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

de Araujo, LeonardoLeonardode AraujoCabibbe, Andrea MaurizioAndrea MaurizioCabibbeMhuulu, LusiaLusiaMhuuluRuswa, NunuraiNunuraiRuswaDreyer, ViolaViolaDreyerDiergaardt, AzariaAzariaDiergaardtGünther, GunarGunarGüntherClaassens, MareliMareliClaassensGerlach, ChristianeChristianeGerlachUtpatel, ChristianChristianUtpatelCirillo, Daniela MariaDaniela MariaCirilloNepolo, EmmanuelEmmanuelNepoloNiemann, StefanStefanNiemann2024-10-252024-10-252023https://boris-portal.unibe.ch/handle/20.500.12422/169827Targeted 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.enGenomic diagnostic Genomic surveillance Mycobacterium tuberculosis complex (MTBC) NGS clinical use NGS programmatic implementation Next generation sequencing (NGS) high TB burden countries low- and middle-income countries600 - Technology::610 - Medicine & healthImplementation of targeted next-generation sequencing for the diagnosis of drug-resistant tuberculosis in low-resource settings: a programmatic model, challenges, and initial outcomes.article10.48350/1861363767467410.3389/fpubh.2023.1204064