The Xpert Omni Performance Evaluation for Linkage to Tuberculosis Care (The XPEL TB Trial) is a multi-centre cluster-randomized trial that aims to compare patient outcomes at health centers randomized to intervention versus standard of care TB diagnostic evaluation strategies, to identify processes and contextual factors that influence the effectiveness and fidelity of the intervention TB diagnostic evaluation strategy and to compare the costs and epidemiological impact of intervention versus standard of care TB diagnostic evaluation strategies. The overall goal of the study is to assess the effectiveness, implementation and costs of a streamlined TB diagnostic evaluation strategy based around rapid, onsite molecular testing.