Tuberculosis (TB)

Use of tuberculosis interferon-gamma release assays (IGRAs) in low- and middle-income countries

Policy statement


Publication details

Number of pages: 70
Publication date: 2011
Languages: English
ISBN: 978 92 4 150267 2
WHO reference number: WHO/HTM/TB/2011.18



The majority of IGRA studies have been performed in high-income countries and mere extrapolation to low- and middle-income settings with high background TB infection rates is not appropriate. Systematic reviews have suggested that IGRA performance differs in high- versus low TB and HIV incidence settings, with relatively lower sensitivity in high-burden settings. The WHO Stop TB Department (WHO-STB) therefore commissioned systematic reviews on the use of IGRAs in low- and middle-income countries, in pre-defined target groups, with funding support from the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and TREAT-TB/The Union. The target groups and major findings of the GRADE evidence synthesis process are summarised below.

This Policy Statement applies to the use of commercial IGRAs in low- and middle-income countries only. Several international guidelines on IGRA use in high-income countries are available. This Policy Statement is not intended to apply to high-income countries or to supersede their national guidelines.