CD4 and diabetes mellitus: CD4 counts when available can help clinicians interpret presentation more accurately, as non-classic presentations may accompany lower CD4 counts.23 Over-reliance on sputum smear microscopy which is a low-sensitivity visual diagnostic test that cannot determine drug resistance has side-lined individuals whose illnesses are characterised by a lower TB bacillary load, such as children and individuals with HIV and diabetes, and also those with extrapulmonary or drug-resistant tuberculosis.29