弥合实施差距:将全基因组测序纳入低资源环境中的结核病监测中的挑战和机遇
Lisa Nkatha Micheni1, Sammy Wambua2, Karani Magutah3
1School of Health and Human Sciences, Pwani University, Kilifi, Kenya; Research Department, Zihi Institute, Nairobi, Kenya.
Diagnostic microbiology and infectious disease
|February 4, 2026
概括
全基因组测序 (WGS) 提供了强大的结核病 (TB) 监测,但在低收入国家面临采用障碍. 创新和协作策略是整合WGS的关键,以实现公平的全球结核病控制.
科学领域:
- 基因组监测是指基因组的监测.
- 传染病流行病学传染病流行病学
- 公共卫生基因组学
背景情况:
- 结核病 (TB) 是一个重要的全球卫生问题,不成比例地影响低收入国家.
- 在资源有限的环境中,有限的监测工具阻碍了有效的结核病控制.
- 全基因组测序 (WGS) 已在高收入国家建立,用于结核病监测,为传播,耐药性和疫情提供快速洞察力.
研究的目的:
- 审查目前用于结核病监测的WGS的使用情况.
- 确定阻碍WGS在资源有限的环境中采用WGS的障碍.
- 提出改善这些地区WGS采用的战略.
主要方法:
- 在PubMed,谷歌学者和世卫组织数据库中搜索文献.
- 关键词包括"全基因组测序"",结核病"",监测"",传播"和"耐药性".
- 优先考虑2015年至2025年间发表的研究,重点关注高负担设置.
主要成果:
- 主要挑战包括基础设施不足 (78%的高负担国家),高成本 (>150美元/样本在低资源环境下,高收入环境下为80美元),以及培训人员短缺 (2.3名生物信息学家/非洲国家).
- 其他障碍包括数据主权问题,软弱的监管框架以及与隐私和数据使用有关的伦理问题 (只有31%的低资源国家拥有基因组数据政策).
- 有前途的创新包括便携式测序设备 (高达92%的灵敏度) 和基于云的平台 (70%的计算减少),以及涉及世卫组织,全球基金会和南南合作伙伴关系的合作模式.
结论:
- 一个协调的方法,整合技术进步,政策变化,伦理数据治理和持续投资,对于WGS在结核病流行地区的实施至关重要.
- 应对这些挑战对于公平,基因组学知情的结核病控制与全球消除目标保持一致至关重要.
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