WHO consolidated guidelines on tuberculosis: module 3: diagnosis: web annex B: evidence synthesis and analysis

This web annex to the WHO consolidated guidelines on tuberculosis, Module 3: Diagnosis, compiles the evidence synthesis and analyses used to inform WHO recommendations on diagnostic technologies for tuberculosis and drug-resistant tuberculosis. The publication presents systematic reviews, meta-analyses, qualitative evidence syntheses and economic evaluations examining the diagnostic accuracy, safety, cost–effectiveness and implementation considerations of multiple diagnostic approaches, including low- and moderate-complexity nucleic acid amplification tests, targeted next-generation sequencing technologies and Mycobacterium tuberculosis antigen-based skin tests.

The annex describes the methods applied to identify, assess and synthesize evidence across diverse populations and settings, including adults, adolescents, children and people living with HIV. It addresses the detection of pulmonary and extrapulmonary tuberculosis, rifampicin resistance and multidrug-resistant tuberculosis using respiratory and non-respiratory specimens. The document also examines stakeholder and user perspectives, operational feasibility and factors influencing implementation. Developed in accordance with WHO guideline development standards, the annex provides the technical evidence base underpinning updates to WHO policy guidance on tuberculosis diagnosis and drug-resistance testing.