ArticleThe Lancet. Infectious diseases2018
Genetic sequencing for surveillance of drug resistance in tuberculosis in highly endemic countries: a multi-country population-based surveillance study.
Article in The Lancet. Infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 67 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 2 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2019Guideline
- Global variation in bacterial strains that cause tuberculosis disease: a systematic review and meta-analysis.BMC medicine · 2018Pooled it
- Targeted next-generation sequencing of sputum for diagnosis of drug-resistant TB: results of a national survey in Democratic Republic of the Congo.Scientific reports · 2020Trial
- Algorithmic Determinants of Performance Heterogeneity in Whole-Genome Sequencing-Based Prediction of Drug Resistance inMicroorganisms · 2026Review
- Clinical Evaluation of a Tandem qPCR-CRISPR Assay for Multidrug-Resistant or Rifampicin-Resistant Tuberculosis: A Prospective Diagnostic Accuracy Study.Microorganisms · 2026Article
- Key impact of Beijing strains including new resistant clusters on spread of multidrug-resistant tuberculosis in northern Russia.Microbiology spectrum · 2026Article
- Exploring transmission dynamics in epidemiologically linked pulmonary tuberculosis cases and household contacts: a WGS-based investigation.BMC genomics · 2025Article
- Single-Sample Melt-Based Screening for Rifampicin Susceptibility in the Emerging Mutation Hotspot atACS infectious diseases · 2025Article
- Awareness of management of pulmonary multidrug-resistant tuberculosis (MDR-TB) among private practitioners in suburban areas of Pune city, India: Input for developing an educational tool.PLOS global public health · 2025Article
- Cost-effectiveness of targeted next-generation sequencing (tNGS) for detection of tuberculosis drug resistance in India, South Africa and Georgia: a modeling analysis.EClinicalMedicine · 2025Article
- Exploring gene mutations and multidrug resistance in Mycobacterium tuberculosis: a study from the Lung Hospital in Vietnam.Molecular biology reports · 2024Article
- Diagnostic Value of Targeted Next-generation Sequencing in Pulmonary Mycobacterial Infections.Current medical science · 2024Article
- The Next Frontier in Tuberculosis Investigation: Automated Whole Genome Sequencing forInternational journal of molecular sciences · 2024Article
- Estimation of country-specific tuberculosis resistance antibiograms using pathogen genomics and machine learning.BMJ global health · 2024Article
- Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study.Journal of epidemiology and global health · 2024Article
- Drug-Resistant Characteristics, Genetic Diversity, and Transmission Dynamics of Multidrug-ResistantInfection and drug resistance · 2024Article
- Patterns and profiles of drug resistance-conferring mutations inFrontiers in public health · 2024Article
- Rapid Diagnosis of Drug-Resistant Tuberculosis-Opportunities and Challenges.Pathogens (Basel, Switzerland) · 2023Review
- Designing molecular diagnostics for current tuberculosis drug regimens.Emerging microbes & infections · 2023Article
- Lineage classification and antitubercular drug resistance surveillance ofMicrobiology spectrum · 2023Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedCorrections.2018
Authors and funding
43 authors at 20 institutions in 14 countries.
Funding
Abstract
backgroundIn many countries, regular monitoring of the emergence of resistance to anti-tuberculosis drugs is hampered by the limitations of phenotypic testing for drug susceptibility. We therefore evaluated the use of genetic sequencing for surveillance of drug resistance in tuberculosis.
methodsPopulation-level surveys were done in hospitals and clinics in seven countries (Azerbaijan, Bangladesh, Belarus, Pakistan, Philippines, South Africa, and Ukraine) to evaluate the use of genetic sequencing to estimate the resistance of Mycobacterium tuberculosis isolates to rifampicin, isoniazid, ofloxacin, moxifloxacin, pyrazinamide, kanamycin, amikacin, and capreomycin. For each drug, we assessed the accuracy of genetic sequencing by a comparison of the adjusted prevalence of resistance, measured by genetic sequencing, with the true prevalence of resistance, determined by phenotypic testing.
findingsIsolates were taken from 7094 patients with tuberculosis who were enrolled in the study between November, 2009, and May, 2014. In all tuberculosis cases, the overall pooled sensitivity values for predicting resistance by genetic sequencing were 91% (95% CI 87-94) for rpoB (rifampicin resistance), 86% (74-93) for katG, inhA, and fabG promoter combined (isoniazid resistance), 54% (39-68) for pncA (pyrazinamide resistance), 85% (77-91) for gyrA and gyrB combined (ofloxacin resistance), and 88% (81-92) for gyrA and gyrB combined (moxifloxacin resistance). For nearly all drugs and in most settings, there was a large overlap in the estimated prevalence of drug resistance by genetic sequencing and the estimated prevalence by phenotypic testing.
interpretationGenetic sequencing can be a valuable tool for surveillance of drug resistance, providing new opportunities to monitor drug resistance in tuberculosis in resource-poor countries. Before its widespread adoption for surveillance purposes, there is a need to standardise DNA extraction methods, recording and reporting nomenclature, and data interpretation.
fundingBill & Melinda Gates Foundation, United States Agency for International Development, Global Alliance for Tuberculosis Drug Development.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.