Preferences for TB Point-of-Care Tests among Tuberculosis-Affected Individuals [TBN 082]

A study aimed to quantify preferences among TB-affected adults for point-of-care (POC) TB tests compared with standard facility-based testing. This survey-based discrete choice experiment (DCE) was conducted from December 2022 to September 2024 in outpatient public health facilities in the Philippines, Vietnam, South Africa, Uganda, and India, with an additional community-based sample from Uganda.

Participants were adults aged 18 years or older with presumptive or confirmed TB. The analysis included 1149 participants who met data quality standards: 207 from India, 210 from the Philippines, 219 from South Africa, 305 from Uganda, and 208 from Vietnam. The DCE tested 5 diagnostic attributes: sample type, sensitivity, cost, location, and time to result. Participants completed 12 randomized choice tasks comparing 2 TB test options and stated whether they would actually use their preferred option. The study population had a median age of 42 years, 50.4% were female, 9.1% were HIV-positive, 13.1% had diabetes, and 32.7% had current or prior TB.

POC testing was preferred over standard-of-care testing when sensitivity was equal, with preference shares of 78.8% (95% CI, 77.9–79.8) for facility-based POC testing, 70.0% (95% CI, 68.5–71.5) for community-based POC testing, and 64.6% (95% CI, 62.7–66.5) for home-based POC testing. Preferences declined when POC sensitivity was lower: at 10% lower sensitivity, preference shares were 58.1%, 50.7%, and 47.8%, respectively; at 20% lower sensitivity, they were 41.9%, 36.3%, and 34.4%. Fifteen-minute POC testing was consistently preferred over same-day 3-hour testing, increasing preference shares by 8.6 to 11.9 percentage points. Fewer than 1.5% chose neither test, and sample type had little effect on preferences. Vietnam showed the strongest overall preferences, while country differences were more visible at lower accuracy levels. In Uganda, community-enrolled participants showed higher preferences for community and home testing than facility-enrolled participants.

Overall, TB-affected individuals generally preferred rapid POC TB testing, especially when accuracy matched standard testing, but willingness declined as sensitivity decreased. Key limitations include reliance on stated preferences rather than observed testing behavior and possible limits to generalizability beyond the included high-burden countries and enrollment settings. 

Source: Nalugwa T, Shah KM, Marcelo D, Nakawunde R, Trinh T, Emmanuel J, Nakaweesa A, Schraufnagel A, Andama A, Christopher DJ, Van Luong D. Predicted Preferences for Tuberculosis Point-of-Care Tests among Tuberculosis-Affected Individuals in Five High Burden Countries. Clinical Infectious Diseases. 2026 Jan 14:ciag022.