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 with signs and symptoms of pulmonary TB and with a prior history of TB and an end of treatment within the last 5 years, Xpert Ultra may be used as an initial diagnostic test for TB and for rifampicin-resistance detection in sputum, rather than smear microscopy/culture and phenotypic DST.
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
Remarks The justification for a conditional recommendation is based on:
- low certainty of evidence for test accuracy;
- uncertainty about the interpretation of Xpert Ultra trace results in patients with a prior history of disease and the associated high false-positivity rate; and
- uncertainty about the required resources. For patients with Xpert Ultra trace results, decisions regarding treatment initiation should include considerations of the clinical presentation and the patient context (including prior treatment history, probability of relapse and other test results).
Also Featured In
This recommendation also appears in the following guidelines:
WHO consolidated guidelines on tuberculosis: module 3: diagnosis – rapid diagnostics for tuberculosis detection: web annex 2. GRADE profiles
WHO consolidated guidelines on tuberculosis: module 3: diagnosis – rapid diagnostics for tuberculosis detection: web annex 2. GRADE profiles