Remarks The GDG felt that the implementation of the recommendation depends on the acceptability (for children, parents or caregivers, health care workers and other stakeholders) and the feasibility of conducting repeated testing in the local context. The evidence reviewed evaluated repeating the same test on the same type of specimen. However, from the data reviewed on comparing single tests on different specimen types, there appears to be no difference, regardless of which second specimen is obtained. The recommendation can be extrapolated for children living with HIV (for Xpert MTB/RIF). This includes consideration of the direct benefit from detecting rifampicin resistance in sputum samples (very low certainty of evidence for test accuracy), which the GDG felt can be extrapolated to other samples. The recommendation applies to a moderate or high pretest setting (>5%). If the first test result is positive, the test should not be repeated. In settings with moderate to high pretest probability, the incremental yield of more than two tests is unknown.