{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:43:36Z","timestamp":1791463416374,"version":"4.3.4"},"reference-count":17,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI120793"],"award-info":[{"award-number":["K23AI120793"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI139254"],"award-info":[{"award-number":["R01AI139254"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007813","name":"Center for AIDS Research, University of Washington","doi-asserted-by":"publisher","award":["P30 AI027757"],"award-info":[{"award-number":["P30 AI027757"]}],"id":[{"id":"10.13039\/100007813","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>We evaluated diagnostic performance of oral swab analysis (OSA) for tuberculosis (TB) in a high HIV\/TB burden setting in Kenya.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this cross-sectional study, buccal swabs and sputum were collected from 100 participants with suspected TB in outpatient clinics in Kenya at enrollment and subsequent morning visits. Buccal swabs underwent IS6110-targeted qPCR analysis. Sputum was evaluated by Xpert MTB\/RIF (Xpert) and culture. Diagnostic performance of OSA for TB diagnosis was evaluated relative to a combined reference of sputum Xpert and culture.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among 100 participants, 54% were living with HIV (PLHIV). Twenty percent (20\/100) of participants had confirmed TB (19\/20 [95%] culture-positive, 17\/20 [85%] Xpert-positive). Overall buccal swab sensitivity was 65.0% (95% CI 40.8\u201384.6%) vs. sputum Xpert\/culture and 76.5% (95% CI 50.1\u201393.2%) vs. sputum Xpert alone. Specificity was 81.3% (95% CI 71.0\u201389.1%) and 81.9% (95% CI 72.0\u201389.5%) compared to sputum Xpert\/culture and Xpert alone, respectively. Sensitivity among PLHIV (n = 54) with suspected TB was 83.3% (95% CI 35.9\u201399.6%) vs. sputum Xpert\/culture and 100% (95% CI 47.8\u2013100.0%) vs. sputum Xpert alone. Among participants with TB, mean OSA threshold quantitation cycle (Cq) value was lower (stronger signal) at subsequent morning compared to enrolment visit (33.4 SD \u00b1 3.7 vs. 35.2 SD \u00b1 2.9, p = 0.009).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In this pilot study, results confirm <jats:italic>M<\/jats:italic>. <jats:italic>tuberculosis<\/jats:italic> DNA is detectable in oral swabs including among PLHIV with fair diagnostic performance. Further work is needed to optimize OSA and evaluate its utility in diverse settings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0262123","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T18:49:39Z","timestamp":1642099779000},"page":"e0262123","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":36,"title":["Diagnostic performance of oral swabs for non-sputum based TB diagnosis in a TB\/HIV endemic setting"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9809-5997","authenticated-orcid":true,"given":"Sylvia M.","family":"LaCourse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evans","family":"Seko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred","family":"Bundi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Ouma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Agaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbra A.","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"John-Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Wandiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard A.","family":"Cangelosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"key":"pone.0262123.ref001","volume-title":"Global report: UNAIDS report on the global AIDS epidemic 2015","author":"Joint United Nations Programme on HIV\/AIDS","year":"2015"},{"key":"pone.0262123.ref002","volume-title":"Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB\/RIF system for the diagnosis of pulmonary and extrapulmonary TB in adults and children","author":"World Health Organization","year":"2013"},{"key":"pone.0262123.ref003","first-page":"CD009593","article-title":"Xpert MTB\/RIF and Xpert MTB\/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults","volume":"6","author":"DJ Horne","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"suppl 2","key":"pone.0262123.ref004","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1093\/infdis\/jiu803","article-title":"Tuberculosis