Researchers at the University of Birmingham in the UK are developing a saliva test that could identify children in the Global South who lack immunity to tetanus and may have missed other essential vaccinations, within 15 minutes.

Funded with £1.1m ($1.40m) from the Medical Research Council, the new non-invasive, lateral flow test is designed to be low-cost and easy to administer without the need for blood samples.

The test's main angle is its potential to fill immunity gaps globally, particularly in areas where blood sampling is challenging.

The tetanus immunity test will first undergo laboratory testing before being evaluated in Rwanda through collaborations with the Africa Centre of Excellence for Sustainable Cooling and Cold-chain (ACES), Rwanda Biomedical Center and the Center for Family Health Research in Kigali.

Researchers aim to determine the test's performance in real-world settings and gauge its acceptance within local communities.

The versatility of the saliva-based test allows it to be used in various settings, from outreach programmes to clinics and hospitals, enhancing access to immunity testing in regions that struggle to assess protective status and gather sero-epidemiological data.

University of Birmingham research fellow Dr Jennifer Heaney said: “Our test shows if a person has protection against tetanus within 15 minutes. It can help identify individuals who are not protected and need vaccination.

“As tetanus vaccination features in all combined immunisations alongside other serious diseases, if an individual is unprotected against tetanus, they are also likely to be missing protection against other serious vaccine-preventable diseases.

“The test therefore can measure tetanus immunity but could also help identify broader gaps in vaccine provision.”

The test's potential extends beyond Rwanda, with plans to trial it in other low-middle-income countries (LMICs) to evaluate immunity levels across diverse communities and support vaccination monitoring and planning efforts.

This innovation comes at a critical time, as more than 20 million children worldwide miss life-saving vaccinations, and the Covid-19 pandemic has caused global coverage of the diphtheria-tetanus-pertussis vaccine to drop to a 15-year low, leaving more individuals at risk of serious diseases.

Despite a drop in global tetanus cases, the disease still results in preventable deaths in some LMICs.