Lung and abdominal ultrasound accuracy for tuberculosis: An Indian prospective cohort study.

Background: Tuberculosis (TB) diagnosis remains a challenge, particularly in low-resource settings. Point-of-care ultrasound (POCUS) has shown promise, but most studies focus on HIV-infected populations. In the case of TB, data on lung ultrasound (LUS) are sparse.

AveloMask, a novel breath aerosol collection kit for airborne : a proof-of-principle assessment.

Tuberculosis (TB) remains the world's deadliest infectious disease, with many active cases missed due to challenges in sputum collection. Exhaled breath aerosols (XBA), a major route of (MTB) transmission, offer a promising non-invasive alternative. This study evaluated the diagnostic accuracy and feasibility of the AveloMask-a novel point-of-care breath aerosol collection kit-for detecting active pulmonary TB using quantitative PCR (qPCR).

Informing People-Centered Target Product Profiles for TB Diagnostics: A Multi-Country Qualitative Study.

Background: Timely and accurate tuberculosis (TB) diagnosis remains a key challenge in high-burden settings. The World Health Organization (WHO) has developed Target Product Profiles (TPPs) to guide diagnostic development, which have largely reflected the perspectives of experts, with limited input from people affected by TB. This qualitative study explored preferences and experiences to inform people-centered TB diagnostic strategies.

Performance of whole blood interferon-γ release assays in SARS-CoV-2 and tuberculosis is age dependent.

Introduction: A lot of research has been done, mainly on tuberculosis (TB), on the extent to which cellular immune protection as measured by interferon-γ release assays (IGRA) is age-dependent. In a previous study we showed that following an Omicron infection, adolescents with a hybrid immunity had a higher probability of having a reactive SARS-CoV-2-specific IGRA than children. Therefore, we examined in a large group of minors and adults whether age influences cellular immunity as measured by IGRA in TB and SARS-CoV-2.

Implementation of Point-of-Care PCR-testing for the diagnosis of respiratory infections in vulnerable patient populations.

Background: Point-of-Care (POC) PCR-testing provides accurate, and timely results in diagnosing respiratory viral infections. Despite these benefits, stakeholder perceptions and its potential for improving health outcomes remain insufficiently explored. Therefore, we aim to explore the acceptability and feasibility of POC PCR-testing implementation in settings attended by vulnerable populations.

Projecting the impact and costs of near point-of-care tuberculosis screening assays in community-based active case finding.

Background: Community-based active case finding (ACF) may reduce tuberculosis incidence and mortality but is not widely implemented due to resource constraints. How novel screening test characteristics would affect the impact and costs of ACF strategies is not clear.

Methods: We developed mathematical models of tuberculosis natural history and transmission, calibrated to data from three high tuberculosis burden countries (India, Vietnam and the Philippines) and simulated the impact of annual community-based ACF programs.

Tongue Swab Xpert MTB/RIF Ultra Testing for Tuberculosis Using a Revised Consensus Protocol: A multi-country diagnostic accuracy study.

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.

Performance and feasibility of self-microsampling of capillary blood and saliva for serological testing of SARS-CoV-2.

Background: Serology is a valuable tool to estimate infections, case-fatality rates, and immunity. However, venipuncture and clinical infrastructure hinder scalability. This study evaluated the performance, feasibility and user experience of using a microsampling device for self-collected capillary blood and saliva to determine total SARS-CoV-2 S RBD antibodies.

Preferences for Tongue Swab versus Sputum Collection for Tuberculosis Testing: A Multi-Country Survey.

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.

Comparing the accuracy of computer-aided detection (CAD) software and radiologists from multiple countries for tuberculosis detection in chest X-Rays.

Nearly a third of TB cases go undetected annually. WHO recommends computer-aided detection (CAD) to enhance TB screening, with studies showing comparable performance to local radiologists. Using 774 chest X-rays from the South African National TB Prevalence Survey, we compared 12 CAD software with 11 radiologists from Nigeria, India, the UK, and the US, against a composite microbiological reference standard.

Integrated treatment-decision algorithms for childhood TB: modelling diagnostic performance and costs.

Background: To improve childhood tuberculosis (TB) diagnosis, treatment-decision algorithms (TDAs) with and without chest X-ray (CXR) were developed for children under age 10. We aimed to model diagnostic performance and costs of implementing TDAs in primary healthcare (PHC) and district hospital (DH) settings in Uganda.

Methods: We developed decision-tree models following the TDA pathway from evaluation to treatment-decision.

Responsive population-based cohorts as platforms for characterising pathogen- and population-level infection dynamics for epidemic prevention, preparedness and response.

Establishing population-based cohorts is indispensable for effective epidemic prevention, preparedness and response. Existing passive surveillance systems face limitations in their capacity to promptly provide representative data for estimating disease burden and modelling disease transmission. This perspective paper introduces a framework for establishing a dynamic and responsive nationally representative population-based cohort, with Germany as an example country.

Clinically diagnosed tuberculosis and mortality in high burden settings: a systematic review and meta-analysis.

Background: Clinical diagnosis of tuberculosis (TB), referring to diagnosis without bacteriological confirmation, is common and may affect an individuals' outcomes. We undertook a systematic review to assess the proportion of people with TB who were diagnosed clinically, and mortality compared to those with bacteriologically confirmation in the published literature.

Methods: We searched Medline, Embase, Web of Science and Cochrane Library from January 2010 to December 2024 using terms for 'TB' and diagnostic studies.

Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV.

