Hi Afifa

Do you mean the new cheap methods? There many article that claim new cheap method, but the method that WHO accepts and you can present and compare it everywhere, is Conventional Ziehl–Neelsen with direct smear microscopy.

I am not sure why you asked this question.

The International Standards for Tuberculosis Care, which cover diagnostics, are available at:

http://www.who.int/tb/publications/ISTC_3rdEd.pdf?ua=1

The WHO also provides a set of TB screening and diagnostic algorithms (see annexes of their operational guide at http://apps.who.int/iris/bitstream/handle/10665/181164/9789241549172_eng.pdf?sequence=1).

Many TB reference and diagnostic laboratories have their preferred algorithm for the laboratory diagnosis of TB in their setting. It will depend to some extent on factors that include the prevalence of extra-pulmonary TB, NTMs, drug resistance; use of genotyping; numbers of specimens being routinely processed; and the equipment and facilities available.

The use of the routine screening method with ZN for AFB on repeated samples increase the sensitivity of detecting the bacteria. Now, the Gene Expert is found very sensitive but in terms of cost, it might be relative.

You can use Gene Xpert testing. It is highly sensitive

I propose also Gene Xpert test to you which is currently used in developing countries.

As the GeneXpert is a rather expensive tool you can apply other PCR-based assays, e.g.

Development of a highly sensitive one-tube nested real-time PCR for detecting Mycobacterium tuberculosis. Choi Y et al. Diagn Microbiol Infect Dis. (2014).

There are many more assays which can be retrieved from PubMed

But also, the clinical findings are important: Chest X-ray, clinical symptoms and also, albeit not very sensitive, Ziehl-Neelsen staining and microscopy.

For extra-pulmonary tuberculosis, the clinical judgement has a poor sensitivity and specificity. For pleural TB and TB meningitis, adenosine deaminase tests have high sensitivity but with limited specificity.

Agree with Shamaei and Dannis

Sputum for AFB still has big drop back -recent methodes are expensive and not applicable for majority of hospitals

In Pakistan and especially in Lahore there are 3 sites doing GeneXpert free of cost i.e. 1)PHRC TB Research Centre, King Edward Medical University, 2)Gulab Devi Hospital and 3)Jinnah Hospital. All are in Lahore

Your question need further explanation. However, you may contact Dr. Kashif Munir at PHRC TB Research Center, Mayo Hospital, Lahore.

A faster, cheaper way to diagnose tuberculosis -- ScienceDaily

https://www.sciencedaily.com › 2011/08

Sputum tests. If your chest X-ray shows signs of tuberculosis, your doctor may take samples of your sputum — the mucus that comes up when you cough. The samples are tested for TB bacteria. Sputum samples can also be used to test for drug-resistant strains of TB.