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The International Journal of the Royal Society of Thailand
Volume XI - 2019

the genomic sequence analysis to track the outbreak of MDR-TB and initiate the
national network for mycobacterium genotyping (N2MG). Using the pairwise
genetic difference between two strains, it is possible to establish the disease

transmission patterns and tracking the outbreak (Walker et al., 2013; Grabowski
et al., 2018). For example, tracking the outbreak of tuberculosis in prison, school,
hospital, could lead to the target public health intervention, reducing unnecessary
contact investigation while keep the effectiveness of disease control. This
pathogen genomics approach to outbreak investigation can be applied to other
groups of diseases such as food-borne diseases, sexually transmitted diseases,
iatrogenic outbreaks (HCV outbreak in hospital). When this technology is used
in national disease control program, this information will inform the refinement
of strategy and optimizing the usage of resources for diseases control, eventually
leading to Precision Public Health. Precision public health would help in
accelerated the achievement of Sustainable Development Goals 3.

5. Pharmacogenomics

Pharmacogenomics is the study of using genomics information to
prescribe drugs to prevent the adverse drug reactions and to improve the
likelihood of responsiveness to drug. Pharmacogenomics is an important tool
for prevention of Severe Cutaneous Adverse Reaction: SCAR including Steven
Johnson’s Syndrome/ Toxic Epidermal Necrolysis SJS/TENS) in Thailand.
The HLA-B*15:02 test for prevention of SJS/TEN from Carbamazepine (Locharernkul
et al, 2008), the HLA-B*58:01 test for prevention of SJS/TEN from Allopurinol

(Hung et al., 2005) are the example of services that can be implemented across
Thailand.
In Thailand, the reported number of SJS/TEN cases is reducing rapidly

since the introduction of Pharmacogenomics into the health system in 2009, this
is happened because of multiple factors, the unusually high rates of SJS/TEN
in Thailand, likely from the high prevalence of at risk genotype in Thai and
Southeast Asian populations, the readiness of the public health system to provider
Pharmacogenomics tests, the readiness of the front line pharmacists and
clinicians to adopt pharmacogenomics and related measures to prevent SJS/TEN,
the focus of hospital accreditation system on improving the adverse drug
reactions problems in the hospital by monitoring the preventable SJS/TEN at the
hospitals.

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