by Gavin J Churchyard, Wendy S Stevens, Lerole D Mametja et al.
Lancet Glob Health 2015; 3: e450–57
In South Africa, sputum smear microscopy has been replaced with Xpert MTB/RIF as the initial diagnostic test for tuberculosis. In a pragmatic parallel cluster-randomised trial, the authors evaluated the effect on patient and programme outcomes. They conclude that Xpert did not reduce mortality at 6 months compared with sputum microscopy. Improving outcomes in drug-sensitive tuberculosis programmes might require not only better diagnostic tests but also better linkage to care.