Publication date: Nov 01, 2024
Introduction Effective strategies are needed to facilitate early detection and diagnosis of tuberculosis (TB). The over-reliance on passive case detection, symptom screening, and collection of sputum, results in delayed or undiagnosed TB, which directly contributes to on-going TB transmission. We assessed the acceptability and feasibility of in-home, Targeted Universal TB Testing (TUTT) of household contacts using GeneXpert MTB/RIF Ultra at point-of-care (POC) during household contact investigations (HCIs) and compared the feasibility of using sputum vs. tongue swab specimens. Methods Household contacts (HHCs) receiving in-home POC TUTT as part of the TB Home Study were asked to complete a post-test acceptability survey. The survey explored HHCs level of comfort, confidence in the test results, and the perceived appropriateness of in-home POC TUTT. We used the Metrics to Assess the Feasibility of Rapid Point-of-Care Technologies framework to assess the feasibility of using sputum and tongue swab specimens for in-home POC TUTT. Descriptive statistics were used to report participant responses and feasibility metrics. Results Of 313 eligible HHCs, 267/313 (85.3%) consented to in-home POC TUTT. Of those, 267/267 (100%) provided a tongue swab and 46/267 (17.2%) could expectorate sputum. All specimens were successfully prepared for immediate, in-home testing with Xpert Ultra on GeneXpert Edge. Of 164 tongue swab tests conducted, 160/164 (97.6%) generated a valid test result compared to 44/46 (95.7%) sputum-based tests. An immediate test result was available for 262/267 (98.1%) individuals based on in-home swab testing, and 44/46 (95.7%) based on in-home sputum testing. The mean in-home POC TUTT acceptability score (5=highly acceptable) was 4.5/5 (SD= 0.2). Conclusion In-home, POC TUTT using either sputum or tongue swab specimens was highly acceptable and feasible. Tongue swab specimens greatly increase the proportion of HHCs tested compared to sputum. In-home POC TUTT using a combination of sputum and tongue swabs can mitigate shortcomings to case detection.
| Concepts | Keywords |
|---|---|
| Affordable | Acceptability |
| Buffalo | Based |
| June | Feasibility |
| Pcr | Home |
| Household | |
| Medrxiv | |
| Poc | |
| Preprint | |
| South | |
| Sputum | |
| Swab | |
| Test | |
| Testing | |
| Tongue | |
| Tuberculosis |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | IDO | symptom |
| drug | DRUGBANK | Huperzine B |
| disease | IDO | site |
| drug | DRUGBANK | Coenzyme M |
| drug | DRUGBANK | Spinosad |
| disease | IDO | production |
| disease | IDO | assay |
| disease | MESH | death |
| disease | IDO | history |
| disease | IDO | intervention |
| disease | MESH | infection |
| drug | DRUGBANK | Methionine |
| drug | DRUGBANK | Nonoxynol-9 |
| disease | MESH | COVID 19 pandemic |
| disease | IDO | process |
| disease | MESH | malaria |
| pathway | KEGG | Malaria |
| disease | MESH | uncertainty |
| disease | MESH | privacy |
| drug | DRUGBANK | Gold |
| disease | MESH | complications |
| drug | DRUGBANK | Aspartame |
| disease | MESH | pulmonary tuberculosis |
| disease | MESH | lung disease |
| disease | IDO | facility |
| disease | MESH | Infectious Diseases |
| disease | IDO | country |
| disease | IDO | immunodeficiency |