{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:38:33Z","timestamp":1793194713266,"version":"4.5.0"},"reference-count":82,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["eClinicalMedicine"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.eclinm.2026.104232","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:00:40Z","timestamp":1790110840000},"page":"104232","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Diagnostic testing for pulmonary tuberculosis in low and middle-income countries: innovations to achieve universal access\u2014a narrative review"],"prefix":"10.1016","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7696-3776","authenticated-orcid":false,"given":"Nazir A.","family":"Ismail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9692-8748","authenticated-orcid":false,"given":"Rebecca H.","family":"Berhanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"von Knorring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerite Massinga","family":"Loembe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikashmi","family":"Kohli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumina","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siva K.","family":"Shanmugam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Sheokand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achilles","family":"Katamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhukar","family":"Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaheed V.","family":"Omar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib1","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1186\/s12879-021-06745-w","article-title":"Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality\u2014a multicentre prospective cohort study","volume":"21","author":"Kraef","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib2","article-title":"Survival analysis of risk factors for mortality in a cohort of patients with tuberculosis","volume":"2020","author":"Xie","year":"2020","journal-title":"Can Respir J"},{"issue":"8","key":"10.1016\/j.eclinm.2026.104232_bib3","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1016\/j.jiph.2023.05.038","article-title":"Risk of mortality and clinical outcomes associated with healthcare delay among patients with tuberculosis","volume":"16","author":"Bea","year":"2023","journal-title":"J Infect Public Health"},{"issue":"12","key":"10.1016\/j.eclinm.2026.104232_bib4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0000805","article-title":"Magnitude and factors associated with post-tuberculosis lung disease in low-and middle-income countries: a systematic review and meta-analysis","volume":"2","author":"Maleche-Obimbo","year":"2022","journal-title":"PLOS Glob Public Health"},{"issue":"5","key":"10.1016\/j.eclinm.2026.104232_bib5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0037978","article-title":"Pulmonary tuberculosis and delay in anti-tuberculous treatment are important risk factors for chronic obstructive pulmonary disease","volume":"7","author":"Lee","year":"2012","journal-title":"PLoS One"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib6","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s12931-021-01841-6","article-title":"Duration and determinants of delayed tuberculosis diagnosis and treatment in high-burden countries: a mixed-methods systematic review and meta-analysis","volume":"22","author":"Teo","year":"2021","journal-title":"Respir Res"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5588\/pha.21.0022","article-title":"Missed opportunities for diagnosis and treatment in patients with TB symptoms: a systematic review","volume":"12","author":"Divala","year":"2022","journal-title":"Public Health Action"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib8","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2024.e28699","article-title":"Tuberculosis treatment delay and contributing factors within tuberculosis patients in Ethiopia: a systematic review and meta-analysis","volume":"10","author":"Fetensa","year":"2024","journal-title":"Heliyon"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib9","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3390\/tropicalmed7070136","article-title":"Gaps and interventions across the diagnostic care cascade of TB patients at the level of patient, community and health system: a qualitative review of the literature","volume":"7","author":"Shah","year":"2022","journal-title":"Trop Med Infect Dis"},{"issue":"5","key":"10.1016\/j.eclinm.2026.104232_bib10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004409","article-title":"Barriers to engagement in the care cascade for tuberculosis disease in India: a systematic review of quantitative