Browsing by Author "Muzazu S"

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Community Engagement Strategy for Building Trust in Human Challenge Studies Using Participatory and Creative Methods: An Ethical Imperative.
(2025-Sep-12) Kunda-Ng'andu EM; Chirwa M; Muzazu S; Laban N; Chisenga C; Simuyandi M; Mwale S; Chilengi R; Sharma A
Human Infection Challenge studies (HICs) are crucial for advancing global understanding of disease pathogenesis, immune responses, and accelerating vaccine and drug development. Explorations on willingness to participate among medical students revealed the need to ensure full understanding of HIC requirements, for example, for residency, by the broader community. This raised the question of 'How could we ensure informed and understood consent for the ethical conduct of HIC?' We employed iterative participatory discovery and creative design methods, including three Zoom meetings and discussions with university students and community leaders. Neighbourhood Health Committee leaders further refined suggested creatives of a future mass-media campaign for building trust in HICs. Deliberative focus group discussions and workshops were conducted on communication strategies on HICs' requirements, risks, requirements, and benefits. The final creative brief suggested (1) using a pyramid approach utilizing existing community structures, to introduce HIC concepts progressively to larger groups, (2) engaging communities through theatre for development, community dialogue, and engagement meetings, and wide society through social and mass media advertisements, and (3) preference for the term 'Human Challenge Studies' over 'Human Infection Challenge Studies'. We learned that community engagement, if properly conducted, can create systems of ownership of research and build communication strategies to achieve an accurate understanding of HICs and use informed participation that results in trustworthy data. We need further research, including in rural areas, pilot testing of evaluation strategies, and continued engagement with diverse stakeholders to create products that can be adapted by future HIC studies in settings such as Zambia.
Diagnostic Yield of Tongue Swab- Compared to Sputum-Based Molecular Testing for Tuberculosis in Four High-Burden Countries.
(2026-Apr-30) Moe CA; Luswata RK; Barrameda AJ; Le H; Muzazu S; Crowder R; Andama AO; Denkinger CM; Muyoyeta M; Phan H; Cattamanchi A; Yu C
BACKGROUND: Tongue swabs are a promising alternative specimen for tuberculosis (TB) diagnosis. Although test specificity exceeds 98%, sensitivity is lower than sputum-based molecular testing. We investigated whether the use of tongue swabs could increase sample availability, resulting in similar diagnostic yield. METHODS: In this cross-sectional study (July 2024-January 2025), we screened consecutive people with presumptive TB at health centers in the Philippines, Vietnam, Uganda, and Zambia. Participants were asked to provide tongue swabs and referred for routine sputum collection. Tongue swabs were tested in research laboratories using the MiniDock MTB Test (Guangzhou Pluslife Biotech Co., Ltd., China); sputum was tested using WHO-recommended molecular testing per national guidelines. We compared diagnostic yield, defined as proportion of positive test results among all participants, between tongue swab- and sputum-based molecular testing with a prespecified 3.0% non-inferiority margin. RESULTS: Of 1639 participants, 851 (51.9%) were female, 415 (25.3%) were diagnosed with HIV, and 132 (8.1%) were children <5 years. All provided tongue swabs, but only 1389 (84.7%) produced sputum. Diagnostic yield was 3.8% (63/1639) for tongue swabs and 4.1% (68/1639) for sputum-based (68/1639, 4.1%) molecular testing. The difference (0.3%, 95% CI -0.6 to +1.2) was within the prespecified non-inferiority margin. Results were consistent across countries and key subgroups (age, sex, and HIV status). CONCLUSIONS: Tongue swab-based molecular testing with MiniDock MTB achieved non-inferior diagnostic yield compared with sputum-based molecular testing. These findings support scale-up of swab-based platforms as a cost-efficient alternative, particularly where sputum collection is challenging or smear microscopy remains the primary diagnostic method.
"That is why I trust": a qualitative study on acceptability and feasibility of novel tongue swab diagnostics to assess people presenting with tuberculosis symptoms in Viet Nam and Zambia.
(2026-Jun-19) Sales A; Le H; Muzazu S; Kunda-Ng'andu E; Castro MDM; Kerkhoff AD; Phan H; Denkinger CM; Cattamanchi A; West N; Muyoyeta M
BACKGROUND: Millions of tuberculosis (TB) cases are estimated to be undiagnosed and unreported annually. Sputum has been the primary approach for diagnostic testing, but tongue swabs are being investigated as an alternative to expand testing. To understand potential uptake and implementation, we explored the acceptability, usability, and feasibility of tongue swab-based TB testing from the perspectives of healthcare workers, people undergoing TB screening, and caregivers in Viet Nam and Zambia. METHODS: We interviewed people with symptoms of TB, caregivers of children undergoing TB evaluation, and healthcare workers who collected tongue swabs (n = 76 participants) between September 2023 and February 2024. Interviews were analyzed using framework analysis to elucidate preferences, experiences, and acceptability of tongue swabs vs. sputum. Findings were further organized according to acceptability and feasibility to understand barriers and facilitators to uptake. RESULTS: Most participants preferred tongue swab to sputum collection. The perceived usability and feasibility of tongue swabs were high. Key themes that influenced the acceptability of tongue swabs included ease of use, diagnostic accuracy, diagnostic yield, hygiene, risk of TB transmission during sample collection, time to test result, and trust in healthcare workers and the health system. Across interviews, many participants described tongue swabs as a comfortable and easy way to test for TB, compared to the physical discomfort and difficulty expectorating sputum. Participants described tongue swabs as suitable for everyone, yet perceived diagnostic accuracy was crucial in shaping test preference. CONCLUSION: Tongue swab-based testing for TB is likely to be highly acceptable and feasible if incorporated into TB diagnostic guidelines. Future integration of tongue swabs in facilities and communities should target drivers of acceptability.
The Incidence and Risk Factors for Enterotoxigenic
(2024-Mar-29) Sukwa N; Bosomprah S; Somwe P; Muyoyeta M; Mwape K; Chibesa K; Luchen CC; Silwamba S; Mulenga B; Munyinda M; Muzazu S; Chirwa M; Chibuye M; Simuyandi M; Chilengi R; Svennerholm AM
This study aimed to estimate the incidence and risk factors for Enterotoxigenic