WHO Unveils Revised Strategies for Faster, More Accurate TB Diagnosis

The World Health Organization (WHO) has released an updated version of its Operational Handbook on Tuberculosis: Module 3 – Diagnosis, aimed at helping countries strengthen TB detection and prevention efforts. The handbook complements the WHO consolidated guidelines on tuberculosis published earlier this year.

Designed for laboratory personnel, clinicians, health ministries, and technical partners, the document offers practical guidance on implementing WHO’s evidence-based recommendations. It details operational considerations for using WHO-approved diagnostic tests, outlines model algorithms, and sets out steps for introducing and scaling up new testing strategies.

Compared to the 2024 edition, the updated handbook includes several major changes. It combines guidance on diagnosing TB infection, TB disease, and drug resistance into a single reference. It introduces new policy statements on using interferon gamma release assays (IGRAs) to detect TB infection and updated targeted next-generation sequencing for identifying drug-resistant TB. It revises diagnostic accuracy estimates for low-complexity automated and manual nucleic acid amplification tests. It updates diagnostic algorithms and guidance for handling discordant results, including recommendations for concurrent testing of respiratory and non-respiratory samples in people with HIV, children with or without HIV, and those with unknown HIV status. It also presents a new figure to help guide the use of drug susceptibility testing results in selecting appropriate TB treatment regimens.

“The diagnostic options for people with TB infection and disease are increasing thanks to manufacturer engagement and research, generating new evidence,” said Dr. Tereza Kasaeva, Director of WHO’s Department for HIV, TB, Hepatitis and STIs. “Ensuring equitable access to fast and accurate diagnosis for all who need it is essential to strengthen prevention and drive us closer to the goal of ending TB.”

The handbook’s release is part of WHO’s global push to improve early detection, accurate diagnosis, and effective treatment of tuberculosis, which remains one of the world’s leading infectious killers.