{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:11:39Z","timestamp":1791288699075,"version":"4.3.0"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2026,4,27]]},"abstract":"<sec><title>BACKGROUND<\/title>Tongue swabs are a promising specimen type for TB diagnosis. In a previous study, using a consensus protocol, tongue swabs tested with Xpert MTB\/RIF Ultra outperformed sputum smear microscopy, but a substantial proportion (6.1%) of\n results were non-actionable (e.g., invalid\/error). We evaluated a revised protocol for tongue swab Xpert Ultra testing in four high-burden countries.<\/sec><sec><title>METHODS<\/title>Participants aged \u226512 years with presumptive TB were enrolled from outpatient\n clinics in the Philippines, South Africa, Nigeria, and Zambia. Tongue swabs were processed using Sample Reagent (SR, Cepheid, USA) diluted 2:1 with phosphate buffer or phosphate-buffered saline and tested with Xpert Ultra. Diagnostic performance was assessed against culture-based microbiological\n reference standard and compared to sputum tests.<\/sec><sec><title>RESULTS<\/title>From March to November 2024, 1,168 participants were enrolled (median age 37 [IQR: 28\u201348] years; 46.7% female; 21.8% living with HIV; 18.5% culture-confirmed TB). The proportion\n of non-actionable tongue swab results was 5.6% overall, but <4% in all countries except South Africa (15.4%). Tongue swab sensitivity was 66.0% (95% CI: 59.0\u201372.5); specificity was 99.6% (95% CI: 98.9\u201399.9).<\/sec><sec><title>CONCLUSION<\/title>The\n revised protocol yielded low error rates at most sites and moderate sensitivity, supporting tongue swabs as an alternative specimen for Xpert Ultra testing when sputum is unavailable.<\/sec><\/jats:p>","DOI":"10.5588\/ijtld.25.0520","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:34:18Z","timestamp":1777350858000},"page":"211-216","source":"Crossref","is-referenced-by-count":2,"title":["Tongue swab Xpert MTB\/RIF Ultra testing for TB using a revised consensus protocol"],"prefix":"10.5588","volume":"30","author":[{"given":"B.","family":"Ajide","sequence":"first","affiliation":[{"name":"Zankli Research Center, Bingham University, Karu, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.A.","family":"Moe","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Orange, CA, USA;, Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Barrameda","sequence":"additional","affiliation":[{"name":"De La Salle Medical and Health Sciences Institute, Cavite, Philippines;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Chirwa","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia, Lusaka, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Rockman","sequence":"additional","affiliation":[{"name":"DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch\n University, Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"de Haas","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, the Hague, the Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"de Vos","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kato-Maeda","sequence":"additional","affiliation":[{"name":"Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Tasca","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, the Hague, the Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Bimba","sequence":"additional","affiliation":[{"name":"Zankli Research Center, Bingham University, Karu, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Yu","sequence":"additional","affiliation":[{"name":"De La Salle Medical and Health Sciences Institute, Cavite, Philippines;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.M.","family":"Denkinger","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany;, German Centre for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Kremer","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, the Hague, the Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Nahid","sequence":"additional","affiliation":[{"name":"Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA;, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Cattamanchi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Orange, CA, USA;, Center for Tuberculosis, University of California San Francisco, San Francisco, CA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Theron","sequence":"additional","affiliation":[{"name":"DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University,\n Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Muyoyeta","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia, Lusaka, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2026\/00000030\/00000005\/art00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:34:35Z","timestamp":1777350875000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.25.0520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,27]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,4,27]]}},"alternative-id":["1027-3719(20260427)30:5L.211;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.25.0520","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,27]]}}}