Browsing by Author "Yu C"

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    Placing the values and preferences of people most affected by TB at the center of screening and testing: an approach for reaching the unreached.
    (2023) Kerkhoff AD; West NS; Del Mar Castro M; Branigan D; Christopher DJ; Denkinger CM; Nhung NV; Theron G; Worodria W; Yu C; Muyoyeta M; Cattamanchi A
    To reach the millions of people with tuberculosis (TB) undiagnosed each year, there is an important need to provide people-centered screening and testing services. Despite people-centered care being a key pillar of the WHO END-TB Strategy, there have been few attempts to formally characterize and integrate the preferences of people
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    Preferences for Tongue Swab versus Sputum Collection for Tuberculosis Testing: A Multi-Country Survey.
    (2025-Jul-05) Manoj Kumar K; Borkman A; Kim A; Crowder R; Ajide B; Alí-Francia K; Chirwa M; Kamulegeya L; Le H; Trung VN; Venter R; Bimba J; Christopher DJ; Dalay V; Van Hung N; Muyoyeta M; Nakiyingi L; Van Nhung N; Theron G; Yu C; Zamudio-Fuertes C; Atim J; Kerkhoff AD; Castro Noriega MDM; Nahid P; Denkinger CM; Cattamanchi A; Dorman SE; West N
    BACKGROUND: Sputum collection for tuberculosis (TB) diagnosis poses challenges for children, people living with HIV, and those who struggle with sputum production. Tongue swab-based molecular testing offers a promising non-invasive alternative, but person-centered research on acceptability is limited. METHODS: We conducted a pragmatic survey across eight countries (Vietnam, Philippines, South Africa, Nigeria, Zambia, India, Uganda, Peru) among people with presumptive TB attending primary care facilities. Participants provided both tongue swab and sputum samples, then completed a 5-10 minute survey about their collection preferences. RESULTS: From October 2023 to July 2024, 1,297 participants were enrolled (median age 43 years, 45% female, 13% HIV-positive). Overall, 61% (95% CI: 58-64%) preferred tongue swab collection compared to 22% (95% CI: 20-25%) who preferred sputum collection and 17% (95% CI: 15-19%) with no preference. Preference for tongue swab was consistent across demographic and clinical subgroups, with country-level variation ranging from 47% in South Africa to 74% in Zambia and Nigeria. CONCLUSION: Strong preference for tongue swab over sputum collection among individuals with presumptive TB supports this diagnostic innovation's potential to overcome barriers to timely TB testing, particularly for populations struggling with sputum production.
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    Tongue Swab Xpert MTB/RIF Ultra Testing for Tuberculosis Using a Revised Consensus Protocol: A multi-country diagnostic accuracy study.
    (2025-Jul-10) Ajide B; Moe CA; Barrameda J; Chirwa M; Rockman L; de Haas P; de Vos M; Kato-Maeda M; Tasca B; Bimba J; Yu C; Denkinger CM; Kremer K; Nahid P; Cattamanchi A; Theron G; Muyoyeta M
    BACKGROUND: Tongue swabs are a promising specimen for tuberculosis (TB) diagnosis. In a previous study using a consensus protocol, tongue swabs tested with Xpert MTB/RIF Ultra (Xpert Ultra, Cepheid, USA) outperformed sputum smear microscopy, but a substantial proportion (6.1%) of results were non-actionable (e.g., invalid/error). We evaluated a revised protocol in four high TB burden countries. METHODS: Participants aged ≥12 years with presumptive TB were enrolled from outpatient 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 a culture-based microbiological reference standard and compared to sputum-based tests. RESULTS: From March to November 2024, 1168 participants were enrolled (median age 37 [IQR 28-48] years; 46.7% female, 21.8% living with HIV, 18.5% culture-confirmed TB). The proportion of nonactionable results was 5.6% overall, but was less than 4% in all countries except South Africa (15.4%). Tongue swab sensitivity was 66.0% (95% CI 59.0-72.5); specificity was 99.6% (95% CI 98.9-99.9). CONCLUSION: The revised protocol yielded low error rates at most sites and moderate sensitivity, supporting tongue swabs as an alternative when sputum is unavailable.