The Accuracy of an Electronic Nose to Diagnose Tuberculosis in Patients Referred to an Expert Centre

Rosarito Coronel Teixeira, Luis Gómez, Eva González, Nilda Jiménez de Romero, Felipe González, Sarita Aguirre, Martin Boeree, Robin Janssen, Cecile Magis-Escurra

An electronic nose (eNose) device has shown a high specificity and sensitivity to diagnose or rule out tuberculosis (TB) in the past. The aim of this study was to evaluate its performance in patients referred to INERAM.

Although tuberculosis (TB) may seem a ‘silent pandemic’ compared to COVID-19, it is responsible, yearly, for 10 million cases and 1.2 million notified deaths. TB elimination is complex. On the one side due to different elements in the ‘cascade of care’ to establish the diagnosis but also because of factors concerning the bacteria itself as slow duplication and drug resistance which complicates treatment.


Study design and setting
A prospective study was performed in hospitalized and ambulatory patients from January 2016 to December 2017.

Participants, aged ≥ 15 years, presenting with respiratory symptoms for more than 15 days or having started anti-TB treatment already (<3 days before inclusion) were included. Authorization by parents and/or guardians was provided for participants under 18 years old. In Human Immunodeficiency Virus (HIV) positive individuals, the duration of respiratory symptoms was not considered. Exclusion criteria were respiratory failure or not willing or unable to sign informed consent.

We evaluated the performance of the eNose in a referral hospital to diagnose TB in ill patients presenting with respiratory symptoms. We showed that in this study the accuracy of the eNose device was disappointingly only 50%. In this setting the eNose did not perform well enough according to the requisites for new screening tools or tests. Older age and the use of antibiotics are significant risk factors for an incorrect prediction by the eNose with a very high OR for antibiotics use before TB diagnosis.

We would like to thank all participants and the staff of INERAM for their collaboration in collecting data and enabling us to perform this study.

Citation: Coronel Teixeira R, Gómez L, González E, Jiménez de Romero N, González F, Aguirre S, et al. (2023) The accuracy of an electronic nose to diagnose tuberculosis in patients referred to an expert centre. PLoS ONE 18(2): e0276045. https://doi.org/10.1371/journal.pone.0276045

Editor: Tommaso Lomonaco, University of Pisa, ITALY

Received: January 17, 2022; Accepted: September 28, 2022; Published: February 7, 2023.

Copyright: © 2023 Coronel Teixeira et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.