Remarks There are concerns about losing global and national capacity for culture testing – the current reference standard for identifying active TB disease. An Xpert Ultra trace result was considered as negative in these studies. More false positive results are expected for Xpert Ultra for pulmonary TB. The recommendation applies only to the use of Xpert Ultra for clinical case management. When Xpert Ultra gives a positive result, clinical management should be followed according to national guidelines. When Xpert Ultra gives a negative result, the patient should be re-evaluated clinically. In the case of a culture-positive result, clinical management should be followed according to national guidelines. In the case of a culture-negative result, the patient should be re-evaluated clinically. The recommendation does not apply to scientific studies with other objectives, such as the reliable estimation of the prevalence of TB disease in the community, in which alternative testing algorithms (e.g. using more than one test) may be required. Recommendations for the diagnostic algorithm(s) to be used in such studies are beyond the scope of this GDG. Recommendations for the diagnostic algorithm(s) to recommend in national TB prevalence surveys specifically are being developed by WHO and are scheduled for release in 2020.