{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:45:44Z","timestamp":1793295944211,"version":"4.5.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis infection affects an estimated one-quarter of the global population and represents a key target for TB elimination strategies. While interferon-gamma release assays (IGRAs) such as QuantiFERON-TB Gold Plus (QFT-Plus) are WHO-endorsed, they remain logistically complex in low-resource settings. This study evaluates the performance of the AFIAS IGRA-TB, a qualitative fluorescence immunoassay (FIA), compared to QFT-Plus in Paraguay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional diagnostic accuracy study was conducted from January to May 2025 among 210 individuals aged 18\u201359\u202fyears within the Barrio Obrero healthcare network in Asunci\u00f3n, Paraguay. Participants were stratified into three TB risk groups: low-risk (no known exposure), high-risk (close contacts and incarcerated individuals), and active TB cases. Blood samples were tested with both AFIAS and QFT-Plus assays. Discordant results were retested after six to eight weeks. Concordance was assessed using Cohen\u2019s Kappa; quantitative correlations and ROC curves were also analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 210 participants, 75.2% were male. Overall positivity rates were 38.5% for QFT-Plus and 37.0% for AFIAS, with an agreement of 89.0% (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u202f=\u202f0.767;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001). Strong concordance was observed in high-risk groups. Among 23 discordant cases, retesting confirmed the initial AFIAS result in 5 cases and QFT-Plus in 3; 7 remained discordant. Spearman correlation showed strong, significant association between quantitative values. ROC analysis yielded an AUC of 0.890 for AFIAS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AFIAS IGRA-TB demonstrates comparable performance to QFT-Plus with operational advantages, suggesting it is a viable diagnostic alternative for TB infection, particularly in decentralized or resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1729859","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:30:09Z","timestamp":1768285809000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Performance evaluation of the AFIAS IGRA-TB (IFN-gamma) test versus QuantiFERON\u00ae-TB gold plus (QFT\u00ae-Plus) ELISA in the Barrio Obrero hospital network, Asunci\u00f3n\u2014Paraguay, 2025"],"prefix":"10.3389","volume":"13","author":[{"given":"Cynthia","family":"C\u00e9spedes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Riveros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Villalba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Ocampo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad\u00e1n","family":"Godoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarita","family":"Aguirre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9lica","family":"Medina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Sequera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref1","volume-title":"Global tuberculosis report 2024","year":"2024"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e1002152","DOI":"10.1371\/journal.pmed.1002152","article-title":"The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling","volume":"13","author":"Houben","year":"2016","journal-title":"PLoS Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/j.1440-1843.2009.01673.x","article-title":"Stopping tuberculosis in the 21st century: goals and strategies","volume":"15","author":"Onozaki","year":"2009","journal-title":"Respirology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1183\/09031936.00120908","article-title":"LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement","volume":"33","author":"Mack","year":"2009","journal-title":"Eur Respir J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1183\/09031936.00196608","article-title":"Evaluating the non-tuberculous mycobacteria effect in the tuberculosis infection diagnosis","volume":"35","author":"Latorre","year":"2010","journal-title":"Eur Respir J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/1471-2334-14-258","article-title":"Correlation between tuberculin skin test and IGRAs with risk factors for the spread of infection in close contacts with sputum smear positive in pulmonary tuberculosis","volume":"14","author":"de Souza-Galv\u00e3o","year":"2014","journal-title":"BMC Infect Dis"},{"key":"ref7","year":"2025"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"220226","DOI":"10.1183\/20734735.0226-2022","article-title":"Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries","volume":"18","author":"Vasiliu","year":"2022","journal-title":"Breathe"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s41479-024-00133-z","article-title":"Early detection of tuberculosis: a systematic review","volume":"16","author":"Yayan","year":"2024","journal-title":"Pneumonia (Nathan)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"805","DOI":"10.7196\/SAMJ.5851","article-title":"Implementation of Xpert MTB\/RIF for routine point-of-care diagnosis of tuberculosis at the primary care level","volume":"102","author":"Clouse","year":"2012","journal-title":"S Afr Med J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"21247","DOI":"10.1038\/s41598-020-77504-1","article-title":"Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay","volume":"10","author":"Sequera","year":"2020","journal-title":"Sci Rep"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e0148624","DOI":"10.1128\/jcm.01486-24","article-title":"Standard E TB-Feron ELISA and Standard F TB-Feron FIA positivity rates and agreement with QuantiFERON-TB gold plus among TB high-risk population in Bandung, Indonesia","volume":"63","author":"Turbawaty","year":"2025","journal-title":"J Clin Microbiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"100518","DOI":"10.1016\/j.jctube.2025.100518","article-title":"Diagnostic accuracy study of STANDARD TB-Feron FIA and STANDARD TB-Feron ELISA tests for tuberculosis infection diagnosis in eastern European setting","volume":"39","author":"Crudu","year":"2025","journal-title":"J Clin Tuberc Other Mycobact Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1729859\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:30:09Z","timestamp":1768285809000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1729859\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":13,"alternative-id":["10.3389\/fpubh.2025.1729859"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1729859","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]},"article-number":"1729859"}}