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It is not known if schools are high-risk settings for Mycobacterium tuberculosis (MTB) transmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To detect airborne MTB genomic DNA in classrooms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 72 classrooms occupied by 2,262 students in two South African schools. High-volume air filtration was performed for median 40 (interquartile range [IQR], 35\u201354) minutes and assayed by droplet digital PCR (ddPCR)-targeting MTB region of difference 9 (RD9), with concurrent CO2 concentration measurement. Classroom data were benchmarked against public health clinics. Students who consented to individual tuberculosis screening completed a questionnaire and sputum collection (Xpert MTB\/RIF Ultra) if symptom positive. Poisson statistics were used for MTB RD9 copy quantification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>ddPCR assays were positive in 13\/72 (18.1%) classrooms and 4\/39 (10.3%) clinic measurements (P\u2009=\u20090.276). Median ambient CO2 concentration was 886 (IQR, 747\u20131223) ppm in classrooms versus 490 (IQR, 405\u2013587) ppm in clinics (P\u2009&amp;lt;\u20090.001). Average airborne concentration of MTB RD9 was 3.61 copies per 180,000 liters in classrooms versus 1.74 copies per 180,000 liters in clinics (P\u2009=\u20090.280). Across all classrooms, the average risk of an occupant inhaling one MTB RD9 copy was estimated as 0.71% during one standard lesson of 35 minutes. Among 1,836\/2,262 (81.2%) students who consented to screening, 21\/90 (23.3%) symptomatic students produced a sputum sample, of which one was Xpert MTB\/RIF Ultra positive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Airborne MTB genomic DNA was detected frequently in high school classrooms. Instantaneous risk of classroom exposure was similar to the risk in public health clinics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202102-0405oc","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T18:24:17Z","timestamp":1636482257000},"page":"350-356","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":19,"title":["Molecular Detection of Airborne\n                    <i>Mycobacterium tuberculosis<\/i>\n                    in South African High Schools"],"prefix":"10.1093","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-1089","authenticated-orcid":false,"given":"Erick W.","family":"Bunyasi","sequence":"first","affiliation":[{"name":"South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine"},{"name":"Department of Pathology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Middelkoop","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Koch","sequence":"additional","affiliation":[{"name":"SAMRC\/NHLS\/UCT Molecular Mycobacteriology Research Unit, Institute of Infectious Disease and Molecular Medicine, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeenat","family":"Hoosen","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Humphrey","family":"Mulenga","sequence":"additional","affiliation":[{"name":"South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine"},{"name":"Department of Pathology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelique K. 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