STUDY PROTOCOL article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1668926
This article is part of the Research TopicWorld TB Day 2025: Yes! We Can End TB: Commit, Invest, DeliverView all 6 articles
Consolidation of a Genomic Epidemiological Surveillance Network for Tuberculosis (REVIGET) in Northern and Northeastern Brazil: A Study Protocol
Provisionally accepted
Emilyn Costa Conceição1,2,3*
Karla Valéria Batista Lima4,5Cristiane Cunha Frota6
Theolis Barbosa3,7Adriana Ayden Ferreira8
Abhinav Sharma1
Davi Josué Marcon4,5Layana Rufino Ribeiro4,9Alex Brito Souza4,5Danna Karen Correa dos Santos4,5
Carlos Augusto Abreu Alberio10
Ricardo Jose de Paula Souza e Guimaraes11,9Ismari Perini Furlaneto12Lilian Eduarda De Oliveira Freitas8Emmily Oliveira Amador4,5
Hendor Neves Ribeiro De Jesus7
Barreto LBPF13
Maria Cristina da Silva Lourenco13Tulio De Oliveira2
Robin Mark Warren1- 1DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; SAMRC Centre for Tuberculosis Research; Division of MBHG, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- 2Centre for Epidemic Response and Innovation, School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- 3Rede Brasileira de Pesquisas em Tuberculose, Rio de Janeiro, Brazil
- 4Secao de Bacteriologia, Instituto Evandro Chagas, Ananindeua, Brazil
- 5Programa de Pos-graduacao em Biologia Parasitária na Amazonia, Universidade do Estado do Para, Belém, Brazil
- 6Universidade Federal do Ceara, Programa de Pos-graduacao em Patologia, Fortaleza, Brazil
- 7Instituto Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, Brazil
- 8Laboratorio Central do Amazonas, Fundacao de Vigilancia em Saude do Amazonas Dra Rosemary Costa Pinto, Manaus, Brazil
- 9Programa de Pos-graduacao em Epidemiologia e Vigilancia em Saude, Instituto Evandro Chagas, Ananindeua, Brazil
- 10Hospital Universitário Joao de Barros Barreto da Universidade Federal do Para, Belem, Brazil
- 11Geoprocessamento, Instituto Evandro Chagas, Ananindeua, Brazil
- 12Centro Universitario do Para, Belem, Brazil
- 13Laboratorio de Bacteriologia e Bioensaios em Micobacterias, Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
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Globally, tuberculosis (TB) remains a top cause of death from infectious diseases, with an estimated 1.5 million deaths annually. Given its substantial social and economic burden, TB is a priority in the United Nations 2030 Agenda for Sustainable Development. The WHO's End TB Strategy emphasizes research, innovation, and the rapid implementation of new technologies, such as whole-genome sequencing (WGS), which are pivotal for precision health approaches and drug-resistant TB (DR-TB) surveillance. This study aims to strengthen genomic TB surveillance in the North and Northeast Brazilian regions by applying WGS to study DR-TB cases, training professionals in genomics and bioinformatics, and deploying a national surveillance platform (GEMIBRA). This is an observational, cross-sectional, prospective, quantitative, and qualitative study to be conducted in the states of Pará, Amazonas, Ceará, and Bahia. A total of 500 Mycobacterium tuberculosis complex (MTBC) isolates from DR-TB cases will undergo whole-genome sequencing (WGS), representing 87% of the expected DR-TB cases, including non-tuberculous mycobacteria (NTM) isolates among the DR samples. Data will be analyzed for genotype-phenotype correlations, mutation patterns, and associations with clinical and epidemiological characteristics. Capacity-building activities, including theoretical and hands-on bioinformatics training, will be carried out. The GEMIBRA platform will support data visualization, spatial distribution, and clinical decision-making. The project will generate evidence to validate the contribution of WGS integration in Brazil's TB surveillance system, support precision treatment approaches, and inform public health interventions. It will also contribute to workforce development and the introduction of decentralized WGS-based diagnostics in resource-limited regions. The project adopts a translational research model and a networked, decentralised approach, facilitating the prompt integration of the knowledge generated into public health practice. Ultimately, this work will contribute to combating TB transmission by identifying transmission dynamics,
Keywords: Drug-resistant tuberculosis, Genomic surveillance, Whole-genome sequencing, Capacity Building, Brazil
Received: 18 Jul 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Conceição, Lima, Frota, Barbosa, Ferreira, Sharma, Marcon, Ribeiro, Souza, dos Santos, Alberio, Guimaraes, Furlaneto, De Oliveira Freitas, Amador, Neves Ribeiro De Jesus, LBPF, Lourenco, De Oliveira and Warren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Emilyn Costa Conceição, emilyncosta@sun.ac.za
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