A systematic review and meta-analysis evaluated the diagnostic accuracy of Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults. Across included studies, the molecular assay showed high specificity and substantially improved sensitivity compared with smear microscopy, particularly in smear-positive disease. The review also demonstrated that performance can vary by clinical context, with lower sensitivity in people with HIV and in some paucibacillary settings. For clinicians, the practical message is that Xpert MTB/RIF can accelerate diagnosis and provide early information about rifampicin resistance, but a negative molecular test does not automatically exclude tuberculosis when clinical suspicion remains high. This is especially important in the NAPCON context, where molecular diagnostics and integration with the national TB program are explicit themes. The paper supports a diagnostic pathway in which rapid molecular testing is used early, while microscopy, culture and clinical assessment remain important components of comprehensive evaluation. It also reinforces the principle that test interpretation depends on pretest probability and specimen quality. The publication is useful for HCP education because it demonstrates both the strengths and the limits of molecular diagnosis rather than presenting Xpert as a stand-alone substitute for clinical judgment.