Rapid implementation of the Xpert MTB/RIF diagnostic test: technical and operational 'How-to'; practical considerations

Overview

Earlier and improved tuberculosis (TB) case detection - including smear-negative disease often associated with HIV - as well as expanded capacity to diagnose multidrug-resistant tuberculosis (MDR-TB) are global priorities for TB control. MDR-TB poses formidable challenges due to its complex diagnostic and treatment requirements, while HIV-associated TB largely goes undetected due to the limitations of current diagnostic techniques. Alarming increases in MDR-TB, the global emergence of extensively drug- resistant TB (XDR-TB), documented institutional transmission, and rapid mortality in MDR-TB and XDR-TB patients with HIV co- infection have highlighted the urgency for rapid diagnostic methods.

This document is a product of the discussions and consensus reached during the Global Consultation on implementation and scale-up of the Xpert MTB/RIF system, convened by WHO-STB in early December 2010, and subsequent active interaction by the various Working Groups and their secretariats.