The diagnostic accuracy of interferon-gamma release assays for detecting Mycobacterium tuberculosis infection has been a focal point of tuberculosis diagnostics, especially given the limitations of traditional methods like the tuberculin skin test. IGRAs measure the release of interferon-gamma from sensitized T-cells in response to specific Mtb antigens, providing a more specific and reliable diagnostic tool for both latent tuberculosis infection and, to some extent, active TB. These assays were assessed for their sensitivity, specificity, and overall diagnostic accuracy under varying clinical and demographic conditions. The study enrolled a diverse cohort of participants, including individuals with confirmed active TB, those with presumed latent TB infection, and healthy controls with no history of TB exposure. Participants included adults and children from high-burden and low-burden TB regions to ensure that the assays were evaluated across a range of epidemiological and immunological contexts. The diagnosis of active TB was confirmed through microbiological evidence, such as positive sputum cultures or polymerase chain reaction tests, while latent TB infection was defined based on exposure history and positive TST results.
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