P030

1:University of Washington; 2:University of Washington; 3:University of Washington; 4:University of Washington; 5:University of Washington; 6:University of Washington; 7:University of Washington; 8:University of Washington; 9:San Raffaelle University; 10:San Raffaele Scientific Institute; 11:University of Washington

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 mitigate these risks and challenges. Tongue swabbing is now being assessed in community settings worldwide, and plans are underway to seek WHO endorsement. For the latter, evidence is needed to assess the acceptability of TS for TB diagnostics by healthcare workers. This study aimed to evaluate HCWs’ perceived risks, opportunities, and barriers regarding TS use for TB screening among migrants in Italy.

Through purposive sampling, we enrolled HCWs experienced with sputum and TS collection for in-depth semi-structured interviews. Enrollment started in November of 2023 and will continue until July 2025 or until thematic saturation is reached. We adapted Hamilton’s Rapid Qualitative Analysis Methods to summarize key findings.

HCWs interviewed (N=6) indicated a preference for TS over sputum to support the scaling up of TB screening in migrant settings. 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 ensure adherence to the protocol. They also emphasized the need for solutions to language barriers and 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.