Current laboratory diagnostics for tuberculosis: from conventional approaches to next-generation molecular and immunological technologies.

Tuberculosis (TB) remains a major global public health concern despite advances in diagnosis and treatment. Early and accurate diagnosis is essential for timely treatment initiation, interruption of transmission, and effective management of drug-resistant TB.Although microscopy and culture remain the cornerstones of TB diagnosis, their limited sensitivity and long turnaround times have driven the integration of molecular and immunological methods.This review summarizes current TB diagnostic approaches, including conventional methods, nucleic acid amplification tests (NAATs), line probe assay (LPA), next-generation sequencing (NGS), point-of-care systems, and interferon-gamma release assays (IGRAs).Emerging technologies, including host-response biomarkers, multi-omics approaches, artificial intelligence-based imaging, nanotechnology-based systems, and CRISPR/Cas-based diagnostics, are also discussed, with emphasis on their diagnostic performance, clinical applications, and current limitations.Current evidence indicates a shift from pathogen detection alone toward integrated approaches incorporating rapid molecular diagnosis, drug-resistance detection, host-response profiling, and immunological assessment.Future TB diagnostics are likely to increasingly rely on multimodal platforms combining molecular tools, host-response biomarkers, multi-omics data, and artificial intelligence to support more precise and clinically actionable TB management.