Tuberculosis (TB), a deadly contagious disease, is among the top three killer infectious diseases causing high mortality and morbidity worldwide.1 Tuberculosis infects one third of the world population with an estimated 8.7 million new cases and 1.4 million deaths each year (WHO, 2012)2. Prevention of tuberculosis has become more complex due to increasing resistance against several antibiotics, including rifampin. 3TB is a socioeconomic disaster that is occurring across the world, especially in Asia and Africa.4 Pakistan ranks 6th in terms of the estimated number of tuberculosis cases in the world. Health Organization (WHO) among high burden countries.5 It is the second leading cause of death of adults in poor communities of Pakistan.6Mycobacterium tuberculosis (MTB) is the main causative organism that attacks the lungs but can also infect other organs of the body . M.tuberculosis is an intracellular pathogen highly adapted to humans.7 The bacterium spreads primarily through aerosolized infectious particles generated by the coughing and sneezing of individuals with pulmonary tuberculosis and less commonly through skin wounds.8. The most important factors influencing the current tuberculosis epidemic in resource-poor settings are closely related to malnutrition, overcrowded conditions and lack of access to free or affordable healthcare services.9 Early diagnosis of tuberculosis is essential to limit the spread of Mycobacterium tuberculosis infection due to the primary route of infection in humans. Microscopic examination of sputum has remained the cornerstone of tuberculosis diagnosis in the global strategy to control the disease. 10 The global targets for tuberculosis control, adopted by the World Health Assembly, are to cure 85% of new smear positive tests detected T...... half of the document ......are Diagnostic accuracy statistics of ELISA reported in several studies were also established. 22,23 Regarding serology in extra-pulmonary tuberculosis, several studies regarding the detection of antibodies in Mycobacterium Tuberculosis have shown good results with high sensitivity and specificity.24 In a study comparing the conventional AFB smear method with the PCR technique for the detection of tuberculosis conducted in Sudan in 2004, showed that the microscopic sensitivity was 65% and the specificity was 90.5%, while the sensitivity of PCR was 88.5% and the specificity was by 98.6%. They concluded that although the sensitivity of PCR was 13.1% higher than smear microscopy.25 In a recent study, the diagnostic role of XpertMTB/RIF demonstrated a sensitivity of 98.2% and 72.5 % with smear-positive and smear-negative TB, respectively. The specificity of the tests was 99.2% in patients without tuberculosis. 26