In addition to improving diagnostics, therapeutics, and prevention, the fourth key aspect of TB control is controlling transmission. Genomic epidemiology has increased the precision with which we can monitor TB transmission in our local populations. However, major challenges arise when trying to adapt TB genomic surveillance to the new needs that arise in the current epidemiological scenario under the influence of global migration. In this project, we aim to launch an advanced genomic epidemiology strategy prepared to respond to these new major challenges. Our project will be articulated in four different observational settings, both in Europe and Latin America, which represent key pieces in the international migration phenomenon. In Europe, we will focus on i) obtaining a reference genomic catalogue of the sequences of M. tuberculosis strains identified at one systematic/structural entry point (Spain) for multinational migration from Africa and Latin America ii) assessing the impact of a sudden circumstantial new entry point (Poland) for uninational migration due to the Russian invasion on Ukraine. Regarding Latin America, we will focus on: i) identifying the more prevalent and/or MDR/XDR strains circulating in a country of origin (Peru) of the LA-Europe migration axis and ii) studying the transnational circulation of strains at different cross-border settings shared by three countries (Brazil, Uruguay and Argentina). In order to tackle TB transmission in all these models of transmission linked to migration, we will implement an innovative analytical package consisting of: transnational integrated genomic analysis, latest-generation rapid sequencing, and the development and distribution to all partners of low-cost tests to facilitate prospective tracking of risk strains. A training program will be coupled to the research activity to enhance the preparation of the professionals responsible for genomic surveillance of TB in both regions.
