WHO consolidated guidelines on tuberculosis: module 3: diagnosis: tests for TB infection

This publication presents WHO consolidated guidelines on tests for tuberculosis (TB) infection within Module 3: Diagnosis. The document reviews the use of tuberculin skin tests (TSTs), interferon-gamma release assays (IGRAs) and newer Mycobacterium tuberculosis antigen-based skin tests (TBSTs) for identifying TB infection in different populations and settings. It summarizes the evidence supporting WHO recommendations, including diagnostic accuracy, safety, concordance, implementation considerations, economic evaluations and qualitative evidence related to feasibility, acceptability and equity. The guidelines also address the limitations of currently available tests and their role in supporting tuberculosis preventive treatment strategies.

The publication includes updated WHO recommendations on the use of TBSTs, TSTs and IGRAs, and clarifies that IGRAs and TSTs should not be used for diagnosing active TB disease in low- and middle-income countries. Evidence was assessed through systematic reviews and the GRADE approach, with consideration of patient-important outcomes and operational implications. The guidelines are intended for policy-makers, clinicians, laboratory specialists, TB and HIV programme managers, technical agencies and implementing partners involved in TB prevention and diagnosis.