Introduction
Welcome to the info page for Medical Officers responsible for treating DR-TB patients enrolled in the GenPath PARR-TB project. On this page you will find information regarding the different aspects of the study, such as WGS surveillance, precision medicine, precision prevention, and qualitative study components. If you have questions or concerns, please reach out to the PARR-TB MICK-MAGMA coordinator or the clinical research organisation (CRO). Please see the information pamphlet for a succinct overview:
The organisations involved in this study are:
Whole Genome Sequencing (WGS) Surveillance
WGS surveillance is a key component of the PARR-TB project. It allows for the comprehensive detection of drug resistance mutations in the Mycobacterium tuberculosis genome in real time.
Why it matters: WGS identifies both known and novel resistance mutations, including those not captured by standard tests. It provides a faster and more complete drug resistance profile.
For patient care: Faster and more accurate drug resistance information means patients can start on appropriate regimens sooner.
For public health: WGS allows tracking of resistance trends and informs health system planning.
The MICK-MAGMA platform processes WGS data using a tool called the DR Estimator, which assigns a low, moderate, or high probability that a detected variant confers resistance, supporting informed clinical decisions. For an overview of the value of WGS for routine RR-TB care and prevention click here.
Precision Medicine
Precision medicine in the PARR-TB project refers to the use of WGS data to guide individualized treatment regimens for RR-TB patients.
Why it matters: Not all patients are can receive the standard RR-TB treatment. Personalized regimens are critical for those with treatment failure, complex resistance patterns, or those with contraindications to drugs contained within standard RR-TB treatment regimens.
For patient care: The MICK-MAGMA platform includes a Treatment Recommender tool that uses machine learning to generate expert-informed treatment recommendations tailored to the resistance profile of the patient’s Mtb strain.
Treatment options include BPaLL, BPaLplus, or fully individualized regimens. Healthcare workers can approve or refer these recommendations to an expert committee (PCAC). To view the tutorial video on how to get treatment recommendations for your patients suffering from RR-TB, click here.
IMPORTANT NOTE: As a healthcare worker involved in the PARR-TB study you are required to collect informed consent using the provided ICF form.
Precision Prevention
Precision prevention uses the WGS resistance profile of an RR-TB index case to select the best therapeutic preventive therapy (TPT) for close contacts.
Why it matters: Preventive therapy is more effective when it is matched to the resistance profile of the index case, especially for vulnerable populations like children and people living with HIV.
For patient care: Instead of generic preventive treatment, contacts can receive an optimal TPT based on the resistance profile of the index case.
Implementation: TPT recommendations are generated by MICK-MAGMA. For certain regimens, review by the PCAC and/or NCAC may be required.
Precision Public Health
Precision public health uses WGS and AI to identify transmission clusters, superspreading events, and RR-TB hotspots.
Why it matters: Understanding where and how RR-TB is spreading enables targeted and cost-effective interventions.
For public health action: By combining WGS data with geospatial and population data, health authorities can deploy focused interventions to interrupt transmission.
MICK-MAGMA provides insights for TB control, and these insights are shared with health authorities in the Western Cape to improve public health activities and policies.
Qualitative Study Component
In addition to genomic and clinical data, the PARR-TB project gathers qualitative insights from healthcare workers, patients, and communities.
Why it matters: Understanding these perspectives helps improve how tools MICK-MAGMA are used in routine RR-TB care, management, and control.
Methods include focus group discussions and interviews, focusing on usability, acceptability, and ethical considerations in the use of WGS and AI for TB care and prevention.