Cyrille Mbuli, Jean Bosco Taya-Fokou, Rita Nsamenang, Biatu Nestor, Gildas Nguimfack, Ngha Ndze Mbuh, Joceline Konso, Zourriyah Adamou Mana, Arthur Rausmis Nankouo-Njouonang, Tiamuh Nzebele Magdalene, Nsame Denis, Norah Nyah Ndi, Irene Adeline Goupeyou Wandji, Mercy Fundoh, Maurice Ganava, Ousmanou Bello, M. Paul, Fitame Adeline, Comfort Vuchas, Teyim Pride Mbuh, Valerie Flore Donkeng-Donfack, Tushar Garg, Jacob Creswell, Melissa Sander, Nina Lubeka, Armand Koudjou, Guy Zero Molesa, Joel Wepngong Tabah, Ngowo Eyambe Lydia, Christabelle Ewane, Nguifu Kelly Ngwafung, Angela Neh, Ambo Noeline Niba, Kolla Magang Nelly Celestine, Bechesi Carine, Boum Delphine Agnes Gaetan, Ngu Amanda Mambo, Yinkfu Marcel Ndamnsah, Chifu Nadege Bonkar, Asonganyi Etiendem, Munsi Valerie Nformi, Hella Adzoyo Reine, Elimbi Neline Yameni, Ahmadou Djenabou, Maiyanpa Moksala Josephine, Diana Gladys Kolieghu, Nchu-Nfor Evangeline, Iya A Nyam Aicha, Laban Rhoda Bongshe, Ngapgue Sobdong Dominique Josiane, Tsimene Tamessuing Sandrine, Gingir Beatrice Ndemnwi, Amaya Alhadji Wakar, Souk-ino Wappou Ferdinand, Guidzavai Koliye Paul, Naindouba Beninga Herve Steve, Eban Odi Luisa Nang, Tchindo Dargeo, Edzengte Pascal Steve Landry, Elisée Avaikdepainani, Njikam Daouda Momgbet, Fonyuy Gilford, Mbah Romarick, Baiguerel Erika Myriam
BACKGROUND: Cost and infrastructure requirements limit access to current rapid molecular diagnostic testing for tuberculosis (TB). Recent developments in novel, swab-based assays that can be used closer to the point of care offer the potential to change the TB diagnostic landscape. METHODS: We assessed the diagnostic accuracy of two tests, Molbio Truenat MTB Ultima (MTB Ultima) and Pluslife MiniDock MTB Test (MiniDock MTB), among consecutively enrolled individuals aged 15 and above, against the reference standard of culture and comparators of microscopy and Xpert MTB/RIF Ultra. Two tongue swabs, either self-collected or healthcare worker collected, and two sputum specimens were requested from each participant; MiniDock MTB was tested same day and MTB Ultima was tested after storage. RESULTS: From February to June 2025, 1,097 participants were enrolled in communities (382) and at health facilities (715). Sensitivities of sputum and tongue swabs on MiniDock MTB among 132 people with culture-positive TB were 86% (95% CI, 79-91%) and 76% (95% CI, 68-82%), respectively, and 67% (95%CI, 51-79%) and 44% (29-59%) among those with smear-negative TB. Sensitivities of sputum and tongue swabs on MTB Ultima were 84% (97/116, 95%CI, 76-89%) and 74% (67/91, 95% CI, 64-82%), respectively, and 58% (95% CI, 41-74%) and 33% (95% CI, 18-53%) among those with smear-negative TB. CONCLUSIONS: In this population, the performance of both MiniDock MTB and MTB Ultima on tongue and sputum swabs was similar to target product profile thresholds for near point of care TB tests. Further studies to evaluate performance in diverse populations and settings are needed.