Tongue Swab User Acceptance for Tuberculosis Diagnosis: Characterizing the Facilitators and Barriers of Tongue Swab Use During the Era of COVID-19

Abstract

Workers who come into contact with tuberculosis (TB) patients are at elevated risk of TB infection and disease. Tongue swabbing is an alternative diagnostic sample collection approach that was designed to mitigate this risk. This study assessed risk perceptions among healthcare workers (HCWs) using tongue swabs for TB diagnosis in South Africa during a respiratory virus pandemic. We characterized the facilitators and barriers of tongue swab use for TB diagnosis during the era of COVID-19. Our study site location was with one of the world's premier TB research facilities, the South African Vaccine Initiative (SATVI) in the Western Cape, South Africa, where TB is endemic. HCWs making home visits have a complex array of factors influencing their willingness to use the tongue swab method in comparison to the gold standard of sputum sample collection. Findings will guide the development of training materials and/or policies and procedures that enhance worker safety and comfort when using tongue swabs in different contexts such as at home visits or in clinical settings.