: a Best-Worst Scaling exercise in Vietnam and Zambia. medRxiv, 2024.2012.2022.24319450.","DOI":"10.1101\/2024.12.22.24319450"},{"key":"2025070804051058000_2025.07.04.25330895v1.3","doi-asserted-by":"crossref","first-page":"e226","DOI":"10.1016\/S2214-109X(23)00541-7","article-title":"Evaluation of the Xpert MTB Host Response assay for the triage of patients with presumed pulmonary tuberculosis: a prospective diagnostic accuracy study in Viet Nam, India, the Philippines, Uganda, and South Africa","volume":"12","year":"2024","journal-title":"The Lancet Global Health"},{"key":"2025070804051058000_2025.07.04.25330895v1.4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3390\/diagnostics8040078","article-title":"Challenges and progress with diagnosing pulmonary tuberculosis in low-and middle-income countries","volume":"8","year":"2018","journal-title":"Diagnostics"},{"key":"2025070804051058000_2025.07.04.25330895v1.5","doi-asserted-by":"crossref","unstructured":"Shah, K. , Nalugwa, T. , Marcelo, D. , Nakawunde, R. , Trinh, T. , Shankar, D. , et al. (2024). A Multi-Country Evaluation of Patient Preferences for Tuberculosis Diagnostics: A Discrete Choice Experiment to Inform WHO Target Product Profiles. medRxiv, 2024.2006.2019.24309124.","DOI":"10.1101\/2024.06.19.24309124"},{"key":"2025070804051058000_2025.07.04.25330895v1.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae041"},{"key":"2025070804051058000_2025.07.04.25330895v1.7","doi-asserted-by":"crossref","unstructured":"Steadman, A. , Kumar, K.M. , Asege, L. , Kato-Maeda, M. , Mukwatamundu, J. , Shah, K. , et al. (2025). Diagnostic accuracy of swab-based molecular tests for tuberculosis using novel near point-of-care platforms: A multi-country evaluation. medRxiv, 2025.2004.2012.25325603.","DOI":"10.2139\/ssrn.5273912"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.07.04.25330895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:39:59Z","timestamp":1768509599000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.07.04.25330895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,5]]},"references-count":7,"URL":"https:\/\/doi.org\/10.1101\/2025.07.04.25330895","relation":{},"subject":[],"published":{"date-parts":[[2025,7,5]]},"subtype":"preprint"}}