1. Descriptive summary of studies.
| Study | Country | Design | Settings | Unit of randomization | Diagnostic strategies | Participant eligibility | Age group | Months of follow‐up | Number of clusters per arm | Total sample |
| Calligaro 2015 | South Africa | RCT | intensive care units | individual | smear microscopy + culture vs Xpert MTB/RIF + culture using tracheal aspirate samples | evaluated for TB | 18 years old & older | 26 | n/a | 242 |
| Mupfumi 2014 | Zimbabwe | RCT | ART initiation centre | individual | smear microscopy vs Xpert MTB/RIF | HIV positive and on ART | 18 years old & older | 3 | n/a | 424 |
| Theron 2014a | South Africa, Tanzania, Zambia, Zimbabwe | RCT | primary health facilities | individual participant | smear microscopy vs Xpert MTB/RIF on sputum samples | people evaluated for TB | 18 years old & older | 6 | n/a | 1502 |
| Churchyard 2015 | South Africa | cluster‐RCT | primary health facilities | health facility | smear microscopy vs Xpert MTB/RIF | evaluated for TB | 18 years old & older | 6 | 10 | 4656 |
| Cox 2014 | South Africa | cluster‐RCT | primary health facility | people seen within the calendar week | Xpert MTB/RIF vs routine diagnostic algorithm of smear, culture, and DST | evaluated for TB | 18 years old & older | 6 | 26 weeks (Xpert) and 25 weeks (smear microscopy) | 1985 |
| Ngwira 2019 | Malawi | Cluster ‐RCT | public HIV clinics | Clinic | smear microscopy vs Xpert MTB/RIF | newly registered people with HIV | 18 years old & older | 12 | 6 | 1842 |
| Agizew 2019a | Botswana | stepped‐wedge | public HIV clinics | clinic | smear microscopy vs Xpert MTB/RIF | newly registered people with HIV | all age groups | 6 | 22 | 6041 |
| Durovni 2014 | Brazil | stepped‐wedge | clinics using laboratory services | laboratories | smear microscopy vs Xpert MTB/RIF | evaluated for TB | all age groups | 6 | 14 | 11,705 smear tests; 12,522 Xpert tests performed |
| Schmidt 2017 | South Africa | before/after | primary healthcare facilities | n/a | participants investigated by smear microscopy vs Xpert MTB/RIF | evaluated for TB | 18 years old & older | 6 | n/a | 15,629 before; 10,741 after |
| van Kampen 2015 | Indonesia | before/after | clinics offering PMDT services | n/a | before: sputum sample underwent smear microscopy + culture + DST after: Xpert MTB/RIF + culture + DST |
at risk of MDR‐TB | all age groups | 24 | n/a | 975 before; 1442 after |
| Van den Handel 2015 | South Africa | before/after | district, sub district and primary healthcare facilities | n/a | smear microscopy vs decentralized Xpert MTB/RIF (we excluded centralized Xpert) | evaluated for TB | all age groups | 6 | n/a | 959 |
| Yoon 2012 | Uganda | before/after | national referral hospital | n/a | smear microscopy (baseline) vs Xpert MTB/RIF (implementation) | evaluated for TB | 18 years old & older | 2 | n/a | 287 baseline; 190 implementation |
ART: antiretroviral therapy DST: drug susceptibility testing MDR‐TB: multi‐drug resistant TB n/a: not applicable PMDT: programmatic management of drug‐resistant tuberculosis RCT: randomized controlled trial TB: tuberculosis vs: versus