Next-Generation Tuberculosis Diagnostics: A Detailed Review of Emerging Tools and Global Trends

ABSTRACT: Tuberculosis (TB), caused by Mycobacterium tuberculosis, continues to be one of the world’s most serious infectious diseases, with millions of new cases and deaths annually. Timely and accurate diagnosis remains a cornerstone for effective management and control. Conventional approaches such as sputum smear microscopy, chest radiography, and culture media still play an important role, particularly in resource-limited settings, but are limited by sensitivity, specificity, and turnaround time. Immunological tests, including the tuberculin skin test and interferon-gamma release assays, have been widely used but struggle to differentiate between latent and active infection. Recent advances in molecular and innovative diagnostic technologies—such as nucleic acid amplification tests (GeneXpert, TrueNAT), line probe assays, and polymerase chain reaction techniques—have greatly improved detection accuracy and drug resistance profiling. Emerging approaches, including next-generation sequencing, nanotechnology, biosensors, and artificial intelligence–based diagnostic tools, offer promising solutions for rapid, affordable, and decentralized testing. Despite significant progress, challenges remain regarding accessibility, affordability, and integration into healthcare systems. Strengthening diagnostic capacity through combined conventional and novel methods is essential to achieve effective TB control and move closer to global eradication goals.