Dr. Tony Hu, originally from China, came to the United States in 2012 for his master's in chemistry and his doctorate in biological engineering at the University of Texas in Austin. After two years in postdoctoral training, Hu began his faculty career at Tulane University in 2019.

Hu and fellow Tulane University researchers developed a first-of-its-kind handheld diagnostic device that can deliver rapid, accurate tuberculosis diagnoses in under an hour, according to a study published in Science Translational Medicine in April 2025.

"Diagnosis is the weakest aspect of TB care and control," a Nature study published in 2024 said. "We describe seven critical transitions that can close the massive TB diagnostic gap and enable TB programs worldwide to recover from the pandemic setbacks."

"What we have now is far from being enough, from being satisfying," Hu said.

The smartphone-sized, battery-powered lab-in-tube assay tests blood samples and provides a cost-effective tool that can improve TB diagnoses, particularly in resource-limited rural areas where health care facilities and lab equipment are less accessible, according to Tulane.

"An estimated 4.2 million TB cases were undiagnosed or unreported in 2021," Hu said, "largely due to limitations and costs of testing in areas with high disease burden."

This device is the first to detect Mycobacterium tuberculosis DNA in saliva, in addition to blood and sputum samples. Saliva is easier to obtain than blood or sputum, and the ability to non-invasively obtain samples that yield accurate results is critical for successfully testing children.

Hu is the Weatherhead presidential chair in biotechnology innovation and director of the Tulane Center for Cellular & Molecular Diagnostics.

Why was this new technology needed? How is it different than the standard TB test?

The gold standard is to use sputum, or mucus in the lungs, to test for TB. New technology, called the GeneXpert, was developed by the Cepheid company in the U.S.

This technology dramatically reduces the turnaround time for cultures, or lab tests, from weeks to hours. Regardless of the instrument cost, the use of a sputum is still limiting on diagnoses.

A certain group, about 60%, of patients are diagnosed with what we call pulmonary tuberculosis. The other 40% have TB not located in the lungs, rather they have it in another organ. We call these patients extrapulmonary TB.

For many patients, like children or HIV-infected patients or diabetes, their immune systems are weakened. They don't have a very functional immune system in the pulmonary, the lungs, to cage the bacteria. In those patients, the bacterial infection can spread to other organs easily.

In children and HIV patients, it is very difficult to get the sputum sample. No matter how sensitive, or accurate, the sputum test is, it can only serve about 60 to 65% of the patient population around the world.

We believe the blood-based technology, blood-based testing, could diagnose more patients than the sputum-based detection.

We published our first paper in 2022, the cellphone-sized, or LIT, device demonstrated high accuracy in testing blood samples from children in the Dominican Republic, outperforming the more expensive machine -- 81% sensitivity compared to 68% -- and meeting the World Health Organizations criteria for TB diagnostics.

What inspired you to study this topic?

My inspiration goes back to 2013 when I just start my faculty career in Italy. In my first and second years, we published a lot in our bioengineering group. We published paper after paper, but we don't know how we are going to translate this technology into practice.

That summer, I joined a very small conference in Italy. The organizers invited a very special group of guests: children between four and nine years old who were all HIV positive.

At the time, I had a daughter and son around that age. Seeing them had a big impact on my heart when I saw their smiling faces. They also made a lot of small gifts for the speakers.

It was really not a good feeling as a biomedical scientist. If you think about what you have done, what you've learned and what you've published, it looks like nothing when looking at patients, at those children. It looks like nothing.

After coming back from that conference, I looked to stop doing research for publication, and focused on developing something really useful for the clinic.

How could this technology impact TB diagnosis on a global level?

There is a lot of global interest coming to coming to us.

Now, we have many ongoing international or domestic collaborations that I visit in China, India, Brazil, Indonesia, Taiwan and the Philippines.

This is very important technology for the island nations especially. For example, Indonesia has 18,000 islands with a lot of residents living in the country. It's nearly impossible for them to conduct an effective sputum-based test, package it, send it to labs and test them.

As we move forward, we should think about bringing the test to the point of care in order to serve the populations living in resource-limited areas.