Background: Low-complexity automated nucleic acid amplification tests (LC-aNAATs) are molecular World Health Organization (WHO)-recommended rapid diagnostic tests (also known as mWRDs) widely used to diagnose tuberculosis disease. The lateral flow urine lipoarabinomannan assay (LF-LAM) is recommended by the WHO to assist in diagnosing tuberculosis disease amongst people with HIV. Previous systematic reviews have assessed the diagnostic accuracy of LC-aNAATs and LF-LAM used in isolation for the detection of tuberculosis, but in clinical practice the tests may be used in parallel (i.

Stool processing methods for Xpert Ultra testing in childhood tuberculosis: A prospective, multi-country accuracy study.

Background: Centrifuge-free processing methods support stool Xpert Ultra testing for childhood tuberculosis (TB), but there are limited data on their accuracy, acceptability and usability.

Methods: We conducted a prospective evaluation of stool Xpert Ultra in India, South Africa, and Uganda with three methods: Stool Processing Kit (SPK), Simple One-Step (SOS), and Optimized Sucrose Flotation (OSF). Children <15 years old with presumptive TB had sputum testing with Xpert Ultra and culture.

Decentralized TB diagnostic testing with Truenat MTB Plus and MTB-RIF Dx vs. hub-and-spoke GeneXpert MTB/RIF Ultra in Mozambique and Tanzania: a cost and cost-effectiveness analysis.

In low-and middle-income countries, missed or delayed tuberculosis (TB) diagnoses contribute to avoidable morbidity, mortality, and transmission. Decentralized testing platforms, such as the Molbio Truenat, may offer solutions by providing accurate point-of-care testing, improving access, and lowering out-of-pocket costs. Despite these advantages, the overall cost and cost-effectiveness of identifying additional TB cases using the Truenat MTB assays remain inadequately explored and understood.

Importance of confirmatory test characteristics in optimizing community-based screening for tuberculosis: An epidemiological modeling analysis.

Background: Current active case-finding (ACF) efforts for tuberculosis (TB) are limited by the costs, operational barriers, and sensitivity of available tools to confirm a TB diagnosis. However, it is not well understood which of these limitations has the greatest epidemiological relevance and might therefore warrant prioritization in test development.

Methods: We developed a state-transition model of a one-time, community-based ACF intervention, with a fixed budget of one million United States dollars for screening and confirmatory testing.

Efflux pumps and membrane permeability contribute to intrinsic antibiotic resistance in Mycobacterium abscessus.

Mycobacterium abscessus is a pulmonary pathogen that exhibits intrinsic resistance to antibiotics, but the factors driving this resistance are incompletely understood. Insufficient intracellular drug accumulation could explain broad-spectrum resistance, but whether antibiotics fail to accumulate in M. abscessus and the mechanisms required for drug exclusion remain poorly understood.

Tuberculosis Visualized With the Ultrasound Probe: A Systematic Review of Sonographic Pattern Descriptions and an Analysis of Common Sonographic Features.

Unlabelled: Evidence on tuberculosis (TB) ultrasound patterns is scarce. We systematically reviewed the literature aiming to identify common TB ultrasound features. Sources included PubMed, Cochrane Library, and others (1 January 2000 through 30 August 2021).

Programmatic Diagnostic Accuracy and Clinical Utility of Xpert MTB/XDR in Patients With Rifampicin-Resistant Tuberculosis in Georgia.

Background: Xpert MTB/XDR (Cepheid) is recommended by the World Health Organization for drug susceptibility testing in patients with tuberculosis, with potential for rapid detection of isoniazid and fluoroquinolone resistance. However, diagnostic accuracy and clinical utility in a programmatic setting are unknown.

Methods: We evaluated the accuracy and clinical utility of Xpert MTB/XDR in patients with rifampicin-resistant pulmonary tuberculosis during programmatic implementation in Georgia between July 2022 and August 2024, using phenotypic drug susceptibility testing (DST) as a reference standard.

Stool processing methods for Xpert Ultra testing in childhood tuberculosis: A prospective, multi-country accuracy study.

Background: Centrifuge-free processing methods support stool Xpert Ultra testing for childhood tuberculosis (TB), but there are limited data on their accuracy, acceptability and usability.

Methods: We conducted a prospective evaluation of stool Xpert Ultra in India, South Africa, and Uganda with three methods: Stool Processing Kit (SPK), Simple One-Step (SOS), and Optimized Sucrose Flotation (OSF). Children <15 years old with presumptive TB had respiratory specimen testing with Xpert Ultra and culture.

Diagnostic Accuracy of Lung and Abdominal Ultrasound for Tuberculosis in a German Multicenter Cohort of Patients With Presumed Tuberculosis Disease.

Background: There is limited evidence on point-of-care ultrasound for tuberculosis (TB), but studies suggest high sensitivity, especially for lung ultrasound (LUS). However, insufficient data are available on specificity of the examination and its generalizability to a broader patient population.

Aims: Our study aimed to establish accuracy for lung, chest, and abdominal ultrasound, individually and in combination, for TB diagnosis.

C-Reactive Protein-based Screening of People with Tuberculosis Symptoms: A Diagnostic Accuracy Study.

C-reactive protein (CRP)-based tuberculosis (TB) screening is recommended for people with HIV. However, its performance among people without HIV and in diverse settings is unknown. In a multicountry study, we aimed to determine whether CRP meets the minimum accuracy targets (sensitivity ⩾ 90%, specificity ⩾ 70%) for an effective TB screening test.

Urine-Xpert Ultra for the diagnosis of tuberculosis in people living with HIV: a prospective, multicentre, diagnostic accuracy study.

Background: Diagnostic delays for tuberculosis are common, with high resultant mortality. Urine-Xpert Ultra (Cepheid) could improve time to diagnosis of tuberculosis disease and rifampicin resistance. We previously reported on lot-to-lot variation of the Fujifilm SILVAMP TB LAM.