Country of origin and performance for clinical samples evaluated in the current study using the reporter enzyme fluorescence (REF) diagnostic assay. (A) Pie chart showing the percentage of total suspected tuberculosis cases analyzed using REF to identify tuberculosis (REFtb) from each country. Unknown indicates that no data are available for country of origin for those samples. The majority of samples were obtained from Vietnam (102, 64%), with Mexico (12, 8%) second and Bhutan third (9, 6%). (B) Receiver operating characteristic (ROC) curve analyzing all 160 samples for specificity and sensitivity of REFtb diagnosis against smear and culture diagnosis. The ROC curve was generated by plotting the sensitivity versus 1 − specificity using different cutoff points, giving an area under the curve of 76.27% (P = 0.0002).