Tuberculosis (TB)

Webinar Series 2019: Next-generation sequencing for DR-TB

Next-generation sequencing (NGS) has great potential as a method for rapidly diagnosing drug-resistant tuberculosis (DR-TB) in diverse clinical reference laboratory settings worldwide. The NGS approach overcomes many of the significant challenges associated with conventional phenotypic testing as well as the limitations of other less comprehensive molecular tests by providing rapid, detailed sequence information for multiple gene regions or whole genomes of interest. However, the uptake of these technologies for DR-TB diagnosis has been hindered by concerns regarding costs, integration into existing laboratory workflows, technical training and skill requirements for utilization of the technology, and the need for expert guidance regarding the management and clinical interpretation of sequencing data.

  • WEBINAR 1: 5 February 2019

    Basic principles, practices, and guidance

    • - 2018 WHO Technical Guide on NGS for DR-TB. Christopher Gilpin, WHO (access presentation here, and WebEx recording here)
    • - Implementing WGS and Culture-free NGS: An Overview of Challenges and Solutions. Timothy Rodwell, FIND (access here)
    • - Webinar 1 - Q&A Session

    WEBINAR 2: 12 February 2019

    Interpreting Mutations for Clinical Diagnosis of DR-TB

    • - Using a confidence graded mutation list to predict DR-TB phenotypes. Paolo Miotto, Ospedale San Raffaele (access presentation here)
    • - Using WGS data to predict DR-TB phenotypes: A CRyPTIC experience. Timothy Walker, University of Oxford (access here)
    • - Standardized clinical reporting of sequencing data for DR-TB diagnosis. Angela Starks, CDC (access here)
    • - Access WebEx recording of the session here.
    • - Webinar 2 - Q&A Session

    WEBINAR 3: 19 February 2019

    Applications, protocols, and workflows

    • - Sequencing workflows. Andrea Cabibbe, Ospedale San Raffaele (access presentation here)
    • - Clinical use of sequencing and DR-TB epidemiology studies: The Borstel experience. Stefan Niemann/Thomas Kohl, Research Center Borstel (access here)
    • - Using WGS and targeted NGS for surveillance of DR-TB: The WHO experience. Anna Dean, WHO (access here)
    • - Access WebEx recording of the session here.
    • - Webinar 3 - Q&A Session

    WEBINAR 4: 26 February 2019

    Implementation and Utility of Sequencing: Experience from early implementers

    • - Madagascar experience with Minion. Simon Grandjean Lapierre, Université de Montréal hospital and research center (access presentation here)
    • - India experience with Pyrosequencing. Camilla Rodriguez, Hinduja Hospital, Mumbai, India (access here)
    • - UK experience with scale up of WGS at the national level. Derrick Crook, Public Health England, University of Oxford, Oxford University Hospitals FT trust (access here)
    • - Access WebEx recording of the session here.
    • - Webinar 4 - Q&A Session

Key topics

Early TB detection

Too many people have undetected TB for too long; late detection of TB increases their risk of transmitting the disease to others, having poor health outcomes, or that they and their family will suffer distress and economic hardship. Progress in controlling TB and mitigating its consequences can be expedited through early diagnosis and treatment.

Diagnostics and laboratory strengthening

A high-quality laboratory system that uses modern diagnostics is a prerequisite for the early, rapid and accurate detection of TB and drug resistance. WHO has established a structured, systematic process to rapidly review the evidence base for new TB diagnostics, ensuring that new tools meet the required performance standards.

Active case finding/systematic screening

Systematic screening for active TB is defined as the systematic identification of people with suspected active TB, in a predetermined target group, using tests, examinations or other procedures that can be applied rapidly.

Contact investigation

Tuberculosis contacts are people who have close contact with patients with infectious TB. As they are at high risk for infection (and in line with the End TB strategy), TB contacts should be investigated systematically and actively for TB infection and disease.

Outbreak management and air travel

The transmission of airborne infections between people in confined spaces such as aircraft cabins is of particular concern to health officials and the general public.

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