studies","volume":"21","author":"Jhaveri","year":"2024","journal-title":"PLoS Med"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib11","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s44263-025-00166-6","article-title":"Social isolation, social exclusion, and access to mental and tangible resources: mapping the gendered impact of tuberculosis-related stigma among men and women living with tuberculosis in Eastern Cape Province, South Africa","volume":"3","author":"Medina-Marino","year":"2025","journal-title":"BMC Glob Public Health"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib12","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1186\/s12889-022-14419-8","article-title":"Gender-related factors associated with delayed diagnosis of tuberculosis in Eastern Europe and Central Asia","volume":"22","author":"Turusbekova","year":"2022","journal-title":"BMC Public Health"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib13","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3390\/ijerph23010018","article-title":"Women's experiences in the process of illness and care during tuberculosis treatment: systematic review of a qualitative evidence","volume":"23","author":"Assump\u00e7\u00e3o","year":"2025","journal-title":"Int J Environ Res Publ Health"},{"key":"10.1016\/j.eclinm.2026.104232_bib14","article-title":"Lessons on the quality of tuberculosis diagnosis from standardized patients in China, India, Kenya, and South Africa","volume":"16","author":"Daniels","year":"2019","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0316273","article-title":"Factors associated with the delay in diagnosis of extrapulmonary tuberculosis at the patient and health system level: a study from a rural setting in India","volume":"20","author":"Hassan","year":"2025","journal-title":"PLoS One"},{"issue":"3","key":"10.1016\/j.eclinm.2026.104232_bib16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0320691","article-title":"Diagnostic and treatment delay in extrapulmonary tuberculosis and association with mortality: experiences from Mbeya, Tanzania","volume":"20","author":"Gr\u00f8nningen","year":"2025","journal-title":"PLoS One"},{"issue":"9","key":"10.1016\/j.eclinm.2026.104232_bib17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0203593","article-title":"Diagnostic delay in extrapulmonary tuberculosis and impact on patient morbidity: a study from Zanzibar","volume":"13","author":"J\u00f8rstad","year":"2018","journal-title":"PLoS One"},{"issue":"4","key":"10.1016\/j.eclinm.2026.104232_bib18","doi-asserted-by":"crossref","first-page":"148","DOI":"10.5588\/pha.23.0037","article-title":"Care-seeking pathways and diagnostic delays in extrapulmonary TB patients","volume":"13","author":"Wali","year":"2023","journal-title":"Public Health Action"},{"issue":"9","key":"10.1016\/j.eclinm.2026.104232_bib19","doi-asserted-by":"crossref","first-page":"e559","DOI":"10.1016\/S1473-3099(24)00144-0","article-title":"The epidemiology, transmission, diagnosis, and management of drug-resistant tuberculosis-lessons from the South African experience","volume":"24","author":"Naidoo","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.eclinm.2026.104232_bib20","series-title":"Global TB Report","year":"2025"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib21","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1186\/s12879-022-07855-9","article-title":"Impact of molecular diagnostic tests on diagnostic and treatment delays in tuberculosis: a systematic review and meta-analysis","volume":"22","author":"Lee","year":"2022","journal-title":"BMC Infect Dis"},{"key":"10.1016\/j.eclinm.2026.104232_bib22","article-title":"Impact of rapid nucleic acid amplification tests for tuberculosis on patient outcomes","volume":"12","author":"Otieno","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"10.1016\/j.eclinm.2026.104232_bib23","article-title":"Impact of the diagnostic test Xpert MTB\/RIF on patient outcomes for tuberculosis","volume":"5","author":"Haraka","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"10.1016\/j.eclinm.2026.104232_bib24","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S2214-109X(18)30458-3","article-title":"Effect of Xpert MTB\/RIF on clinical outcomes in routine care settings: individual patient data meta-analysis","volume":"7","author":"Di Tanna","year":"2019","journal-title":"Lancet Glob Health"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib25","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1186\/s12879-025-11310-w","article-title":"The contribution of TB rapid diagnostic testing in reducing TB-related mortality in Sub-Saharan Africa-in both Person-Living with HIV and HIV-Negative populations: a 9-year quantitative retrospective analysis","volume":"25","author":"Chi","year":"2025","journal-title":"BMC