{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:17:56Z","timestamp":1787840276886,"version":"build-2784847793"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective\/Background:<\/jats:title>\n                    <jats:p>\n                      Global indices show that Nigeria has the highest tuberculosis (TB)-related mortality rate. Overdependence on Ziehl\u2013Neelsen (ZN) smear microscopy for diagnosis and human immunodeficiency virus (HIV)\/AIDS has limited control efforts. The new polymerase chain reaction-based XpertMTB\/Rif (Cepheid Inc., CA, USA), which detects\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      and rifampicin resistance, was introduced in Cross River State in 2014. We evaluated the increment in pulmonary TB case detection following introduction of XpertMTB\/Rif into the Cross River State TB control program.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Data from three XpertMTB\/Rif centers in Cross River were prospectively collected from June 2014 to December 2015. One spot specimen and one early morning sputum specimen were collected from each patient and tested using microscopy while one specimen was used for XpertMTB\/Rif.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 2326 patients comprising 47.4.0% (1103) males and 52.6% (1223) females were evaluated. Their mean age was 38.8 years (range 4\u201389 years); 42.6% (991) were HIV positive and 50.9% (1183) HIV negative, and for 6.5% (158) HIV status was unknown. XpertMTB\/Rif detected\n                      <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                      in 22.9% (534) of patients, while 16.8% (391) were ZN smear positive. Smear microscopy missed 24.5% (131\/534) of cases (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). When patients where categorized according to HIV status, XpertMTB\/Rif detected 23.7% (280\/1183) and ZN smear microscopy detected 18.5% (219\/1183) of HIV-negative patients. XpertMTB\/Rif detected 21.5% (213\/991) and ZN smear 14.1% (140\/991) of HIV-positive patients. TB case detection was significantly higher in HIV-negative patients than in HIV-positive patients when either XpertMTB\/Rif and\/or ZN was used (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018 and 0.012, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The use of XpertMTB\/Rif has significantly increased TB case detection and data in Cross River State. Scale-up of additional strategies such as culture is still required to improve TB detection in HIV patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/2212-5531.201890","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T11:07:10Z","timestamp":1495105630000},"page":"94-96","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of Pulmonary Tuberculosis Case Detection Improvement with the Deployment of XpertMTB\/Rif in the Tuberculosis Control Program of Cross River State, Nigeria"],"prefix":"10.4103","volume":"6","author":[{"given":"Ernest Afu","family":"Ochang","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ubleni E.","family":"Emanghe","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atana","family":"Ewa","sequence":"additional","affiliation":[{"name":"Departments of Paediatrics, University of Calabar, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akaninyene","family":"Otu","sequence":"additional","affiliation":[{"name":"Departments of Internal Medicine, University of Calabar, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonah B.","family":"Offor","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Buruli and Leprosy Control Programme, Cross River State Ministry of Health, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micheal","family":"Odo","sequence":"additional","affiliation":[{"name":"Family Health International 360, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniekan","family":"Etokidem","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, University of Calabar, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barinadaa","family":"Afirima","sequence":"additional","affiliation":[{"name":"Family Health International 360, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oju Eni","family":"Owuna","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Buruli and Leprosy Control Programme, Cross River State Ministry of Health, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunday M.","family":"Obeten","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, Buruli and Leprosy Control Programme, Cross River State Ministry of Health, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Meremikwu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, University of Calabar, Calabar, Nigeria"},{"name":"Institute of Tropical Disease Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-20250603","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijmyco.2013.04.007","article-title":"Evaluation of Ziehl-Neelsen smear for diagnosis of pulmonary tuberculosis in childhood in a rural hospital in Ethiopia","volume":"2","author":"Ramos","year":"2013","journal-title":"Int J Mycobacteriol"},{"key":"R4-20250603","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1056\/NEJMoa0907847","article-title":"Rapid molecular detection of tuberculosis and rifampin resistance","volume":"363","author":"Boehme","year":"2010","journal-title":"N Engl J Med"},{"key":"R5-20250603","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1093\/cid\/cis190","article-title":"Increased and expedited case detection by Xpert MTB\/RIF assay in childhood tuberculosis: A prospective cohort study","volume":"54","author":"Rachow","year":"2012","journal-title":"Clin Infect Dis"},{"key":"R8-20250603","doi-asserted-by":"crossref","first-page":"482","DOI":"10.3201\/eid2203.151227","article-title":"Decreased time to treatment initiation for multidrug resistant tuberculosis patients after use of Xpert MTB\/Rif test, Latvia","volume":"22","author":"Stagg","year":"2016","journal-title":"Emerg Infect Dis"},{"key":"R9-20250603","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa055524","article-title":"Microscopic-observation drug-susceptibility assay for the diagnosis of TB","volume":"355","author":"Moore","year":"2006","journal-title":"N Engl J Med"},{"key":"R10-20250603","doi-asserted-by":"crossref","first-page":"e63170","DOI":"10.1371\/journal.pone.0063170","article-title":"Prevalence of non-tuberculous mycobacterial infections among tuberculosis suspects in Nigeria","volume":"8","author":"Aliyu","year":"2013","journal-title":"PLoS One"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01929415-201706010-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:19:06Z","timestamp":1787836746000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01929415-201706010-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.4103\/2212-5531.201890","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]}}}