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

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

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1204064

DOI=10.3389/fpubh.2023.1204064

ISSN=2296-2565

ABSTRACT=<p>Targeted next-generation sequencing (tNGS) from clinical specimens has the potential to become a comprehensive tool for routine drug-resistance (DR) prediction of <italic>Mycobacterium tuberculosis</italic> 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.</p>