Molecular testing using saliva has demonstrated high accuracy for detecting pulmonary tuberculosis, significantly outperforming oral swabs in a recent prospective study. This advancement addresses a critical need for rapid, nonsputum diagnostics, especially for patients who find sputum production difficult.
The research evaluated molecular testing on saliva and oral swabs from adults and children assessed for pulmonary tuberculosis at primary care centers in Colombia. A total of 648 participants were enrolled, with data analyzed from 95 confirmed cases and 95 matched controls.
Saliva testing achieved a sensitivity of 90.5% and a specificity of 95.8%. In comparison, oral swabs showed a sensitivity of 71.6% and a specificity of 99%. Saliva demonstrated an 18.9% higher sensitivity than oral swabs, with comparable specificity.
These findings are significant because sputum, the current standard, can be challenging for children, individuals with HIV, asymptomatic patients, and those with nonproductive coughs. Saliva and oral swabs are minimally invasive and highly acceptable to patients. The study supports saliva as a practical and accurate alternative specimen, potentially improving case finding in various clinical and community settings.