Profiles of Volatile Biomarkers Detect Tuberculosis from Skin

Abstract Tuberculosis (TB) is an infectious disease that threatens >10 million people annually. Despite advances in TB diagnostics, millions of patients continue to receive insufficient diagnosis, as TB symptoms are not specific. Many existing bio-diagnostic tests are slow, have low sensitivity and/or specificity, and can be too expensive or complex for resource-limited settings. Early diagnosis of TB contributes to morbidity mitigation and prevents the disease spread. Here, we report on a new physiological pathway for TB diagnostics via TB-specific profile of volatile organic compounds (VOCs) that are detected and quantified from air trapped above the skin (“skin headspace”). Beyond the exploration aspect that relies on clinical samples from 636 individuals in two clinical sites, we demonstrate the utility of these VOC profiles in a point-of-care diagnosis, by means of specifically-designed intelligent nanoarray, both in lab setting and online, in-situ wearable devices. The results show excellent discrimination between active pulmonary TB patients and controls with 89.4% accuracy. This fulfills the triage TB test requirements according to the World Health Organization (WHO).