Translating genomics research into control of MDR tuberculosis: Lessons learned and future prospects

Abstract

Abstract: The global MDR-TB caseload is increasingly driven by primary transmission of MDR-TB in high burden countries. Control will require interruption of transmission through earlier detection, effective outbreak investigation, detailed resistance testing to guide tailored treatment for patients with highly resistant TB and development and rapid access to better drugs. Genomics research and the application of technologies enabled through genomic research and technological innovation can play a critical role in each of these areas. Early diagnosis is facilitated through rapid and sensitive molecular detection of resistance-conferring mutations, real-time whole genome sequencing is now being used to target outbreak investigation and to rapidly identify resistance to second-line drugs and drug development has been enabled through the development of sophisticated screening methods supported by genomic tools. However, the promise of the genomic revolution has not yet been translated to more effective control of MDR-TB, and significant obstacles and gaps in knowledge remain. This presentation will highlight recent advances in this area, describe where existing genomic technologies are already being applied in MDR-TB programmes and identify key knowledge gaps that remain.