Precision Medicine of Tuberculosis in Africa

Abstract Tuberculosis (TB), caused by Mycobacterium tuberculosis , remains a significant global health challenge, in particular, in the African continent. In 2020, Africa accounted for 25% of new TB cases, with 14 African countries ranking among the top 30 in terms of TB burden. This burden is exacerbated in sub-Saharan Africa, where a dual challenge of TB and human immunodeficiency virus (HIV) co-infection contributes to over 50% of cases. This chapter on TB explores the role and emergence of precision medicine as a pivotal player in the pursuit of more effective TB treatment. This exploration is particularly pertinent in the era of the escalating threat posed by drug-resistant TB within the African population. This approach involves tailoring treatment regimens based on various factors, including drug susceptibility, comorbidities such as HIV, and host genetics. Precision medicine offers a promising avenue for personalised and targeted interventions, aiming to optimise treatment efficacy while minimising adverse effects. Moreover, this chapter discusses how the diverse genetic landscape across Africa significantly influences TB pharmacogenetics. Variations in genetic factors affect drug metabolism, treatment response, and susceptibility to adverse effects. In conclusion, and as we navigate the intricate interplay of TB, drug resistance, and the unique challenges presented by the African context, it is imperative to show how precision medicine holds promise for optimising TB treatment in Africa; additionally, extensive research and validation across diverse African populations are crucial for its successful implementation. Addressing TB’s complex interplay with genetics, comorbidities, and drug resistance is vital for improving outcomes in this high-burden region.