Frontiers in Public Health (Aug 2023)

Implementation of targeted next-generation sequencing for the diagnosis of drug-resistant tuberculosis in low-resource settings: a programmatic model, challenges, and initial outcomes

  • Leonardo de Araujo,
  • Andrea Maurizio Cabibbe,
  • Lusia Mhuulu,
  • Nunurai Ruswa,
  • Viola Dreyer,
  • Azaria Diergaardt,
  • Gunar Günther,
  • Gunar Günther,
  • Mareli Claassens,
  • Christiane Gerlach,
  • Christian Utpatel,
  • Daniela Maria Cirillo,
  • Emmanuel Nepolo,
  • Stefan Niemann,
  • Stefan Niemann

DOI
https://doi.org/10.3389/fpubh.2023.1204064
Journal volume & issue
Vol. 11

Abstract

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Targeted next-generation sequencing (tNGS) from clinical specimens has the potential to become a comprehensive tool for routine drug-resistance (DR) prediction of Mycobacterium tuberculosis complex strains (MTBC), the causative agent of tuberculosis (TB). However, TB mainly affects low- and middle-income countries, in which the implementation of new technologies have specific needs and challenges. We propose a model for programmatic implementation of tNGS in settings with no or low previous sequencing capacity/experience. We highlight the major challenges and considerations for a successful implementation. This model has been applied to build NGS capacity in Namibia, an upper middle-income country located in Southern Africa and suffering from a high-burden of TB and TB-HIV, and we describe herein the outcomes of this process.

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