Portable Test Detects Tuberculosis from Tongue Swabs in 30 Minutes

Despite decades of effective drug regimens, tuberculosis remains the leading cause of death from an infectious disease, driven in part by limited access to accurate, rapid testing. Conventional diagnostics often miss cases or depend on centralized laboratories that are scarce in high-burden settings, and diagnosis is especially challenging in patients unable to produce sputum. A new study now shows that a battery-powered handheld device can deliver laboratory-level tuberculosis detection in under 30 minutes.

Investigators at University of California, San Francisco (UCSF) and University of California, Irvine (UC Irvine) evaluated MiniDock MTB, a portable platform designed for point-of-care tuberculosis testing. The handheld, battery-powered instrument is simple to use, with providers in the study able to operate it after reading instructions. The study highlights its potential to address diagnostic gaps in clinics without advanced laboratory infrastructure and among patients who cannot reliably produce sputum.

MiniDock MTB employs DNA-based molecular testing similar to technology used in hospital COVID-19 assays to identify Mycobacterium tuberculosis. By directly detecting bacterial DNA, the device delivers results in less than half an hour. The approach is designed to bring accurate nucleic acid detection closer to patients, reducing delays associated with centralized testing.

According to the study, published in the New England Journal of Medicine, MiniDock MTB performed as effectively as a laboratory test. The researchers reported that it detected cases even among individuals who struggle to provide sputum, a common barrier in children and in some adults with HIV. The World Health Organization has issued its first recommendation for this type of tuberculosis test, underscoring interest in rapid, clinic-based molecular diagnostics.

Global health experts have sought faster tuberculosis testing options because existing “point-of-care” tests often rely on smear microscopy, a method dating to the 19th century. The reported performance and ease of use suggest the platform could streamline diagnostic workflows in settings with limited resources. Study authors emphasized that enabling accurate molecular testing where patients first seek care can change clinical decision-making on the same day.

“For patients who can't produce sputum, like children or people with HIV, tongue swabs move the needle from ‘no diagnosis possible at this clinic’ to ‘accurate molecular testing here now,’” said Adithya Cattamanchi, MD, MPH, a professor of Medicine at UC Irvine, adjunct professor at UCSF, and co-lead author of the study.

“Patients who today would have to leave a clinic undiagnosed could soon be diagnosed and treated the same day. We hope to see more widespread adoption as evidence like ours stacks up,” said Dr. Cattamanchi

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