Mumbai: A month after the World Health Organisation (WHO) recommended that countries with a high burden of tuberculosis (TB) could try certain new, speedier and easier tests, there are indications that the BMC may conduct a pilot project to check the efficacy of one of these recommendations: tongue swabs.Tongue swabs entail using a swab to collect saliva/fluid from the tongue. Contrast this with the usual TB test that entails coughing out mucus (sputum) from deep inside the lungs. “Collecting tongue swabs would be easier for some patients, especially children,” said BMC executive health officer Dr Daksha Shah.While it’s early days yet for such a pilot project, Dr Shah said the BMC has always been interested in newer methods to improve TB detection. A few years back, the BMC was the first civic corporation to carry out a pilot project to check the use of artificial intelligence (AI) in detecting TB in X-ray scans.Mumbai is one of the high-density TB hubs in the world, with the emergence of extremely difficult-to-treat drug-resistance cases emerging in the city in 2011-12. The National TB programme rolled out a special TB plan for Mumbai, fast-tracking new tests and medicines. While 65,435 TB cases were registered in Mumbai in 2022, the numbers dropped to 54,390 TB patients; 8% of them had drug-resistant TB.On Feb 26, the WHO recommended new near-point-of-care (NPOC) molecular tests for the diagnosis of TB; easy-to-collect tongue swab samples to simplify and expand access to testing.Canada-based epidemiologist and public health expert Dr Madhukar Pai told TOI: “This new WHO policy is a big deal in the world of TB. For the first time, it has approved a near point-of-care molecular test that can be used at the primary care level, and also with a tongue swab since many people are unable to produce a sputum.”Dr Pai said this new test is available via Global Drug Facility at $3.5 per test and is “far more affordable than any molecular test so far”. He added that two companies, Huwel and Molbio from India, have products that fit into this category.When contacted, Goa-based Molbio Diagnostics president Shiva Sriram said his company’s technology, the Truenat platform, which is deployed in primary health centres across the country, is already designed to accommodate multiple sample types, including tongue swabs.However, he said tongue swab-based testing is still an emerging approach with limited field data. “As programmatic adoption increases, it is expected to generate stronger evidence and inform scaled implementation,” he said.
