23 May, Antananarivo, Oxford, Cambridge, New York – Scientists in Madagascar have for the first time performed DNA sequencing in-country using novel, portable technology to rapidly identify the bacteria responsible for tuberculosis (TB) and its drug resistance profile. The project, led by an ambitious, global team of doctors and scientists from Madagascar’s National TB Program, Institute Pasteur Madagascar, University of Oxford, European Bioinformatics Institute (EMBL-EBI) and Stony Brook University, is seeking to transform the surveillance, diagnosis and treatment of TB and other infectious diseases in Madagascar.

TB is a devastating disease, which affected 59,000 Malagasy patients and killed about 13,000 of them in 2016 (WHO, 2017). Drug resistant strains circulate in the country and the National TB Program along with its partners have been driving new methods to rapidly identify and interrupt the spread of the disease in Madagascar. 

Beyond performing DNA sequencing on samples submitted to the national reference laboratory for TB, the team partnered with TB clinics in the country to evaluate the ability to perform these analyses outside the labs or “in the field”. To achieve public health impact, their objective is to bring TB DNA sequencing closer to the patients for rapid diagnosis.

“This exercise has provided evidence that we can identify TB and its drug resistance properties using real time DNA sequencing technology,” explains Dr Niaina Rakotosamimanana, from Institut Pasteur de Madagascar. “We have done this in the lab and are doing more development towards providing this in a rural setting without traditional lab facilities and very limited resources. This is exactly where technology is needed – close to where the TB outbreaks are actually taking place.”

“The traditional diagnostic pathway for TB is slow and expensive; previous diagnosis methods take a couple of months,” says Zamin Iqbal, Research Group Leader at EMBL-EBI. “There is an urgent need for rapid screening and diagnosis of drug-resistant TB. Our work in Madagascar can pave the way for similar projects in other countries where TB has a huge human and economic impact.”

 

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