{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:13:02Z","timestamp":1780927982222,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Non\u2010invasive methods based on exhaled breath samples have emerged as promising alternatives for the diagnosis of pulmonary tuberculosis, especially in settings where sputum collection is challenging and laboratory infrastructure is limited. We aimed to map the evidence on advanced technologies available for detecting pulmonary tuberculosis using alveolar breath, bioaerosols, or exhaled breath condensate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A comprehensive scoping review following international guidelines was performed (OSF:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/TRJ7W\">10.17605\/OSF.IO\/TRJ7W<\/jats:ext-link>\n                      ). Searches were conducted in PubMed, Scopus and Web of Science (June 2025). Primary studies evaluating physical or chemical diagnostic methods based on biological exhaled breath samples for detecting pulmonary tuberculosis in symptomatic patients were included. Studies' metadata, including method accuracy metrics, were extracted for diagnosis performance comparison. Evidence was synthesised using descriptive statistical and qualitative methods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 19 studies published between 2010 and 2025 were included, mostly conducted in high tuberculosis\u2010burden countries such as South Africa (16%), China (11%) and Paraguay (11%). The most evaluated techniques were electronic nose (e\u2010nose) (42%), gas chromatography coupled with mass spectrometry (GC\u2013MS\/MS\u2010based) (21%) and machine learning applied to mass spectrometry (ML\u2013MS) approaches (11%). Important heterogeneity in studies' design and analytical approaches was observed. All included studies used non\u2010invasive samples and were classified as intended for screening purposes; none aimed for confirmatory diagnosis. Among the included studies, 10 (53%) were classified as near point\u2010of\u2010care approaches. Of these, 8 (80%) met the minimum sensitivity requirement for screening tests, although only one also achieved the corresponding specificity threshold. The highest diagnostic performance reported showed a sensitivity of 98.5% (95% CI: 92.1\u2013100) and a specificity of 100% (95% CI: 93.5\u2013100).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although research on exhaled breath\u2010based technologies for pulmonary tuberculosis diagnosis is advancing, with some alternatives presenting moderate\u2010to\u2010high performance, their implementation still requires standardised validation, methodological improvements and field testing in real\u2010world settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70084","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T02:00:02Z","timestamp":1769392802000},"page":"397-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Advanced Technologies for the Diagnosis of Pulmonary Tuberculosis Using Exhaled Breath Samples: A Systematic Scoping Review"],"prefix":"10.1111","volume":"31","author":[{"given":"F. L.","family":"Ad\u00e3o\u2010Ara\u00fajo","sequence":"first","affiliation":[{"name":"Postgraduate Program in Internal Medicine and Health Science Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. G.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Pharmaceutical Sciences Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Pontarolo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4262-8608","authenticated-orcid":false,"given":"F. S.","family":"Tonin","sequence":"additional","affiliation":[{"name":"Pharmacy and Pharmaceutical Technology Department, Social and Legal Pharmacy Section University of Granada  Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7907-7585","authenticated-orcid":false,"given":"S. M.","family":"Raboni","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Internal Medicine and Health Science Federal University of Paran\u00e1  Curitiba Brazil"},{"name":"Department of Community Health Federal University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.54394\/CJQU6666"},{"key":"e_1_2_9_3_1","volume-title":"Target Product Profiles for Tuberculosis Diagnostics [Internet]","author":"World Health Organization","year":"2024"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098\u2010018\u20102811\u20100"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01847\u201018"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000525142"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.564194"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2018.01.004"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1088\/1752\u20107163\/adcfba"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2019.07.056"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408\u2010024\u201000779\u2010y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-24-09"},{"key":"e_1_2_9_13_1","volume-title":"Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. 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