ZIBELINE INTERNATIONAL PUBLISHING Matrix Science Medica Matrix sci. medica 2521-0424 2521-0807 DISCRIMINATING CAPACITY OF SERUM Α1-ANTITRYPSIN IN NIGERIAN TB CARE Copyright © 2017 zibeline international publishing https://doi.org/10.26480/msm.01.2026.05.09 Olawuyi Abdullahi Olaleye Olaniyan Mathew Folaranmi Ijeoma Evangeline Umeche Abdulwaheed Adewale Ademosun Adeosun O. Ganiyu Ademuyiwa Isaac Adewole Godfrey Innocent Iyare Olatunbosun Luqman Olayinka Busira Tijani Adesina Alpha-1 antitrypsin, Pulmonary tuberculosis, Diagnostic triage, Biomarker, Nigeria https://matrixscmedica.com/archives/1msm2017/1msm2026-05-09.pdf https://matrixscmedica.com/xml/1msm2017/1msm2026-05-09.xml 1 1 01-02 https://matrixscmedica.com/msm-01-2026-05-09/ Summary

α1-antitrypsin (A1AT) levels in active TB is not consistent and performance in routine Nigerian care is not well defined . A cross-sectional, three-arm case–control study with N = 75 (25 Non-TB; 25 NewDx; 25 Treated TB) was conducted. Serum A1AT measured by immunoassay. We compared groups via ANOVA and Welch post-hoc with Hedges g; and estimated ROC AUCs with bootstrap 95% CIs. A1AT was highest in NewDx TB (293.7 ± 73.9 mg/dL) vs Non-TB (151.5 ± 25.9) and Treated TB (160.0 ± 22.6); ANOVA p 0.001. Discrimination for Non-TB vs NewDx: AUC 0.928 (95% CI 0.833–1.000), threshold ~220 mg/dL, sensitivity 0.88, specificity 1.00; for Non-TB vs All-TB: AUC 0.772 (0.667–0.869), threshold ~167 mg/dL, sensitivity 0.68, specificity 0.80. In Nigerian care, A1AT provides excellent triage discrimination for newly diagnosed TB and moderate discrimination when treated cases are included. A1AT-guided referral to confirmatory testing warrants multi-site validation, quality assurance, and cost-effectiveness evaluation.