WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection, 2021 update

Overview

The “WHO consolidated guidelines on tuberculosis. Module 3: Diagnosis - Rapid diagnostics for tuberculosis detection 2021 update” is the latest document replacing the one issued in 2020. Three new nucleic acid amplification test (NAAT) classes are endorsed by WHO and included in the latest consolidated guideline:

• moderate complexity automated NAATs, recommended for the initial detection of TB and resistance to rifampicin and isoniazid, providing more options for early diagnosis of TB and rifampicin-resistant TB but also addressing an important gap in the rapid diagnosis of isoniazid-resistant and rifampicin-susceptible TB; 
• low complexity automated NAATs, recommended for the detection of resistance to isoniazid and second-line anti-TB agents, which will improve access to testing of resistance to fluoroquinolones at peripheral level; and
• high complexity reverse hybridization-based NAATs, recommended for the detection of pyrazinamide resistance, representing the first molecular tests for resistance determination to this drug.

  The consolidated guideline provides background, justification and recommendations on these and earlier endorsed TB diagnostic technologies. This document is accompanied by the “WHO operational handbook on tuberculosis. Module 3: Diagnosis - Rapid diagnostics for tuberculosis detection 2021 update”, which aims at facilitating the implementation of the WHO recommendations by the Member States, technical partners, and others involved in managing patients with TB and DR-TB.