Insight into the epidemiology of laboratory confirmed human tuberculosis in Ibadan, Nigeria.

Nigeria being one of the leading nations with the highest burden of tuberculosis (TB) urgently needs more impetus in the diagnosis of this disease judging from the increased incidence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). As culture of mycobacteria provides the definitive diagnosis of TB, this study reviews its use in the confirmation of laboratory samples from patients presented at different clinics in Ibadan from April, 2004 to April, 2008. Fine needle aspirates, sputum and stool samples were collected from suspected tuberculous patients who were either seropositive or negative for HIV. The samples were processed and cultured using the Lowenstein Jensen media. Samples from 1, 992 patients were processed (males=892 and females=1100; age range=1 week old to 90 years); and from these, 19.9% (396/1992) were positive for TB. The result showed that culture was a useful tool for the confirmation of mycobateria in TB patients, those coinfected with TB/HIV as well as those suffering from tuberculous lymphadenitis. This work also shows its usefulness in the diagnosis of TB in children using stool samples. Despite the inherent limitations of culture, its optimisation will however be useful in handling complicated problems ofTB associated with HIV, multi drug resistance-TB (MDR-TB) and several cases of extrapulmonary TB which makes smear microscopy insensitive and non-specific. Finally, there is an urgent need to upgrade all the TB laboratories in the country to include culture and other modem diagnostic techniques that will facilitate prompt and efficient diagnosis of the disease and accelerate its control.