Infect Dis"},{"issue":"12","key":"10.1016\/j.eclinm.2026.104232_bib26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2024-015830","article-title":"Ten-year health impact, economic impact and return on investment of the South African molecular diagnostics programme for HIV, tuberculosis and SARS-CoV-2","volume":"9","author":"Nichols","year":"2024","journal-title":"BMJ Glob Health"},{"issue":"26","key":"10.1016\/j.eclinm.2026.104232_bib27","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1056\/NEJMoa2105470","article-title":"Multicomponent strategy with decentralized molecular testing for tuberculosis","volume":"385","author":"Cattamanchi","year":"2021","journal-title":"N Engl J Med"},{"issue":"4","key":"10.1016\/j.eclinm.2026.104232_bib28","article-title":"Implementing the Molbio Truenat platform and tuberculosis assays versus standard of care at primary care clinics for the detection and treatment of tuberculosis in Mozambique and Tanzania (TB-CAPT CORE): a cluster-randomised trial","volume":"1","author":"Khosa","year":"2025","journal-title":"Lancet Prim Care"},{"issue":"11","key":"10.1016\/j.eclinm.2026.104232_bib29","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2025-020117","article-title":"An extended cost-effectiveness analysis of decentralised TB diagnostic testing with Molbio Truenat MTB\/RIF versus hub-and-spoke GeneXpert MTB\/RIF in Mozambique and Tanzania","volume":"10","author":"Bashir","year":"2025","journal-title":"BMJ Glob Health"},{"key":"10.1016\/j.eclinm.2026.104232_bib31","series-title":"WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection","year":"2024"},{"key":"10.1016\/j.eclinm.2026.104232_bib32","series-title":"Target product profile for tuberculosis diagnosis and detection of drug resistance","year":"2024"},{"key":"10.1016\/j.eclinm.2026.104232_bib33","series-title":"Near point-of-care tests, tongue swabs, and sputum pooling for TB","year":"2026"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib35","article-title":"Xpert MTB\/RIF Ultra assay for pulmonary tuberculosis and rifampicin resistance in adults and adolescents","volume":"7","author":"Horne","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.eclinm.2026.104232_bib36","article-title":"Xpert MTB\/RIF Ultra assay for tuberculosis disease and rifampicin resistance in children","volume":"10","author":"Kay","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"10.1016\/j.eclinm.2026.104232_bib37","first-page":"Cd015543","article-title":"Truenat MTB assays for pulmonary tuberculosis and rifampicin resistance in adults and adolescents","volume":"3","author":"Inbaraj","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib38","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/j.cmi.2025.04.013","article-title":"Diagnostic accuracy of Truenat MTB Ultima on sputum for pulmonary tuberculosis diagnosis in an HIV-endemic setting","volume":"31","author":"Abdulgader","year":"2025","journal-title":"Clin Microbiol Infect"},{"key":"10.1016\/j.eclinm.2026.104232_bib39","article-title":"Diagnostic performance of the Pluslife MiniDock MTB and Molbio MTB Ultima assays to detect tuberculosis from tongue and sputum swabs among outpatients and in active case finding in Cameroon","volume":"83","author":"Mbuli","year":"2025","journal-title":"Clin Infect Dis"},{"issue":"17","key":"10.1016\/j.eclinm.2026.104232_bib40","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1056\/NEJMoa2509761","article-title":"Pulmonary Tuberculosis detection with MiniDock MTB using swab samples","volume":"394","author":"Yerlikaya","year":"2026","journal-title":"N Engl J Med"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib41","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1080\/22221751.2021.1959271","article-title":"EasyNAT MTC assay: a simple, rapid, and low-cost cross-priming amplification method for the detection of mycobacterium tuberculosis suitable for point-of-care testing","volume":"10","author":"Zhang","year":"2021","journal-title":"Emerg Microbes Infect"},{"issue":"6","key":"10.1016\/j.eclinm.2026.104232_bib42","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanmic.2025.101330","article-title":"Multicountry assessment of tongue swabs for tuberculosis using a common protocol for Xpert MTB\/RIF Ultra testing: a prospective diagnostic accuracy study","volume":"7","author":"de Vos","year":"2026","journal-title":"Lancet Microbe"},{"issue":"12","key":"10.1016\/j.eclinm.2026.104232_bib43","doi-asserted-by":"crossref","first-page":"e2024","DOI":"10.1016\/S2214-109X(24)00357-7","article-title":"Urine-Xpert Ultra for the diagnosis of tuberculosis in people living with HIV: a prospective, multicentre, diagnostic accuracy study","volume":"12","author":"Sossen","year":"2024","journal-title":"Lancet