To minimize the spread of droplet nuclei, any coughing patient with a respiratory infection – in particular, patients with or
suspected of having TB – should be educated in cough etiquette and respiratory hygiene; that is, in the need to cover their
nose and mouth when sneezing and/or coughing (see rest of the recommendation p. 12 of the guideline).

It is also crucial to separate infectious patients after triage. The specific criteria (e.g. smear and culture status) for separating
patients will depend on the local settings and patient population. In particular, patients living with HIV or with strong clinical

Health workers may gain additional protection from TB through the use of particulate respirators that meet or exceed the
N95 standards set by the United States Centers for Disease Control and Prevention/National Institute for Occupational
Safety and Health (CDC/NIOSH) or the FFP2 standards that are CE certified (see rest of recommendation p. 15 of guideline).

Prompt identification of people with TB symptoms (i.e. triage) is crucial. The specific criteria for triaging patients will depend
on the local settings and patient population. However, in general, people suspected of having TB must be separated from
other patients, placed in adequately ventilated areas, educated on cough etiquette and respiratory hygiene, and be diagnosed as a matter of priority (i.e. fast tracked).

In adults and children with signs and symptoms of extrapulmonary TB, Xpert MTB/RIF or Xpert Ultra should be used for rifampicin-resistance detection rather than culture and phenotypic DST.

In adults and children with signs and symptoms of extrapulmonary TB, Xpert Ultra may be used in lymph node aspirate and lymph node biopsy as the initial diagnostic test for lymph nodes TB rather than smear microscopy/culture.

In adults and children with signs and symptoms of extrapulmonary TB, Xpert MTB/RIF may be used in lymph node aspirate, lymph node biopsy, pleural fluid, peritoneal fluid, pericardial fluid, synovial fluid or urine specimens as the initial diagnostic test for respective form of extrapulmonary TB rather than smear microscopy/culture.

In adults and children with signs and symptoms of TB meningitis, Xpert MTB/RIF or Xpert Ultra should be used in cerebrospinal fluid (CSF) as an initial diagnostic test for TB meningitis rather than smear microscopy/culture.

In children with signs and symptoms of pulmonary TB, Xpert Ultra should be used as the initial diagnostic test for TB and detection of rifampicin resistance in sputum or nasopharyngeal aspirate, rather than smear microscopy/culture and phenotypic DST.

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.