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在大流行期间建立 SARS-CoV-2 的基因组监测平台:真正的南北合作。

Building up a genomic surveillance platform for SARS-CoV-2 in the middle of a pandemic: a true North-South collaboration.

机构信息

Pediatrics and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan.

Biorepository and Omics Research Group, Medical College Pakistan, The Aga Khan University, Karachi, Sindh, Pakistan.

出版信息

BMJ Glob Health. 2023 Nov;8(11). doi: 10.1136/bmjgh-2023-012589.

Abstract

Next-generation sequencing technology has revolutionised pathogen surveillance over the last two decades. However, the benefits are not equitably distributed, with developing countries lagging far behind in acquiring the required technology and analytical capacity. Recent declines in the cost associated with sequencing-equipment and running consumables have created an opportunity for broader adoption. During the COVID-19 pandemic, rapid diagnostics development and DNA sequencing revolutionised the ability to diagnose and sequence SARS-CoV-2 rapidly. Socioeconomic inequalities substantially impact the ability to sequence SARS-CoV-2 strains and undermine a developing country's pandemic preparedness. Low- and middle-income countries face additional challenges in establishing, maintaining and expanding genomic surveillance. We present our experience of establishing a genomic surveillance system at the Aga Khan University, Karachi, Pakistan. Despite being at a leading health sciences research institute in the country, we encountered significant challenges. These were related to collecting standardised contextual data for SARS-CoV-2 samples, procuring sequencing reagents and consumables, and challenges with library preparation, sequencing and submission of high-quality SARS-CoV-2 genomes. Several technical roadblocks ensued during the implementation of the genomic surveillance framework, which were resolved in collaboration with our partners. High-quality genome sequences were then deposited on open-access platforms per the best practices. Subsequently, these efforts culminated in deploying Pakistan's first SARS-CoV-2 phyllo surveillance map as a Nextstrain build. Our experience offers lessons for the successful development of Genomic Surveillance Infrastructure in resource-limited settings struck by a pandemic.

摘要

在过去的二十年中,下一代测序技术彻底改变了病原体监测。然而,这些好处并不均等分配,发展中国家在获取所需技术和分析能力方面远远落后。最近测序设备和运行耗材相关成本的下降为更广泛的应用创造了机会。在 COVID-19 大流行期间,快速诊断开发和 DNA 测序极大地提高了快速诊断和测序 SARS-CoV-2 的能力。社会经济不平等极大地影响了对 SARS-CoV-2 菌株进行测序的能力,并破坏了发展中国家的大流行准备工作。中低收入国家在建立、维护和扩大基因组监测方面面临额外的挑战。我们介绍了在巴基斯坦卡拉奇的 Aga Khan 大学建立基因组监测系统的经验。尽管我们是该国领先的健康科学研究机构,但我们遇到了重大挑战。这些挑战与为 SARS-CoV-2 样本收集标准化的背景数据、采购测序试剂和耗材以及文库制备、测序和提交高质量 SARS-CoV-2 基因组有关。在实施基因组监测框架期间出现了一些技术障碍,这些障碍是与我们的合作伙伴合作解决的。然后,按照最佳实践将高质量的基因组序列存放在开放获取平台上。随后,这些努力最终促成了部署巴基斯坦第一张 SARS-CoV-2 叶状监测图作为 Nextstrain 构建。我们的经验为资源有限的国家在大流行期间成功开发基因组监测基础设施提供了经验教训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ef2/10660681/35c1ead5633b/bmjgh-2023-012589f01.jpg

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