Tuberculosis (TB) remains one of the leading causes of death in the developing world, particularly in Africa, where the fight against the disease faces significant challenges. One critical gap in TB diagnosis is the detection of extrapulmonary TB (EPTB), a form of the disease affecting areas outside the lungs, such as the pleural space, pericardium, and brain. In regions with high rates of HIV, EPTB accounts for over a third of TB cases, yet current diagnostic tools often fall short, particularly in detecting EPTB in fluid samples. Traditional methods, such as GeneXpert and ADA tests, are limited by poor sensitivity and specificity.The Epi-TB project seeks to address this issue through a groundbreaking diagnostic tool, IRISA-TB, developed by Antrum Biotech, a University of Cape Town spin-off. IRISA-TB offers a low-cost, same-day diagnostic solution that has already shown promise in smaller clinical trials. This large-scale study, funded by the EDCTP and Horizon Europe, will evaluate IRISA-TB in various types of EPTB across South Africa, Zambia, and Zimbabwe, with the goal of improving TB diagnosis and treatment in real-world settings. By promoting an African-designed innovation, Epi-TB aims to revolutionize TB diagnosis and support the fight against this deadly disease.