Glob Health"},{"issue":"6","key":"10.1016\/j.eclinm.2026.104232_bib44","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanmic.2024.100963","article-title":"Performance of stool-based molecular tests and processing methods for paediatric tuberculosis diagnosis: a systematic review and meta-analysis","volume":"6","author":"Carratal\u00e0-Castro","year":"2025","journal-title":"Lancet Microbe"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib45","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanmic.2025.101085","article-title":"Performance of stool Xpert MTB\/RIF Ultra for detection of Mycobacterium tuberculosis among adults living with HIV: a multicentre, prospective diagnostic study","volume":"6","author":"Kasule","year":"2025","journal-title":"Lancet Microbe"},{"issue":"10","key":"10.1016\/j.eclinm.2026.104232_bib46","article-title":"Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in people living with HIV","volume":"10","author":"Bjerrum","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"10.1016\/j.eclinm.2026.104232_bib47","article-title":"Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV","volume":"6","author":"Bjerrum","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"issue":"11","key":"10.1016\/j.eclinm.2026.104232_bib48","doi-asserted-by":"crossref","first-page":"5756","DOI":"10.1172\/JCI140461","article-title":"Diagnostic accuracy of 3 urine lipoarabinomannan tuberculosis assays in HIV-negative outpatients","volume":"130","author":"Broger","year":"2020","journal-title":"J Clin Investig"},{"key":"10.1016\/j.eclinm.2026.104232_bib49","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ijregi.2022.06.004","article-title":"Value of urine-based lipoarabinomannan (LAM) antigen tests for diagnosing tuberculosis in children: systematic review and meta-analysis","volume":"4","author":"Seid","year":"2022","journal-title":"IJID Reg"},{"issue":"3","key":"10.1016\/j.eclinm.2026.104232_bib50","doi-asserted-by":"crossref","DOI":"10.1016\/j.diagmicrobio.2022.115879","article-title":"Diagnostic accuracy of urine based lipoarabinomannan point of care tuberculosis diagnostic test in HIV negative children: a systematic review and meta-analysis","volume":"105","author":"Sood","year":"2023","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib51","doi-asserted-by":"crossref","first-page":"e126","DOI":"10.1016\/S2214-109X(22)00463-6","article-title":"Novel FujiLAM assay to detect tuberculosis in HIV-positive ambulatory patients in four African countries: a diagnostic accuracy study","volume":"11","author":"Huerga","year":"2023","journal-title":"Lancet Glob Health"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib52","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1186\/s12879-025-12055-2","article-title":"FujiLAM assays for tuberculosis detection in people with HIV: a systematic review and meta-analysis","volume":"25","author":"Taye","year":"2025","journal-title":"BMC Infect Dis"},{"key":"10.1016\/j.eclinm.2026.104232_bib53","article-title":"A new rapid lipoarabinomannan urine assay for tuberculosis: a two-centre diagnostic accuracy evaluation in outpatients with and without HIV","author":"Hamasur","year":"2025","journal-title":"Res Sq"},{"issue":"12","key":"10.1016\/j.eclinm.2026.104232_bib54","doi-asserted-by":"crossref","DOI":"10.1128\/jcm.01269-25","article-title":"Clinical evaluation of the diagnostic performances and treatment monitoring of the new PATHFAST TB LAM Ag assay in sputum specimens of patients with tuberculosis or with nontuberculous mycobacteria pulmonary disease","volume":"63","author":"Fouchet","year":"2025","journal-title":"J Clin Microbiol"},{"issue":"2","key":"10.1016\/j.eclinm.2026.104232_bib55","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.cmi.2025.11.010","article-title":"Diagnostic accuracy of a novel point-of-care tongue swab assay for pulmonary tuberculosis: a multicentre prospective study","volume":"32","author":"Wu","year":"2026","journal-title":"Clin Microbiol Infect"},{"issue":"10024","key":"10.1016\/j.eclinm.2026.104232_bib56","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/S0140-6736(15)01092-2","article-title":"Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label, randomised controlled trial","volume":"387","author":"Peter","year":"2016","journal-title":"Lancet"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib57","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1093\/cid\/cix513","article-title":"Does disseminated nontuberculous mycobacterial disease cause false-positive determine TB-LAM lateral flow assay results? A retrospective review","volume":"65","author":"Nel","year":"2017","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.eclinm.2026.104232_bib58","doi-asserted-by":"crossref","first-page":"24","DOI":"10.12688\/gatesopenres.13112.1","article-title":"Adoption