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How will new generation sequencing revolutionise tuberculosis treatment

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Robert McBride, Senior Director-Sales Asia Pacific and Japan, Illumina highlights that while current methodologies used pose challenges in providing a comprehensive picture of drug resistance, Next Generation Sequencing (NGS) overcomes these significant challenges associated with conventional and less comprehensive molecular tests

As per the WHO Global Tuberculosis Report 2021, India accounted for 41 per cent total cases drop of 1.3 billion globally between 2019 & 2020 due to COVID-19.[1]

India has been a home to a approx. 2.64 million tuberculosis cases.[2]  Currently, TB is one of the India’s most critical health challenges, which is disrupting health, financial and social consequences for patients and communities at large. It usually impacts active workers, resulting in lost income and catastrophic costs (costs that account for more than 20 per cent of household income)[3]

A major disease behind morbidity and mortality worldwide, which was further exacerbated by the COVID-19 pandemic. It has proved to be a disruption in essential health services and have unravel years of progress against tuberculosis (TB).

TB is mainly caused by Mycobacterium tuberculosis, which usually attacks the lungs. It is spread through air when people suffering from lung TB cough, sneeze, or spit. A person can get infected by inhaling only a few germs.

Routine TB drug resistance surveillance and drug-susceptibility testing (DST) are critical to combat the global TB epidemic In India, currently, early, and accurate diagnosis of TB is a major challenge. In 2020, there was overall 25 per cent of low detection rate due to COVID-19. Therefore, this has become more important as government aims to have a TB-free India by 2025, which is shorter as compared to the global target of 2030.

New generation sequencing: Accelerating detection for a TB free India

The Mycobacterium tuberculosis is a bacteria which causes TB and are extremely slow in growing, hence, making it possible to test them in a lab and helps analyse the effective treatment options. This can take as long as a month. However, with Next-generation sequencing (NGS) it can be accomplished in a few days. It enables accurate and high throughput decoding of Mycobacterium tuberculosis genetic information. While DST helps determine appropriate TB treatment regimes, NGS, can revolutionise universal access to accurate DST and routine TB drug resistance surveillance, which are critical to combat the global TB epidemics.

India TB report 2021 also specified that NGS test has been recommended by the central TB division as a preferred technology for TB.[4] to facilitate timely diagnosis and treatment. NGS has proven to be fast, sensitive, scalable, and culture-free DST method that provides a comprehensive anti-TB drug resistance profile.

Comprehensive care with NGS

While current methodologies used pose challenges in providing a comprehensive picture of drug resistance, NGS overcomes these significant challenges associated with conventional and less comprehensive molecular tests. NGS is perceived to be cost-effective than phenotypic DST for multiple drugs. It is currently the only approach that has the ability to scan through hundreds of genome-wide targets parallelly for rare mutations, and for resistance to multiple first and second-line anti-TB drugs. As a result, the right course of treatment can be initiated to combat that strain and reduce the spread of the disease whilst preventing drug resistance.

NGS is a critical tool to bridge the existing gaps to accelerate India TB care response to facilitate better TB prevention and treatment.

 

References:

[1] WHO Global Tuberculosis Report – 2021

[2] https://tbcindia.gov.in/showfile.php?lid=3587

[3] https://www.who.int/news-room/fact-sheets/detail/tuberculosis

[4] https://tbcindia.gov.in/showfile.php?lid=3587

 

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