Sentinel: Strengthening Surveillance Capacity in West Africa for Preparedness and Response

Sentinel Program Overview

• 💡 The Sentinel program, led by Dr. Al Ozanoff, aims to strengthen surveillance capacity in West Africa for infectious disease preparedness and response.
• 🎯 It's a collaboration between the Broad Institute and the Institute of Genomics and Global Health (IGH) in Nigeria, founded by Pardis Sabeti and Christian Happy.
• 🌍 Operating in Nigeria and Sierra Leone, with expansion plans, the program addresses systematic gaps in staffing, training, and infrastructure in a region prone to outbreaks.

Core Pillars and Technology

• 🛠️ Sentinel focuses on three main pillars: enhancing testing capacity, developing robust data systems, and training public health professionals.
• 🔬 The program leverages genomic technology to improve surveillance, including low-cost, high-throughput diagnostic platforms like Carmen for multiplex pathogen testing.
• 🧬 Metagenomics protocols are used to identify unknown or emerging pathogens, complementing targeted testing for known diseases.

Data Systems and Workflow

• 📊 The Lookout data platform integrates genetic sequences with patient case data, enabling comprehensive analysis, visualization, and reporting for public health authorities.
• ✅ Sentinel employs a hub-and-spoke model, connecting central laboratory hubs with rural clinics for sample collection, point-of-care testing, and batched multiplex screening.
• 📈 This workflow supports routine surveillance and has processed over 14,000 samples and 100,000 tests, detecting thousands of previously unknown cases.

Mpox Outbreak Response in Sierra Leone

• ⚠️ Sentinel provided rapid support during the 2024 Mpox outbreak in Sierra Leone, which saw nearly 4,000 confirmed cases.
• 🧬 Genomic sequencing revealed a single dominant lineage originating around November 2024, with a doubling time of approximately two weeks.
• 🔍 The outbreak shows widespread transmission across the population, with an equal male-female distribution, differing from previous Mpox transmission patterns.

Future Vision and Impact

• 🚀 The program aims to establish a regional network for cross-border surveillance and response, complementing efforts by organizations like Africa CDC.
• 🌱 Sentinel's modular technology stack is designed to complement existing systems and integrate genomic tools into routine public health practice in LMICs.
• 🤝 Emphasizing local ownership of data and research leadership by West African scientists, the program fosters a self-sustaining and stronger public health infrastructure.