“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 Article Swipe
Alyssa Sales
,
Hien Thi Thu Le
,
Seke Muzazu
,
Evelyn Muleba Kunda‐Ng'andu
,
María del Mar Castro
,
Andrew D. Kerkhoff
,
Ha Phan
,
Claudia M. Denkinger
,
Adithya Cattamanchi
,
Nora West
,
Monde Muyoyeta
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.06.30.25330535
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.06.30.25330535
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 perspective of healthcare workers, people undergoing TB screening, and caregivers in Viet Nam and Zambia. 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. 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 swab suitability for everyone, yet perceived diagnostic accuracy was crucial in shaping test preference. Tongue swab-based testing for TB is likely to be highly acceptable and feasible if incorporated into TB diagnostic guidelines.
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2025.06.30.25330535
- https://www.medrxiv.org/content/medrxiv/early/2025/07/01/2025.06.30.25330535.full.pdf
- OA Status
- green
- Cited By
- 3
- References
- 29
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411848345
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411848345Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2025.06.30.25330535Digital Object Identifier
- Title
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“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 ZambiaWork title
- Type
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preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2025Year of publication
- Publication date
-
2025-07-01Full publication date if available
- Authors
-
Alyssa Sales, Hien Thi Thu Le, Seke Muzazu, Evelyn Muleba Kunda‐Ng'andu, María del Mar Castro, Andrew D. Kerkhoff, Ha Phan, Claudia M. Denkinger, Adithya Cattamanchi, Nora West, Monde MuyoyetaList of authors in order
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https://doi.org/10.1101/2025.06.30.25330535Publisher landing page
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https://www.medrxiv.org/content/medrxiv/early/2025/07/01/2025.06.30.25330535.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
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https://www.medrxiv.org/content/medrxiv/early/2025/07/01/2025.06.30.25330535.full.pdfDirect OA link when available
- Concepts
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Viet nam, Tuberculosis, Qualitative research, Medicine, Psychology, Family medicine, Nursing, Economic growth, Sociology, Pathology, Economics, Ethnology, Social scienceTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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2025: 3Per-year citation counts (last 5 years)
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29Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.(TB) | 4 |
| abstract_inverted_index.2023 | 96 |
| abstract_inverted_index.Most | 133 |
| abstract_inverted_index.Viet | 66 |
| abstract_inverted_index.been | 16 |
| abstract_inverted_index.ease | 161 |
| abstract_inverted_index.easy | 200 |
| abstract_inverted_index.from | 53 |
| abstract_inverted_index.into | 247 |
| abstract_inverted_index.many | 191 |
| abstract_inverted_index.risk | 169 |
| abstract_inverted_index.swab | 137, 218 |
| abstract_inverted_index.test | 178, 203, 230 |
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| abstract_inverted_index.time | 176 |
| abstract_inverted_index.use, | 163 |
| abstract_inverted_index.were | 101, 118, 149 |
| abstract_inverted_index.with | 73 |
| abstract_inverted_index.2024. | 99 |
| abstract_inverted_index.being | 27 |
| abstract_inverted_index.cases | 5 |
| abstract_inverted_index.high. | 150 |
| abstract_inverted_index.swabs | 25, 89, 114, 148, 159, 195 |
| abstract_inverted_index.trust | 181 |
| abstract_inverted_index.using | 103 |
| abstract_inverted_index.Across | 189 |
| abstract_inverted_index.Sputum | 14 |
| abstract_inverted_index.Tongue | 232 |
| abstract_inverted_index.during | 173 |
| abstract_inverted_index.expand | 33 |
| abstract_inverted_index.health | 187 |
| abstract_inverted_index.highly | 241 |
| abstract_inverted_index.likely | 238 |
| abstract_inverted_index.people | 59, 72 |
| abstract_inverted_index.sample | 174 |
