Tongue swab-based molecular diagnostics for pulmonary tuberculosis and drug resistance in adults: A prospective multicenter diagnostic accuracy study

PCR-based tongue swab testing offers a rapid, non-invasive alternative for TB diagnosis with high accuracy, particularly in paucibacillary cases or individuals unable to provide sputum. Although all participants in this study were able to provide sputum, tongue swabs may offer an alternative in situations where sputum collection is challenging. Further optimization of sampling and molecular techniques is essential to improve reliability and support broader implementation. Integrating tongue swab diagnostics with existing TB control programs could enhance the detection accuracy, improve drug resistance monitoring and reduce transmissions.