Cough bio-aerosol sampling for TB GeneXpert through a repurposed tobacco Water Pipe Filter in pulmonary tuberculosis: a diagnostic accuracy study

<bold>Introduction:</bold> Tuberculosis (TB) remains a major global health challenge, with diagnosis difficult in patients unable to produce sputum. <bold>Objective:</bold> To explore the potential of aerosol sampling, collected through the use of a repurposed tobacco water pipe filter device, as a method for diagnosing tuberculosis (TB). Methodology. In this single-center, prospective, diagnostic accuracy study done in a private hospital in Cebu City, 27 bio-aerosol samples were collected using the repurposed tobacco water pipe filter device. The sensitivity and specificity; positive and negative predictive values (PPV, NPV); positive and negative likelihood ratios (LR+, LR-); the diagnostic odds ratio (DOR); and the overall diagnostic accuracy of this method were calculated using a confidence interval set at 95%, and significance at <0.05. <bold>Results:</bold> The cohort's average age was 52.85, mostly female (62.96%). Symptoms included persistent cough (70.37%) and fever (44.44%), with no lymphadenopathy. Most were non-smokers (77.78%), with comorbidities like diabetes (22.22%) and alcohol abuse (33.33%). Radiologic findings suggested TB in 48.15%. The filter showed 0% sensitivity but 100% specificity, with a NPV of 70.37%, indicating its efficiency in ruling out TB. The LR- was 1.00, showing the method's comparability to chance in identifying TB-negative individuals. Overall accuracy stood at 70.37%. <bold>Conclusion:</bold> Aerosol sampling with a repurposed tobacco water pipe filter offers moderate accuracy in TB detection, efficiently identifying TB-negative cases.