India has the highest burden of tuberculosis (TB). This article presents a review of the diagnostic utility and various limitations of the Mantoux and the interferon-gamma release assays (IGRA) tests in this high TB endemic setting. While both the tests cannot differentiate between latent and active TB, recent guidelines from WHO strongly recommends against the use of IGRA as an alternative to Mantoux test for India.
Central Tuberculisis Division, GOI. National Guidelines in treatment and management of Pediatric Tuberculosis. Available from: https://tbcindia.gov.in/index1.php?sublinkid=4200&level=2&lid=2848&lang=1. Accessed on Jan 10, 2019.
Pai M, Denkinger CM, Kik SV, et al. Gamma interferon release assays for detection of Mycobacterium tuberculosis infection. Clin Microbiol Rev. 2014;27(1):3-20.
WHO. Report of WHO Expert Group on use of interferon-c release assays(IGRAs) in tuberculosis control in low-and-middle-income setting, 20–21 July, 2010. http://www.who.int/tb/advisory_bodies/stag_tb_report_2010.pdf. Accessed on Jan 10, 2019
CDC. TB Elimination. Available from: https://www.cdc.gov/tb/publications/factsheets/testing/IGRA.pdf. Accessed on Jan 14, 2019
Gupta KB. Challenges in diagnosis and treatment of latent tuberculosis infection. Indian J Tuber 2012: 59:1-5.