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.

WHO recommends against using LF-LAM to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children: without TB symptoms and with a CD4 cell count of 100–200 cells/mm3.

WHO recommends against using LF-LAM to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children: without TB symptoms and unknown CD4 cell count or without TB symptoms and CD4 cell count greater than or equal to 200 cells/mm3.

WHO recommends against using LF-LAM to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children: without assessing TB symptoms.

In adults with signs and symptoms of pulmonary TB and without a prior history of TB (≤5 years) or with a remote history of TB treatment (>5 years since end of treatment), Xpert Ultra should be used as an initial diagnostic test for TB and for rifampicin-resistance detection in sputum, rather than smear microscopy/culture and phenotypic DST.

WHO suggests using LF-LAM to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children: irrespective of signs and symptoms of TB and with a CD4 cell count of less than 100 cells/mm3.

WHO suggests using LF-LAM to assist in the diagnosis of active TB in HIV-positive adults, adolescents and children with signs and symptoms of TB (pulmonary and/or extrapulmonary) or seriously ill.