Consenting adults presenting with signs and symptoms compatible with pulmonary tuberculosis will be interviewed for demographic and medical information, and then will be asked to provide 3-4 expectorated sputum specimens. In the study laboratory, sputa will be tested using conventional and investigational diagnostic tests for tuberculosis and rifampin resistance.

Case Detection Group

Inclusion Criteria:

• Age 18 years or above;
• Provision of informed consent;
• Willingness to provide 4 sputum specimens at enrolment;
• Willingness to have a study follow-up visit approximately 42 to 70 days after enrolment
• Clinical suspicion of pulmonary TB (including cough ≥2 weeks and at least 1 other symptom typical of TB)

Exclusion Criteria:

• Receipt of any dose of TB treatment within 6 months prior to enrolment
• Participants for whom, at the time of enrolment, the follow-up visit is judged to be poorly feasible (e.g. individuals planning to relocate)

Drug-Resistant TB Group

Inclusion Criteria:

• Age 18 years or above;
• Provision of informed consent;
• Willingness to provide 4 sputum specimens at enrolment;
• Non-converting pulmonary TB cases (category I and category II failures) or multi-drug resistant (MDR) suspect* (based on World Health Organization definition), i.e. at least one of the following: i) retreatment cases, ii) active TB cases that are MDR-contacts and iii) patients at high risk for MDR-TB as determined by local program (e.g. prisoners)

Exclusion Criteria:

• none

Individuals who have symptoms consistent with pulmonary TB presenting to participating centres.

Two groups of participants will be recruited, namely a 'Case Detection Group' and a 'Drug-Resistant TB Group'.