Informing People-Centered Target Product Profiles for TB Diagnostics: A Multi-Country Qualitative Study

Area of Science:

• Global Health
• Diagnostic Development
• Qualitative Research

Background:

• Accurate tuberculosis (TB) diagnosis is crucial in high-burden areas.
• Current TB diagnostic development, guided by WHO's Target Product Profiles (TPPs), has lacked input from TB-affected individuals.
• This study addresses the need for people-centered TB diagnostic strategies.

Purpose of the Study:

• To explore the preferences and experiences of individuals undergoing TB evaluation.
• To inform the development of people-centered TB diagnostic strategies.
• To provide insights for updating WHO policy on TB diagnostics.

Main Methods:

• Conducted 75 semi-structured interviews with adults undergoing TB evaluation across five countries (India, Philippines, South Africa, Uganda, Vietnam).
• Employed purposive sampling to ensure participant diversity (sex, TB status, age, treatment).
• Utilized thematic analysis to interpret interview data.

Main Results:

• Key preference domains identified: perceived accuracy, sample collection, turnaround time, cost, and location.
• Diagnostic accuracy and trustworthiness were paramount, with participants willing to sacrifice comfort for reliable results.
• Sputum and blood tests were trusted more than tongue swabs or urine, despite collection difficulties. Rapid results and affordable indirect costs were valued.
• Hospital-based testing was preferred for perceived reliability, though community-based options were appealing if privacy and accuracy were assured.

Conclusions:

• Individuals with TB prioritize test accuracy and trustworthiness above comfort and convenience.
• These patient-centered preferences should inform WHO policy, particularly regarding novel sample types and testing strategies.
• Incorporating patient preferences can enhance the uptake and equitable access of new TB diagnostics.