Tuberculosis remains the major public health concern worldwide responsible for about 1.6 million deaths and 0.3 million co-infected with Human immunodeficiency virus (HIV) annually. Mycobacterium is the causative agent of tuberculosis infection and is transmitted principally through air when an infected person coughs, talks, sneezes etc. This infection can be diagnosed using different Microbiological, Molecular and Immunological techniques including, sputum smear microscopy, sputum culture, nucleic-acid amplification test (NAAT), genotyping assay, tuberculin skin test (TST), interferon-gamma release assay (IGRAs) etc. These techniques vary in sensitivity and specificity as well as the ease with which they are carried out. World Health Organisation (WHO) encourages the use of techniques that are sensitive, patient-friendly, and those which produce accurate results in any clinical setting world-wide. Hence, this review highlights smear microscopy and incorporation of more rapid and sensitive diagnostic techniques such as Gene Xpert, IGRAs and urinary antigen analysis in clinical setting in the detection of Mycobacterium. These techniques show high sensitivity, are less time consuming do not require a repeat for a single result,  some are able to differentiate latent and active TB infections, and have the capacity to be  used to screen people unable to expectorate. This review encourages the incorporation of smear microscopy, GeneXpert, IGRAs, urinary antigen analysis into routine laboratory diagnosis especially in high TB burden countries. It is believed that high level of sensitivity and less time used in producing results display by these techniques will yield reduction in mortality rate, decline in static nature of TB status and possibly zero TB 2020 proposed by WHO.

Although, different plant extracts have frequently been used singly and in combinations in folklore treatment of different ailments, the hidden truth behind their activity and efficacy is still to be fully scientifically established.  Aim: To evaluate the effects of combined 50% methanol extracts of Euphorbia abyssinica (Desert Candle), and Coleus sp. on Candida albicans, Trichophyton mentagrophytes, Microsporum gypseum and Epidermophyton floccossum. Study Design: The completely randomised block design, two-way analysis of variance was used to analyse the data and Duncan’s New Multiple Range Test, for mean separation. Place and Duration of Study: The research was carried out in the Department of Microbiology, University of Nigeria Nsukka, Enugu State, Nigeria, between April 2011 and August 2012. Methodology: All the fungal strains used in the research were collected from the University of Nigeria Teaching Hospital Enugu, Nigeria. Susceptibility testing was done using a pour-plate method, while the checkerboard and Time-kill assays were employed to evaluate the efficacy of the different combinations of the two plant extracts. Results: The individual plant extracts inhibited all the fungal strains tested at different concentrations; but Coleus sp. extracts were observed to be more active than Euphorbia abyssinica extracts. The extract combinations inhibited the test fungi for more than two weeks. In the Time Kill assay, the combinations showed synergy on E. Floccossum only.  It showed additive or antagonistic activity on the rest of the fungi tested. The Checkerboard combinations showed synergy on T. mentagrophytes, M. gypseum, and E. foccossum. Epidermophyton foccosum was the most susceptible among the fungi tested while C. albicans was the least susceptible. The control drug voriconazole also inhibited all the fungi tested. Significant antifungal activity (P=0.05) was observed in the checkerboard assay more than in the Time Kill assay. Conclusion: These findings simply authenticate some of the folklore claims that these plants have a wide range of curative uses, suggesting that they can be used as alternative sources of agents for the treatment of resistant fungal infections.

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