Tuberculosis (TB) is the second leading cause of death from a single infectious agent worldwide. Bangladesh ranks 7th among the 30 high TB burdened countries in the world. Accurate detection of Mycobacterium tuberculosis complex (MTBC) is challenging for developing countries as most of the resource-poor settings are not suitable for performing molecular techniques. The purpose of the study was to compare the multiplex TB-LAMP assay with MTB/NTM qPCR, culture, Z-N staining, and fluorescence microscopy in order to assess the effectiveness of the LAMP assay for detecting cases of pulmonary tuberculosis. This research work was done from March 2022 to February 2023. Fulfilling the inclusion criteria 130 sputum samples were collected. TB-LAMP assay, qPCR, culture in L-J media, Z-N staining, and fluorescence microscopy were performed. Out of 130 samples qPCR detected MTBC in 56.92 % cases, and TB-LAMP detected 53.85 %. MTBC was detected by culture 46.15 %, by Fluorescence microscopy 40.77 %, and Z-N staining 36.92 %. TB-LAMP detected 16.93 % more cases than Z-N staining and 13.08 % more cases than fluorescence microscopy. The sensitivity, specificity, positive, and negative predictive values of multiplex-LAMP assay were 95 %, 81.4 %, 81.4 %, and 95 %, respectively considering culture as a gold-standard. MTBC negative culture samples (18.57 %) showed positivity by LAMP assay as well as by qPCR. This study detected 7.69 % non-tuberculous mycobacteria (NTM) by qPCR. All NTM positive samples were negative by TB-LAMP. TB-LAMP is an easy to perform, cost-effective, reliable assay with high sensitivity and specificity. World Health Organization recommended TB-LAMP as a rapid molecular test for rapid detection of tuberculosis and as replacement of microscopy in resource poor settings/hard to reach areas. Bangladesh being a high TB burden country it is essential to implement TB-LAMP to achieve End TB Strategy by 2035.

Md. Zaber is an Assistant Professor in the Department of Microbiology at Gazi Medical College, Khulna, Bangladesh. He holds an MBBS degree from Mymensingh Medical College and an MD in Microbiology from Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. With 5 years of research experience in microbiology and 2 years of teaching experience, Md. Zaber specializes in optimizing culture conditions for bacterial isolation, understanding molecular technologies for organism detection, and analyzing antimicrobial resistance patterns. His research also focuses on detecting cytokine levels for COVID-19 diagnosis and identifying Mycobacterium TB and NTM.