Genetic testing in adult critical care across resource-limited Asian and African countries: barriers and pathways forward

Background: Genetic testing can potentially transform the management of critically ill adults in intensive care units. However, the implementation of genetic testing in resource-limited settings across Asia and Africa faces distinct challenges. Objective: This review summarizes the challenges and opportunities related to genetic testing in adult intensive care units within these regions. Methods: We synthesized findings based exclusively on the published literature, focusing on issues specific to Asian and African populations. Results: The high genetic diversity in these populations and their limited representation in global genomic databases create difficulties in interpreting genetic variants and applying pharmacogenomic data. Despite these challenges, there are clear opportunities to improve the diagnosis of unexplained critical illnesses, optimize drug therapies, and enhance risk prediction in critical care. Major obstacles include limited infrastructure, high costs, and a lack of local genomic data. Conclusion: Collaborative strategies are essential in advancing genetic testing in these settings. Key priorities include building sustainable local capacity, generating population-specific genomic data, adopting cost-effective technologies, engaging communities to develop ethical guidelines, and establishing supportive government policies. A strategic and context-specific approach is needed to integrate genetic testing into critical care and improve outcomes in Asia and Africa.