Preventing Future Pandemic from Infectious Diseases

Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis which remains a global health problem to date. In 2021, Indonesia ranked 3rd in TB incidents after India and China, with an estimated > 800,000 new cases per year. Alarmingly, it is estimated that only 31% of TB cases were managed with appropriate and effective treatment in Indonesia. In addition, 3.4% of new cases and 18% of cases that have undergone TB treatment reportedly have the potential to become drug-resistant TB.

Drug resistance is a major global public health problem and control measures are needed to slow this problem. This however requires better understanding of the interplay between pathogens, drug resistance encoding genes, and mobile genetic elements at a microbial level.

Recent advancements in rapid and affordable DNA sequencing technologies is rapidly changing the landscape of diagnostic microbiology and microbial surveillance thanks to the availability of bioinformatics tools and online accessible databases. These tools make surveillance of the resistome (the genes associated with drug resistance) possible, and recent studies suggest that genomic data alone can be sufficient to predict drug resistance.

Culture-based microbiological diagnostics are widely used to improve the selection of treatment, but these tests are slow thus potentially leading to the use of inappropriate treatment. NGS-based diagnostic approaches will overcome these limitations and offer the prospect of improved outcomes.

Host innate immune genes are proposed to play an important role in shaping the first host/pathogen contact, in driving the subsequent response to Mycobacterium tuberculosis and in determining whether a host will be resistant or susceptible to infection. Understanding the host genomics factors associated with disease susceptibility. This will in turn enable the identification of those at high risk of disease and a focus on this target population for public health interventions

Vision

We aim to bring cutting-edge sequencing technology to the fight against TB in Indonesia both to strengthen surveillance at the population level and to improve patient outcomes at the individual level through personalized treatment based on pathogen genomics information.

Disease Target

Tuberculosis

Outcome

• Implementation of genomics-based testing of pathogen for treatment personalisation
• Identification of genomic prognostic/ predictive factors of infection