Simple oral swab test could revolutionise TB detection in children

In a week when new technological advances dominated the news agenda of The Union’s World Conference, a press conference held today presented a diagnostic test for tuberculosis (TB) that is simple, potentially ground-breaking, yet very low-tech.

Oral swab analysis (OSA) is a novel alternative to sputum analysis for pulmonary TB diagnosis and active case finding. Swabs take just seconds to collect and are easier to amass than other samples that are routinely used in TB identification, including blood, urine, exhaled breath, stools and saliva. Preliminary results have shown that M. tuberculosis DNA is frequently present and detectable in the oral mucosa of adult patients with active pulmonary TB and, by using OSA, sputum production is not required. For patients who are unable to produce sputum for TB diagnosis, such as children, the results could be game-changing.

Dr Angelique Luabeya, from the University of Cape Town, presented the initial findings to journalists attending the conference. “The oral swabs are easier to collect and transport, and are promising to be an interesting tool for screening and including in active case finding strategies.

“The method has been tested for other pathologies, such as Ebola, and in animals for TB. We now want to see how this would work in children.”

Diagnosing TB in children is notoriously difficult, involving invasive gastric tests that can require a stay in hospital. A swab is cleaner, easier, quicker – and could revolutionise how we detect childhood TB.

Dr Luabeya added, “This test is simple, and doesn’t need new technologies. The swab scrapes the cells at specific points in the mouth and provides a more accurate sample – it is the approach that is innovative rather than the actual method itself.”

Dr Paula Fujiwara, Scientific Director at The Union and chair of the session, said

“To make inroads into the TB epidemic, new methods are essential. And we have every reason to be excited about where the science in TB is headed.

“But this is so simple and if proven to work effectively in children, the impact on them – and on TB – will be incredible. We also cannot underestimate the impact of this simple test on underdeveloped public health services – requiring minimal staff training and taking less time to collect.”