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Xpert MTB/RIF (Cepheid, https://www.cepheid. com) is a cartridge-based nucleic amplification assay for use with Cepheid's GeneXpert diagnostic instrument systems that detects both Mycobacterium tuberculosis complex (MTB) and resistance to rifampin [...]

Background Type 2 diabetes mellitus (DM) and HIV increase the risk of tuberculosis (TB). The frequency of DM among patients with TB with and without HIV is poorly documented in many low- and middle-income countries. Methods This was a cross-sectional hospital-based study performed in Abuja, Nigeria. Adults with presumptive TB were screened consecutively. Sputum culture was used for TB screening and blood was used for HIV screening, as well as fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) assessment for the diagnosis of DM. HbA1c was measured using the D-10 Haemoglobin Testing System and a point-of-care test (A1C Now+ system) for comparison. Patients were classified as having DM or pre-diabetes using the D-10 reference test. Results Four hundred and ten individuals had TB culture, FPG, and HbA1c results. Participants had a mean (± standard deviation) age of 37.8 ± 12.6 years and 217 (54.8%) were male. One hundred and thirteen (27.6%) patients were culture-positive, 62 (15.1%) had DM, and 46 (11.2%) had pre-diabetes. One hundred and eighty-four (53.3%) participants were HIV-positive and 95 (51.6%) were on antiretroviral therapy (ART). Patients with pre-diabetes and DM were more likely to have TB (odds ratio (OR) 1.94, 95% confidence interval (CI) 0.01–3.74, and OR 2.39, 95% CI 1.35–4.24, respectively). After adjustment for HIV, age, and sex, only DM was statistically associated with TB (adjusted OR (AOR) 3.10, 95% CI 1.62–5.94). HIV-negative patients with DM had a higher risk of TB (AOR 4.32, 95% CI 1.57–11.92) than HIV-positive patients with DM (AOR 3.31, 95% CI 1.29–8.54), but the difference was not statistically significant. A1C Now+ HbA1c measurements correlated poorly with the D-10 HbA1c reference test. Conclusion A high proportion of patients in Abuja have markers of DM and pre-diabetes at the time of TB diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Nigeria ranks fourth among the high tuberculosis (TB) burden countries. This study describes the prevalence of drug resistance and the genetic diversity of Mycobacterium tuberculosis in Abuja's Federal Capital Territory., Materials and Methods: Two hundred and seventy-eight consecutive sputum samples were collected from adults with presumptive TB during 2013-2014. DNA was extracted from Löwenstein-Jensen cultures and analyzed for the identification of nontuberculous mycobacteria species, detection of drug resistance with line probe assays, and high-throughput spacer oligonucleotide typing (spoligotyping) using microbead-based hybridization., Results: Two hundred and two cultures were positive for M. tuberculosis complex, 24 negative, 38 contaminated, and 15 positive for nontuberculous mycobacteria. Five (2.5%) M. tuberculosis complex isolates were resistant to rifampicin (RIF) and isoniazid (multidrug resistant), nine (4.5%) to RIF alone, and 15 (7.4%) to isoniazid alone; two RIF-resistant isolates were also resistant to fluoroquinolones and ethambutol, and one multidrug resistant isolate was also resistant to ethambutol. Among the 180 isolates with spoligotyping results, 164 (91.1%) were classified as lineage 4 (Euro-American), 13 (7.2%) as lineage 5 (West African 1), two (1.1%) as lineage 2 (East Asia), and one (0.6%) as lineage 6 (West African 2). One hundred and fifty-six (86.7%) isolates were grouped in 17 clusters (2-108 isolates/cluster), of which 108 (60.0%) were grouped as L4.6.2/Cameroon (spoligotype international type 61)., Conclusion: The description of drug resistance prevalence and genetic diversity of M. tuberculosis in this study may be useful for improving TB control in Nigeria., Competing Interests: Disclosure MKG and CS are among the founders of the Beamedex SAS company that produces and commercializes the spoligotyping (TB-SPOL) kit as a “Research Use Only” assay, to be run on Luminex 200 and on MagPix devices (Luminex Corporation, Austin, TX, USA). These authors held Beamedex shares during the study. However, CS does not hold any share in Beamedex anymore. MKG and CS also declare that they do not hold any share in Luminex Corporation nor were they financed by Luminex. The authors report no other conflicts of interest in this work.