Updated Recommendation
A new evidence synthesis was published:2025, WHO consolidated guidelines on tuberculosis: module 3: diagnosis
View latest version (2025)Bibliographic information
Recommendation
In adults and children with signs and symptoms of pulmonary TB, the Truenat MTB or MTB Plus may be used as an initial diagnostic test for TB rather than smear microscopy/culture.
Recommended in favor
Conditional
Certainty of evidence
Moderate
Notes and Remarks
Remarks The recommendation includes patients who are smear negative. There is uncertainty about the use of these assays in PLHIV. In smear-negative patients, the sensitivity is lower than in all patients. The indirect data on test accuracy in smear-negative patients (given that there are no data on PLHIV for this version of Truenat) made it possible to extrapolate this recommendation to PLHIV. However, the certainty of evidence for test accuracy would need to be lowered to account for additional indirectness. In the case of children, there were no data available to assess the accuracy of the test in different specimens, and not enough indirect evidence to extrapolate for specimens other than sputum. This recommendation is extrapolated to children for sputum, although the tests are expected to be less sensitive in children