The European Tuberculosis Laboratory Initiative (ELI), with its secretariat at the WHO Regional Office for Europe, has developed this technical document to address the need in the WHO European Region for increasing timely and accurate detection of tuberculosis (TB) and multidrug-resistant TB (MDR-TB) through scaling-up the appropriate use of WHO-recommended rapid molecular diagnostic techniques. The document presents comprehensive algorithms for diagnosis and treatment-monitoring of pulmonary TB and MDR-TB using rapid molecular techniques recommended by WHO. To yield the maximum benefit of each technique, the appropriate and accurately timed sequence of different laboratory tests and correct interpretation and communication of results between laboratories and clinicians need to be ensured. For effective operation and efficient outcomes, sustainable financial and human resources need to be directed towards increasing testing capacities and optimizing sample transportation and data communication. This document aims to address these issues, taking the challenges and opportunities of the countries of the Region into account. Core group members of the European TB Laboratory Initiative are from 10 countries across the Region including Armenia, Azerbaijan, Belarus, Georgia, Germany, Kyrgyzstan, the Russian Federation, Sweden, Tajikistan and the United Kingdom. Technical inputs were provided by the Global Laboratory Initiative (GLI) secretariat, the WHO Global TB Programme and the regional Green Light Committee (rGLC).

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