Diagnostics in 2015: Landscape, Priorities, Needs, and Prospects","volume":"211","author":"M Pai","year":"2015","journal-title":"J Infect Dis"},{"key":"pone.0262123.ref005","doi-asserted-by":"crossref","first-page":"8668","DOI":"10.1038\/srep08668","article-title":"Detection of Mycobacterium tuberculosis DNA on the oral mucosa of tuberculosis patients","volume":"5","author":"RC Wood","year":"2015","journal-title":"Sci Rep"},{"issue":"3","key":"pone.0262123.ref006","doi-asserted-by":"crossref","first-page":"e01847","DOI":"10.1128\/JCM.01847-18","article-title":"Noninvasive Detection of Tuberculosis by Oral Swab Analysis","volume":"57","author":"AK Luabeya","year":"2019","journal-title":"J Clin Microbiol"},{"issue":"1","key":"pone.0262123.ref007","doi-asserted-by":"crossref","first-page":"10789","DOI":"10.1038\/s41598-019-47302-5","article-title":"Microbiological diagnosis of pulmonary tuberculosis in children by oral swab polymerase chain reaction","volume":"9","author":"MP Nicol","year":"2019","journal-title":"Sci Rep"},{"issue":"Suppl 2","key":"pone.0262123.ref008","first-page":"211","article-title":"Defining the needs for next generation assays for tuberculosis","volume":"2","author":"CM Denkinger","year":"2015","journal-title":"J Infect Dis"},{"issue":"1","key":"pone.0262123.ref009","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S1473-3099(17)30691-6","article-title":"Xpert MTB\/RIF Ultra for detection of Mycobacterium tuberculosis and rifampicin resistance: a prospective multicentre diagnostic accuracy study","volume":"18","author":"SE Dorman","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"pone.0262123.ref010","doi-asserted-by":"crossref","first-page":"e0167685","DOI":"10.1371\/journal.pone.0167685","article-title":"Performance of Clinical Screening Algorithms for Tuberculosis Intensified Case Finding among People Living with HIV in Western Kenya","volume":"11","author":"S Modi","year":"2016","journal-title":"PLoS One"},{"key":"pone.0262123.ref011","unstructured":"Kenya Ministry of Health. Kenya Tuberculosis Survey 2017 [cited 2019 June 5]. Available from: https:\/\/www.nltp.co.ke\/survey-reports-2\/."},{"key":"pone.0262123.ref012","volume-title":"Global Tuberculosis Report 2020","author":"World Health Organization","year":"2020"},{"key":"pone.0262123.ref013","unstructured":"World Health Organization. Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings 2011 [February 5, 2020]. Available from: http:\/\/whqlibdoc.who.int\/publications\/2011\/9789241500708_eng.pdf."},{"issue":"5","key":"pone.0262123.ref014","doi-asserted-by":"crossref","first-page":"e0251422","DOI":"10.1371\/journal.pone.0251422","article-title":"Characterization of oral swab samples for diagnosis of pulmonary tuberculosis","volume":"16","author":"RC Wood","year":"2021","journal-title":"PLoS One"},{"key":"pone.0262123.ref015","doi-asserted-by":"crossref","first-page":"100148","DOI":"10.1016\/j.jctube.2020.100148","article-title":"Oral swab testing by Xpert\u00ae MTB\/RIF Ultra for mass tuberculosis screening in prisons","volume":"19","author":"F Lima","year":"2020","journal-title":"Journal of clinical tuberculosis and other mycobacterial diseases"},{"key":"pone.0262123.ref016","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2147\/IDR.S284157","article-title":"Diagnostic Yield of Oral Swab Testing by TB-LAMP for Diagnosis of Pulmonary Tuberculosis","volume":"14","author":"Y Song","year":"2021","journal-title":"Infect Drug Resist"},{"issue":"8","key":"pone.0262123.ref017","doi-asserted-by":"crossref","first-page":"e760","DOI":"10.1016\/S2214-109X(17)30201-2","article-title":"Comparison of sputum collection methods for tuberculosis diagnosis: a systematic review and pairwise and network meta-analysis","volume":"5","author":"S Datta","year":"2017","journal-title":"Lancet Glob Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T18:50:00Z","timestamp":1642099800000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262123"}},"subtitle":[],"editor":[{"given":"Seyed Ehtesham","family":"Hasnain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,13]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0262123","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,13]]}}}