| abstract_inverted_index.sputum | 139 |
| abstract_inverted_index.themes | 152 |
| abstract_inverted_index.tongue | 24, 49, 88, 113, 136, 147, 158, 194, 217 |
| abstract_inverted_index.uptake | 38 |
| abstract_inverted_index.yield, | 167 |
| abstract_inverted_index.Zambia. | 69 |
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| abstract_inverted_index.shaping | 229 |
| abstract_inverted_index.sputum. | 116, 214 |
| abstract_inverted_index.system. | 188 |
| abstract_inverted_index.testing | 22, 52, 234 |
| abstract_inverted_index.uptake. | 132 |
| abstract_inverted_index.workers | 85, 184 |
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| abstract_inverted_index.February | 98 |
| abstract_inverted_index.Findings | 117 |
| abstract_inverted_index.Millions | 1 |
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| abstract_inverted_index.analyzed | 102 |
| abstract_inverted_index.approach | 19 |
| abstract_inverted_index.barriers | 128 |
| abstract_inverted_index.children | 79 |
| abstract_inverted_index.compared | 206 |
| abstract_inverted_index.explored | 42 |
| abstract_inverted_index.feasible | 244 |
| abstract_inverted_index.hygiene, | 168 |
| abstract_inverted_index.included | 160 |
| abstract_inverted_index.physical | 209 |
| abstract_inverted_index.symptoms | 74 |
| abstract_inverted_index.testing. | 34 |
| abstract_inverted_index.workers, | 58 |
| abstract_inverted_index.September | 95 |
| abstract_inverted_index.according | 121 |
| abstract_inverted_index.accuracy, | 165 |
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| abstract_inverted_index.collected | 87 |
| abstract_inverted_index.described | 193, 216 |
| abstract_inverted_index.elucidate | 107 |
| abstract_inverted_index.estimated | 7 |
| abstract_inverted_index.everyone, | 221 |
| abstract_inverted_index.framework | 104 |
| abstract_inverted_index.organized | 120 |
| abstract_inverted_index.perceived | 142, 223 |
| abstract_inverted_index.potential | 37 |
| abstract_inverted_index.preferred | 135 |
| abstract_inverted_index.usability | 143 |
| abstract_inverted_index.Interviews | 100 |
| abstract_inverted_index.acceptable | 242 |
| abstract_inverted_index.caregivers | 64, 77 |
| abstract_inverted_index.diagnostic | 21, 164, 166, 224, 249 |
| abstract_inverted_index.difficulty | 212 |
| abstract_inverted_index.discomfort | 210 |
| abstract_inverted_index.healthcare | 57, 84, 183 |
| abstract_inverted_index.influenced | 154 |
| abstract_inverted_index.screening, | 62 |
| abstract_inverted_index.swab-based | 50, 233 |
| abstract_inverted_index.undergoing | 60, 80 |
| abstract_inverted_index.understand | 36, 127 |
| abstract_inverted_index.unreported | 12 |
| abstract_inverted_index.usability, | 45 |
| abstract_inverted_index.alternative | 31 |
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| abstract_inverted_index.collection. | 140 |
| abstract_inverted_index.comfortable | 198 |
| abstract_inverted_index.evaluation, | 82 |
| abstract_inverted_index.feasibility | 47, 125, 145 |
| abstract_inverted_index.guidelines. | 250 |
| abstract_inverted_index.interviewed | 71 |
| abstract_inverted_index.interviews, | 190 |
| abstract_inverted_index.perspective | 55 |
| abstract_inverted_index.preference. | 231 |
| abstract_inverted_index.suitability | 219 |
| abstract_inverted_index.undiagnosed | 10 |
| abstract_inverted_index.Participants | 215 |
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| abstract_inverted_index.facilitators | 130 |
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| abstract_inverted_index.investigated | 28 |
| abstract_inverted_index.participants | 134, 192 |
| abstract_inverted_index.preferences, | 108 |
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| abstract_inverted_index.tuberculosis | 3 |
| abstract_inverted_index.acceptability | 111, 123, 156 |
| abstract_inverted_index.expectorating | 213 |
| abstract_inverted_index.participants) | 93 |
| abstract_inverted_index.acceptability, | 44 |
| abstract_inverted_index.implementation, | 40 |
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| cited_by_percentile_year.min | 96 |
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| institutions_distinct_count | 11 |
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| citation_normalized_percentile.is_in_top_10_percent | True |