A novel transnational strategy to control highrisk tuberculosis transmission events

Publishable summary: 

Molecular epidemiology has transformed our knowledge of how tuberculosis (TB) is transmitted. However, strategies combining maximum discriminatory power and high speed of identification of transmission events are needed. The aim of this project is to develop a novel strategy for more efficient surveillance and control of the transmission of TB by reconciling both requirements through integration of high resolution whole genome sequencing data and the speed and transferability of PCR-based designs. The project is based on a 2part strategy: first, identification of the most relevant TB transmission events in the populations covered by the Latin American and European partners, namely, active transmission involving migrants, vulnerable populations, and highrisk transmission of MDR/XDR strains, and second, development of novel, strain-specific molecular tools tailored from whole genome sequencing data to track the transmission of those strains in situ. The proposal will evaluate the impact on TB control programs of integrating realtime information to specifically track the most actively transmitted and highestrisk strains in very challenging epidemiological contexts. The added value of the project takes the form of scientific-technical transfer between the nodes, improved wellbeing of vulnerable populations, and cost savings by directing genotyping and chanelling resources towards the more relevant transmission events. We propose an alternative model for surveillance of transmission of TB based on a transnational network of laboratories sharing novel molecular tools tailored to the specific demands of transmission at each node.