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  • It is important to balance the risks of over-diagnosis which will delay proper treatment of the patient and produce undue costs with the possibility of under-diagnosis which can lead to continued transmission and increased morbidity and mortality, especially in people living with HIV.

  • The WHO developed algorithm for clinical diagnosis does not perform equally in all settings

  • Diagnosing patients with negative smear or Xpert MTB/RIF results will require clinicians to adapt to local epidemiology and the financial needs and specific situation of the patient.
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