Genomic Sequencing of Tuberculosis in India

The Department of Biotechnology (DBT) in India has made strides in understanding tuberculosis (TB) through genomic sequencing. On March 24, 2025, it was announced that the DBT has sequenced 10,000 samples of Mycobacterium tuberculosis, part of a larger initiative to sequence 32,500 samples across the country. This effort aims to combat drug-resistant TB and enhance the understanding of the TB bacterium’s unique genomic features.

Background of the Initiative

The genomic sequencing project is part of the “Dare2eraD TB” programme, launched in 2022. This initiative is aligned with India’s goal to eradicate TB by 2025, five years ahead of the World Health Organisation (WHO) target of 2030. The project involves collaboration between nine DBT labs, the Council of Scientific and Industrial Research (CSIR), and the Indian Council of Medical Research (ICMR). The complete sequencing of samples is expected to be completed by October 2025.

Current Statistics on TB in India

India accounts for approximately 28% of new TB cases globally. In 2022, India reported 1,990 TB cases per million, a decrease from 2,370 cases per million in 2015. This statistic marks the ongoing challenge of TB in the country. The WHO defines “eradicating” a disease as reducing cases to near zero, while “eliminating” it means lowering the incidence to about one case per million.

Drug Resistance and Its Implications

Among the sequenced samples, 7% were found to be resistant to at least one drug. This raises concerns about the prevalence of drug-resistant TB, which complicates treatment options. The presence of drug-resistant strains poses challenge to TB eradication efforts.

Demographics of TB Patients

The majority of TB cases in the sequenced dataset were found in individuals aged 18-45 years. Many of these patients also exhibited comorbid conditions, such as diabetes and underweight status. This demographic trend suggests that targeted interventions may be necessary for younger adults, particularly those with additional health challenges.

Technological Advancements in TB Testing

The integration of artificial intelligence (AI) into TB testing is expected to revolutionise diagnosis. Current methods take about three weeks to confirm TB, but advancements could reduce this time to just one week. This rapid testing could improve management and treatment outcomes for patients.

Challenges Ahead

Despite progress, the large pool of asymptomatic individuals with latent TB remains hurdle. These individuals can continue to spread the disease, contributing to the rise of new TB cases. Addressing this issue will be crucial for the success of TB eradication efforts in India.

Questions for UPSC:

1. Examine the role of genomic sequencing in combating drug-resistant tuberculosis in India.
2. Discuss the impact of comorbid conditions on tuberculosis prevalence in the younger population.
3. Critically discuss the measures needed to control the spread of latent tuberculosis in India.
4. Analyse the significance of India’s target to eradicate tuberculosis by 2025 in the context of global health initiatives.

Answer Hints:

1. Examine the role of genomic sequencing in combating drug-resistant tuberculosis in India.

1. Genomic sequencing helps identify unique features of Mycobacterium tuberculosis, aiding in understanding drug resistance.
2. It allows for the tracking of mutations that contribute to drug-resistant strains, informing treatment strategies.
3. The initiative is part of the “Dare2eraD TB” program, which aims to sequence 32,500 samples to enhance TB management.
4. Collaboration among multiple research institutions ensures a comprehensive approach to data collection and analysis.
5. AI integration in testing could expedite diagnosis and improve treatment outcomes for drug-resistant TB cases.

2. Discuss the impact of comorbid conditions on tuberculosis prevalence in the younger population.

1. Many TB patients aged 18-45 also have comorbidities like diabetes, which can exacerbate TB severity and treatment complications.
2. Comorbid conditions may lead to a higher risk of TB transmission and progression from latent to active disease.
3. Younger adults with health challenges may face barriers to accessing timely TB diagnosis and treatment.
4. Targeted health interventions for this demographic are essential to manage both TB and its comorbid conditions effectively.
5. About these dynamics can help shape public health policies and resource allocation for TB control.

3. Critically discuss the measures needed to control the spread of latent tuberculosis in India.

1. Increased screening and early detection of latent TB in high-risk populations is essential for controlling spread.
2. Public awareness campaigns can educate communities about latent TB and its potential risks for transmission.
3. Implementing preventive treatment protocols for individuals with latent TB can reduce future active cases.
4. Strengthening healthcare infrastructure to ensure access to testing and treatment for latent TB is crucial.
5. Collaboration with community health workers can enhance outreach and support for at-risk populations.

4. Analyse the significance of India’s target to eradicate tuberculosis by 2025 in the context of global health initiatives.

1. India’s target aligns with global health goals, aiming to reduce TB incidence ahead of the WHO’s 2030 deadline.
2. Achieving this target could set a precedent for other nations facing similar TB challenges, demonstrating effective intervention strategies.
3. It marks India’s commitment to public health and disease eradication, potentially attracting international support and funding.
4. Successful eradication efforts could alleviate the global burden of TB, contributing to overall health improvements.
5. The initiative puts stress on the importance of innovation in research and technology for tackling infectious diseases globally.