In December, 2010, WHO announced the official endorsement of the new Xpert molecular technology.

Xpert MTB/RIF has been described by many as a revolutionary breakthrough in the fight against TB. Xpert MTB/RIF detects M. tuberculosis as well as Rifampicin-conferring resistant mutations and provides results within 100 minutes. It is an automated cartridge-based Nucleic Acid Amplification Test (NAAT) for TB based on the GeneXpert multi-disease platform.

It is fast, cheap and easy and can be performed by lab personnel with less expertise and in a setting outside of the conventional laboratory.

WHO HQ encouraged countries with possible high burden of MDR cases to adopti and Implement the Xpert MTB/RIF by providing a Rapid Implementation guide; in Nigeria, through the TBCARE consortium the National TB control programme to prioritize the adoption of this technology.

In collaboration with KNCV Tuberculosis Foundation within the TBCARE 1 consortium, WHO Nigeria supported the National TB and Leprosy Control Programme to introduce this molecular test in the country in a multi country TBCARE project support.

With the support of the technical assistance of WHO and funding from TBCARE 1 project, 8 Xpert machines were installed in 8 health care institutions including the Nigeria Institute of Medical Research (NIMR), National TB and Leprosy Training Centre (NTBLTC), Zaria, Mainland hospital, Lagos, Chest Hospital, Jericho, Ibadan, Central Hospital, Benin, Zankli Medical Centre, Abuja, St Patrick's Hospital, Abakaliki and State Specialist Hospital, Gombe.

Results

Preliminary assessment of progress has shown the technology to provide the opportunity for setting up routine Drug Resistance TB (DR-TB) surveillance system in the country..

At the end of December, 2011, a total of 113 tests were conducted from 6 of the sites which reported, out of which 24 (21%) are Rifampicin resistant.

The challenge now is the provision of DR-TB treatment and care for these Rifampicin resistant cases that have been diagnosed. The NTBLCP through TBCARE 1 and Institute for Human Virology Nigeria (IHVN), Principal Recipient for DR-TB of Round 9 Global Fund grant have procured Second Line Drugs (SLD) for 110 patients. However, the country needs more admission centres for the management of these patients.