Implementation research teams in Armenia, China, Colombia, Ecuador, Ghana, Kazakhstan, Lebanon, Myanmar, Nepal, Sierra Leone, Sudan, Uganda, Ukraine and Uzbekistan explored a variety of factors related to antimicrobial resistance (AMR). These research projects were supported by TDR's Impact Grants for Regional Priorities in collaboration with all six WHO regional offices.
Antimicrobial resistance – the ability of microorganisms to withstand antimicrobial treatments - is one of the top 10 global public health threats, according to WHO. The overuse or misuse of antibiotics makes treatments less effective, posing a serious threat to public health.
Tackling this problem requires a multisectoral approach focused on improved detection, risk factor analysis and clear public information campaigns to explain to health care providers and patients the best use of antimicrobial medicines.
TDR’s Impact Grants for Regional Priorities funded a body of research conducted by medical teams and public health institutions in some 20 countries, including: Armenia, China, Colombia, Ecuador, Ghana, Kazakhstan, Lebanon, Myanmar, Nepal, Sierra Leone, Sudan, Uganda, Ukraine and Uzbekistan.
The research topics investigated included the following:
- Identifying risk factors linked with drug resistance
- Links with migration-related issues
- Approaches to develop evidence-based antibiotics protocols/policies
- Social inequalities in antimicrobial resistance
- Education and public awareness needs
- Human-livestock interface for treatment
Some highlights from the research projects:
Armenia: Assessing the national antimicrobial resistance landscape
A project in Armenia explored the antimicrobial resistance situation in the country, gathering feedback from doctors on health care management. The team reports a very low rate of access to drug resistance testing and high rate of resistance among people
with access. These problems are linked to the management and poor implementation of guidelines.
Kazakhstan: Perceptions to antibiotic use in family groups
The Kazakhstan research team studied the perceptions and decision-making process in patients’ families on the rational use of antibiotics. The researchers assessed awareness levels using a questionnaire to assess current knowledge levels of AMR in this particular group.
Sudan: Antimicrobial resistance in the context of TB
Facing rising cases of multidrug-resistant tuberculosis (MDR-TB), Sudanese scientists analysed its risk factors, linking causal effects from previous TB treatment, HIV infection, type 2 diabetes to the evolution of MDR-TB. They found that identifying these high-risk factors is key to improving the performance of health care systems, particularly for TB management.
Lebanon: Assessing multidrug-resistant TB in refugee populations
A study in Lebanon focused on drug resistance profiling for multidrug-resistant TB among non-national citizens, residents and refugees. This investigation was triggered by the increase in TB cases in the country attributed to the arrival of UNHCR-registered Syrian refugees. The team processed phenotypic and molecular testing nationwide to collect samples of the overall population. The aim was to measure the incidence of AMR to have more robust diagnostics of MDR-TB cases. While incidence of drug resistance was low for this study, investigators noted that patients leaving the country before completing TB treatment was a factor that encourages the emergence of drug resistance.
PROJECTS FUNDED BY TDR’S IMPACT GRANTS FOR REGIONAL PRIORITIES
Assessment of prevalence of antimicrobial resistance towards specific drugs and in specific diseases in Armenia and potential risk factors contributing to antimicrobial resistance
Karapet DAVTYAN – davkaro@gmail.com
Armenia
Implementation of the MTBDRsl Test for Detection of Second-Line Drug Resistance and Validation of its Effectiveness on the Clinical Treatment of Multidrug Resistant Tuberculosis in China
Professor Yi HU – yhu@fudan.edu.cn; aaron_huyi@hotmail.com
School of Public Health, Fudan University, China
Measurement of social inequalities in antimicrobial resistance against Neisseria Gonorrhoeae in Colombia: a mixed research approach
Profamilia Juan Carlos Rivillas GARCIA
Colombia
Study of antimicrobial resistance to fosfomycin and genes fos plasmids in isolates of E. coli resistant to third-generation cephalosporins in the chain production of broilers and humans in the Metropolitan District of Quito, Ecuador
Facultad de Medicina Veterinaria y Zootecnia, Universidad Central del Ecuador
Christian Vinicio VINUEZA
Ecuador
Proposal for the development of an evidence-based antibiotics protocol for the Cape Coast Teaching Hospital using repeated point prevalence surveys and cumulative antibiogram data
Mavis Puopelle DAKORAH
Cape Coast Teaching Hospital
Ghana
Awareness and development of activities aimed to develop skills to contain antimicrobial resistance among the population
Almagul KUZGIBEKOVA – alma_aks@mail.ru
Karaganda State Medical University
Kazakhstan
Antimicrobial resistance in a clinical hospital of a healthcare system of Almaty city
Valentina SON
Kazakhstan
Prevalence and antimicrobial resistance of mycobacterium tuberculosis among non-national citizens, residents and refugees in Lebanon: a nationwide study (PAR-MTB)
Monzer HAMZE – mhamze@monzerhamze.com ; mhamze@ul.edu.lb
Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science Technology and Faculty of Public Health, Lebanese University, Tripoli
Lebanon
Surveillance of health care-associated infections and antibiotic resistance in urban and rural secondary hospitals in Sierra Leone
College of Medicine and Allied Health Sciences, University of Sierra Leone
Sierra Leone
Estimation of the risk factors associated with multi-drug resistance TB in Sudan
Adel ELDUMA – dumanet@yahoo.com
National Public Health Laboratory, Federal Ministry of Health
Sudan
Identifying awareness, practice and awareness raising among general practitioners, patients, farmers and dehkans about antimicrobial resistance issues
Dilfuza ANIYOZOVA
Uzbekistan
Antibiotic resistance: Knowledge of people and AMR profile in Staphylococcus aureus population at the livestock-human-wildlife interface in Lake Mburo National Park, Uganda
Makerere University, College of Veterinary Medicine, Animal Resources and Biosecurity
Uganda
One Health approach to identify local drivers of antimicrobial drug resistance in peri-urban Kampala, Uganda
Joint Clinical Research Centre
Uganda
Bacteriophage-based control of transmission and emergency of carbapenem resistant pathotypes of Escherichia coli and Klebsiella pneumoniae in Uganda
Makerere University
Uganda
For more information on the Impact Grants programme, please contact Dr Garry Aslanyan.