WHO operational handbook on tuberculosis. Module 3

Book excerpt: The “WHO operational handbook on tuberculosis. Module 3: Diagnosis - Rapid diagnostics for tuberculosis detection, third edition” is the latest edition replacing the one issued in 2021. A new class of technologies for drug susceptibility testing is endorsed by WHO and included in this edition: targeted next generation sequencing. The operational handbook 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. It provides practical information on existing and new tests recommended by WHO, step-by-step advice on implementing and scale-up testing to achieve local and national impact and lastly, model diagnostic algorithms, which are updated to incorporate the latest recommendations. An overview of budgetary considerations and information sheets on each of the newly recommended tests is provided. The class of targeted next generation sequencing is recommended for the detection of resistance to a number of first- and second-line anti-TB drugs, rather than culture-based phenotypic drug susceptibility testing. The recommendations will open for faster detection of resistance to a range of anti-TB drugs directly from sputum samples.