and uptake of the lateral flow urine LAM test in countries with high tuberculosis and HIV\/AIDS burden: current landscape and barriers","volume":"4","author":"Singhroy","year":"2020","journal-title":"Gates Open Res"},{"issue":"6","key":"10.1016\/j.eclinm.2026.104232_bib59","doi-asserted-by":"crossref","first-page":"e903","DOI":"10.1016\/S2214-109X(23)00135-3","article-title":"Diagnostic yield of urine lipoarabinomannan and sputum tuberculosis tests in people living with HIV: a systematic review and meta-analysis of individual participant data","volume":"11","author":"Broger","year":"2023","journal-title":"Lancet Glob Health"},{"key":"10.1016\/j.eclinm.2026.104232_bib60","article-title":"Sputum scarcity among adolescents and adults with presumptive tuberculosis: a systematic review and meta-analysis","author":"Gaeddert","year":"2025","journal-title":"medRxiv"},{"issue":"7","key":"10.1016\/j.eclinm.2026.104232_bib61","doi-asserted-by":"crossref","first-page":"e1184","DOI":"10.1016\/S2214-109X(24)00148-7","article-title":"Diagnostic yield as an important metric for the evaluation of novel tuberculosis tests: rationale and guidance for future research","volume":"12","author":"Broger","year":"2024","journal-title":"Lancet Glob Health"},{"issue":"6","key":"10.1016\/j.eclinm.2026.104232_bib62","article-title":"Parallel use of low-complexity automated nucleic acid amplification tests on respiratory and stool samples with or without lateral flow lipoarabinomannan assays to detect pulmonary tuberculosis disease in children","volume":"6","author":"Olbrich","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"10.1016\/j.eclinm.2026.104232_bib63","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanmic.2024.101055","article-title":"Centrifuge-free stool processing methods for Xpert MTB\/RIF Ultra tuberculosis diagnosis in children in Uganda and Zambia: an observational, prospective, diagnostic accuracy study","volume":"6","author":"Lounnas","year":"2025","journal-title":"Lancet Microbe"},{"issue":"4","key":"10.1016\/j.eclinm.2026.104232_bib64","doi-asserted-by":"crossref","first-page":"235","DOI":"10.5588\/ijtldopen.24.0605","article-title":"Incremental yield in detection of TB by testing multiple stool specimens from one person","volume":"2","author":"Tiemersma","year":"2025","journal-title":"IJTLD Open"},{"issue":"5","key":"10.1016\/j.eclinm.2026.104232_bib65","doi-asserted-by":"crossref","DOI":"10.1001\/jamapediatrics.2020.6069","article-title":"Sensitive and feasible specimen collection and testing strategies for diagnosing tuberculosis in young children","volume":"175","author":"Song","year":"2021","journal-title":"JAMA Pediatr"},{"key":"10.1016\/j.eclinm.2026.104232_bib66","series-title":"Module 3: diagnosis","year":"2025"},{"key":"10.1016\/j.eclinm.2026.104232_bib67","article-title":"Diagnostic accuracy of oral swab for detection of pulmonary tuberculosis: a systematic review and meta-analysis","volume":"10","author":"Zhang","year":"2023","journal-title":"Front Med"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib68","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/S2214-109X(23)00469-2","article-title":"Oral swabs with a rapid molecular diagnostic test for pulmonary tuberculosis in adults and children: a systematic review","volume":"12","author":"Church","year":"2024","journal-title":"Lancet Glob Health"},{"issue":"3","key":"10.1016\/j.eclinm.2026.104232_bib69","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad082","article-title":"Diagnostic yield of nucleic acid amplification tests in oral samples for pulmonary tuberculosis: a systematic review and meta-analysis","volume":"10","author":"Wang","year":"2023","journal-title":"Open Forum Infect Dis"},{"issue":"6","key":"10.1016\/j.eclinm.2026.104232_bib70","doi-asserted-by":"crossref","first-page":"e632","DOI":"10.1093\/cid\/ciaf397","article-title":"Oral washes and tongue swabs for Xpert MTB\/RIF ultra\u2013based tuberculosis diagnosis in people with and without the ability to make sputum","volume":"81","author":"Rockman","year":"2026","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.eclinm.2026.104232_bib71","doi-asserted-by":"crossref","first-page":"89","DOI":"10.2147\/IDR.S284157","article-title":"Diagnostic yield of oral swab testing by TB-LAMP for diagnosis of pulmonary tuberculosis","volume":"14","author":"Song","year":"2021","journal-title":"Infect Drug Resist"},{"issue":"2","key":"10.1016\/j.eclinm.2026.104232_bib72","doi-asserted-by":"crossref","first-page":"e0114024","DOI":"10.1128\/jcm.01140-24","article-title":"High-sensitivity detection of Mycobacterium tuberculosis DNA in tongue swab