1.1 Introduction
The Nitrate Enzyme Depletion Analyzer (NEDA), an efficient response colorimetric method, requires simple tuberculosis culture equipment. The NEDA test is easy to use, reasonably priced, repeatable, and dependable. Therefore, it is still crucial to have a quick, inexpensive, reliable, and user-friendly test for Bacillus tuberculosis (BAC-TB) in Nigeria. As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of technical terms.
1.2 Background of Study
Globally, more people are dying from tuberculosis (TB) than from any other infectious disease. In 2011, 8.7 million cases of tuberculosis were estimated by the World Health Organization (WHO), of which 0.43 million deaths were linked to HIV infection and nearly 1 million deaths among HIV-negative cases (WHO, 2012). A total of 51% of cases were detected. The annual mortality rate from all forms of tuberculosis remains at 27 per 100,000 people (WHO, 2012). According to a 2012 survey, Nigeria had the highest tuberculosis burden in Africa and the world, ranking fourth overall. According to WHO (2012), the point estimates for the prevalence of tuberculosis (15 years of age and older) were 318 and 524 per 100,000 people, respectively.
Immune Bacillus tuberculosis (BAC-TB) Poly-Medication Immune is tuberculosis that is resistant to at least two of the most significant first-line medications, isoniazid (INH) and rifampicin (RIF), either with or without additional first-line medications. The national BAC-TB survey conducted in Nigeria revealed a prevalence of 14.3% for retreatment cases and 2.9% for new cases (WHO, 2012). There are currently 6 zonal and 2 national tuberculosis reference laboratories. For culture, most of these labs use Lowenstein-Jensen (LJ) medium, with liquid cultures being used sparingly.
In Africa, the most popular technique for identifying TB drug resistance is indirect susceptibility testing using LJ medium. For the purpose of managing and controlling tuberculosis effectively, it is imperative that MDR and XDR-TB cases be properly and promptly detected. Numerous methods have been developed and assessed for quick DST in recent years. The expense of initial investment and ongoing expenses, however, prevents these strategies from being widely used in resource-limited settings (RLSs) across Africa (Franzblau et al., 1998).
The absence of quick, accurate, and affordable methods for identifying M. tuberculosis is impeding global efforts to control tuberculosis, particularly in environments with limited resources. The conventional culture detection methods yield results that are too late to impact a prompt patient management decision. Early detection is essential for managing patients and preventing the spread of M. tuberculosis. Systems using liquid media, like the Bacillus Growth Indicator Tube (MGIT), are quicker and can identify a greater number of Bacillus isolates than LJ (Goloubeva et al., 2001). The TAT has been improved to roughly 25–45 days with the use of liquid systems, such as the MGIT 960. High biosafety buildings with continuous electricity and expensive equipment are necessary for liquid culture systems (Bouyer et al., 2000).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to assess the Nitrate Enzyme Depletion Analyzer Use in Patients with Poly-Medication Immune Bacillus Tuberculosis.
1.3 Statement of Problems
Studies highlight the shortcomings of previous research, including the lengthy turnaround time (TAT) of 10 to 12 weeks associated with the conventional method of detecting Poly-Medication Immune Bacillus Tuberculosis (BAC-TB) through indirect susceptibility testing. This method involves isolating the bacterium and then testing it for drug susceptibility (Golyshevskaia et al., 1996). Nigeria has long utilized molecular instruments like the Line Probe Assay (LPA), but these instruments are costly to operate and need continuous electricity. Thus, the need for quicker, less expensive, and more trustworthy testing is critical (Moore, 2006).
1.4 Aim and Objectives of Study
The aim of this research is to assess the Nitrate Enzyme Depletion Analyzer Use in Patients with Poly-Medication Immune Bacillus Tuberculosis. In achieving this aim, the following specific objectives were laid out as follows:
- To identify the drug susceptibility testing performed on Nitrate Enzyme Depletion Analyzer (NEDA);
- To detect the Poly-Medication Immune Bacillus Tuberculosis among Patients;
- To assess the process involved in Nitrate Enzyme Depletion Analyzer; and
- To evaluate Nitrate Enzyme Depletion Analyzer for detection of Poly-Medication Immune Tuberculosis compared to LJ proportion method, in Nigeria.
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