The World Health Organization (WHO) is urging countries to expand access to rapid molecular tests for the detection of TB and drug-resistant TB in updated consolidated guidelines, released today. The guidelines are accompanied by an operational handbook to facilitate rapid implementation and roll out of rapid molecular tests by national TB programmes, ministries of health and technical partners.
“The use of rapid molecular assays as the initial test to diagnose TB is recommended instead of sputum smear microscopy as they have high diagnostic accuracy and will lead to major improvements in the early detection of TB and drug-resistant TB,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “We now need to urgently ensure universal access to these rapid molecular tests. This will impact positively on reducing transmission and enabling faster access to accurate life-saving treatment that will lead to better outcomes for those affected.”
The consolidated guidelines and the associated operational handbook recommend key updates of the approaches to diagnose TB including:
- The use of Xpert MTB/RIF assay, Xpert Ultra assay and Truenat assay as the initial test to diagnose pulmonary TB and to detect rifampicin resistance. This replaces smear microscopy and culture.
- The use of Xpert MTB/RIF assay and Xpert Ultra assay for improved diagnosis of TB and rifampicin resistance in children , in specific specimens such as sputum, stool, nasopharyngeal and gastric specimens
- The use of Xpert MTB/RIF assay and Xpert Ultra assay for improved diagnosis of TB and rifampicin resistance in patients with broad range of extrapulmonary TB .