samples","volume":"63","author":"Olson","year":"2025","journal-title":"J Clin Microbiol"},{"key":"10.1016\/j.eclinm.2026.104232_bib73","article-title":"Cost-effectiveness and budget impact of decentralising childhood tuberculosis diagnosis in six high tuberculosis incidence countries: a mathematical modelling study","volume":"70","author":"d'Elb\u00e9e","year":"2024","journal-title":"eClinicalMedicine"},{"issue":"2","key":"10.1016\/j.eclinm.2026.104232_bib74","doi-asserted-by":"crossref","first-page":"e278","DOI":"10.1016\/S2214-109X(22)00509-5","article-title":"Multicomponent strategy with decentralised molecular testing for tuberculosis in Uganda: a cost and cost-effectiveness analysis","volume":"11","author":"Thompson","year":"2023","journal-title":"Lancet Glob Health"},{"issue":"8","key":"10.1016\/j.eclinm.2026.104232_bib75","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1093\/ajrccm\/aamag163","article-title":"Cost-Effectiveness of community tuberculosis screening in South Africa","volume":"212","author":"Deleger","year":"2026","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib76","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1093\/cid\/ciad501","article-title":"Cost-effectiveness of low-complexity screening tests in community-based case-finding for tuberculosis","volume":"78","author":"Br\u00fcmmer","year":"2024","journal-title":"Clin Infect Dis"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib77","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0001179","article-title":"The integration of tuberculosis and HIV testing on GeneXpert can substantially improve access and same-day diagnosis and benefit tuberculosis programmes: a diagnostic network optimization analysis in Zambia","volume":"3","author":"Girdwood","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"10.1016\/j.eclinm.2026.104232_bib78","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2025.103728","article-title":"Cost and impact of decentralized tuberculosis testing: a modeling analysis of price thresholds for molecular instruments in high-burden settings","volume":"91","author":"Ockhuisen","year":"2026","journal-title":"eClinicalMedicine"},{"key":"10.1016\/j.eclinm.2026.104232_bib79","series-title":"Diagnostics, medical devices & other health products catalog","year":"2025"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib80","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1186\/s12879-025-11804-7","article-title":"Predisposing, enabling, and need factors influencing rapid uptake of the world health organization-endorsed TB diagnostic technologies in Africa","volume":"25","author":"Iragena","year":"2025","journal-title":"BMC Infect Dis"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib82","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-026-12852-3","article-title":"Implementation of digital tuberculosis information systems: perspectives from 10 high TB burden countries","volume":"26","author":"Oga-Omenka","year":"2026","journal-title":"BMC Infect Dis"},{"issue":"1","key":"10.1016\/j.eclinm.2026.104232_bib83","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12911-025-03270-7","article-title":"Digital health for Tuberculosis control: findings from the piloting of an electronic medical record in Luanda (Angola)","volume":"26","author":"Robbiati","year":"2025","journal-title":"BMC Med Inform Decis Mak"},{"issue":"11","key":"10.1016\/j.eclinm.2026.104232_bib84","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004824","article-title":"From dependence to self-reliance: the future of the global tuberculosis response","volume":"22","author":"Heitkamp","year":"2025","journal-title":"PLoS Med"},{"key":"10.1016\/j.eclinm.2026.104232_bib85","series-title":"Tuberculosis testing gets a massive boost","author":"Pai","year":"2026"}],"container-title":["eClinicalMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537026004852?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2589537026004852?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:11:06Z","timestamp":1793193066000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2589537026004852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":82,"alternative-id":["S2589537026004852"],"URL":"https:\/\/doi.org\/10.1016\/j.eclinm.2026.104232","relation":{},"ISSN":["2589-5370"],"issn-type":[{"value":"2589-5370","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Diagnostic testing for pulmonary tuberculosis in low and middle-income countries: innovations to achieve universal access\u2014a narrative review","name":"articletitle","label":"Article Title"},{"value":"eClinicalMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.eclinm.2026.104232","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"104232"}}