P022

1:University of Washington; 2:San Raffael Scientific Institute

Reliance on sputum-based assays for the diagnosis of tuberculosis (TB) presents challenges, including occupational infection risk for healthcare workers (HCWs) and the need to collect samples from a symptomatic population. Tongue swab (TS) collection may help mitigate these risks and challenges. This study aims to evaluate HCWs’ perceived risks, opportunities, and barriers regarding TS use for TB screening among migrants in Italy.

Purposive sampling was used to enroll HCWs screening migrants for TB, after which they were invited for an in-depth interview. Enrollment started in November of 2023 and will continue until July 2025 or until saturation among themes is reached. 

The study employed the COM-B implementation science model across study phases, guiding the development of the semi-structured interview questions exploring participants' capabilities to collect and teach migrants to collect TS samples. Hamilton’s Rapid Qualitative Analysis Method was adapted to summarize key findings.

HCWs interviewed (N=6) indicated a preference for TS over sputum to support the scaling up of TB screening in migrants. HCWs shared perceptions that TS reduces their occupational exposure to TB, is safer to perform, is effective on both symptomatic and asymptomatic migrants, and is easier to analyze, with the possibility of pooling samples. HCWs shared that supervision is necessary to collect a high-quality sample and emphasized the need for solutions to language barriers and a lack of educational materials for migrants.

Preliminary results indicate that TS represents a safe tool to perform TB screening if complemented with educational resources tailored for migrant settings.