Post‐Mortem Nasal Swab Testing to Reveal Hidden Respiratory Pathogens: Unlocking Public Health Insights in Bangladesh

ABSTRACT

Respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and lung cancer remain among the leading causes of death globally and in Bangladesh. The burden is further intensified by environmental exposures, rapid urbanisation, climate change, and unequal access to healthcare. Traditional methods for determining the cause of death (CoD), particularly verbal autopsies, often yield non‐specific results, creating substantial data gaps. This study examines the feasibility of integrating post‐mortem nasal swab testing into CoD investigations to improve the detection of respiratory pathogens. A structured feasibility assessment was conducted through stakeholder consultations and a comprehensive desk review, resulting in the prioritisation of 11 respiratory pathogens for post‐mortem detection using multiplex polymerase chain reaction (PCR) technology. While challenges related to infrastructure, procedures, and documentation were identified, the approach shows strong potential to enhance the accuracy of mortality surveillance, inform vaccine strategies, and strengthen pandemic preparedness. Although pilot validation is still required, this study outlines initial feasibility findings and provides strategic recommendations for scaling up post‐mortem diagnostics in resource‐limited settings to support more accurate, evidence‐based public health responses.