DOSA - Diagnostics for One Health and User Driven Solutions for AMR

Lead Research Organisation: University of Edinburgh
Department Name: Sch of Biomedical Sciences


Microbial pathogens resistance to antibiotics is a major challenge to societies around the globe. Microbes are becoming resistant to antibiotics rapidly to due to variety human action i.e., unnecessary prescription in healthcare, blanket prescription in agriculture and careless release of antibiotics into the environment. Lack of appropriate diagnostic methods is one of the major reasons for in appropriate and overuse of antibiotics. In this project, led by the University of Edinburgh and the IIT Delhi, researchers from India and UK with background in social sciences, technology innovation, and experts in different community settings come together to jointly address this issue. They plan to study current practices, user behaviors, social and economic reasons behind antibiotic consumption in India. Based on a user mapping study, they plan to formulate target product profiles i.e., specification of the diagnostic test for three communities setting. They aim to develop/validate rapid diagnostic assays for three different community settings i.e., urinary tract infections in human health, mastitis (infection of cows' udder) in dairy sector and antibiotics residue detection in water from the environment. Currently, due to lack of appropriate diagnostic technologies, doctors are prescribing broad spectrum antibiotics empirically (i.e. in a trial and error fashion) and farmers are using huge quantities of antibiotics in agriculture and fish farming without appropriate guidance and monitoring. Development of these diagnostic methods will help to reduce the unnecessary consumption, blind prescription and release of antibiotics. An improved diagnostic solution built into health/agriculture and environment settings will help to treat patients effectively and reduce mortality; will help agriculture farmers to get a better economic return for their produce and will reduce resistant transmission. This study brings together an interdisciplinary and international team to learn and support each other towards development of solutions to the global anti-microbial resistance challenge.

Planned Impact

The DOSA project aims to develop diagnostic solutions for antimicrobial resistance (AMR) which is one of biggest threats to global health in an interdisciplinary collaboration of research groups from UK and India. DOSA stands for 'Diagnostics for One Health and User Driven Solutions for AMR' referring to the approach to inform diagnostics development through user engagement rather than a technology push and the three sectors DOSA will be operating in India: human health, veterinary health and the environment. Here, DOSA will gather the user needs for rapid diagnostics directly from the people who are in need for tools to make better decisions of using antibiotics and offer better services and products. These user requirements will critically inform the diagnostic developments carried out in the project.

DOSA is focussing on three indications: urinary tract infections as prime example for infections of humans, mastitis as infection of cows, and antibiotic residues in water (and products) from aquacultures. Today, antibiotic use is conventionally done empirically in the chosen sectors and indications, and rapid diagnostic tools are unavailable because they are too expensive, not fit for purpose or don't exist because developers cannot overcome technical hurdles or do no know the user needs. Antibiotic users simply have no other choice than using antibiotics in a trial and error fashion.

We have identified six beneficiary groups 1.) Primary healthcare stakeholders (e.g. clinicians, nurses, hospital management staff and patients); 2.) Dairy farmers, veterinary practitioners, animal husbandry and industry associations; 3.) Aquaculture specialists; 4.) Educationalists; 5.) Local government and policy makers; 6.) Technology experts and developers. In primary healthcare, beneficiaries will have new tools (new diagnostics and instructions to use them, training material) which will enable them to offer better services. These groups will be reached through dissemination activities including publications, conferences and finally the product releases. In a similar way, dairy, fish farmers and their affiliated stakeholders will be reached and benefit from equivalent tools to offer better services and products with positive impact on their animals health, productivity and environment they are operating in. The educational sector will strongly benefit from the user requirements and service design outputs. These set precedence for diagnostics development and implementation as well as successful interdisciplinary research. This sector together with the technology experts and diagnostic innovators will be directly engaged through the DOSA consortium through dissemination and direct collaboration. Here, DOSA offers a unique chance to impact on sustainable development through the fight against AMR by educating the next generation of innovators and providing them with the means to take their ideas forward for further amplified impact. For this, DOSA partners are globally active in networks promoting knowledge exchange and teaching and training. These networks and activities will also help to inform policy makers about new developments in the area of rapid diagnostics to tackle antimicrobial resistance. Finally, and most importantly, the general public will benefit from better services, less harmful animal products and improved quality of life. In summary, the direct immediate outputs of DOSA will be user requirement specifications and service designs for three community settings in India and three performance tested diagnostic prototypes together with a strong network of innovators and researchers trained in advanced service design approaches and cutting edge technologies. These outputs will contribute to the long-term fight against antimicrobial resistance and sustainable development in India and beyond.


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Description The project is in its second year and fully on track. The formal project review was successful as well as a first year internal project review meeting in Edinburgh with lab demonstrations of the diagnostic test under development. All three tracks (human, dairy and aqua culture) are well underway with user needs gathering, diagnostics innovation and baseline assessment. Well over 500 samples have been collected in each track and analysed regarding their bacterial, AMR and antibiotic residue content. Various site visits for ethnographic studies were undertaken and co-design workshops held. A major first year deliverable was the Speculative Design report. This document summaries our findings from the first year of DOSA to identify the user needs for diagnostic solutions in human healthcare, dairy industry and aquaculture. The reported achievements are complemented by the diagnostic innovation activity and extensive baseline assessment of AMR in the three settings of DOSA. The report constitutes a major milestone of delivery for the first year of DOSA. It is testament to the cohesive collaboration of our multidisciplinary and multicultural team which is reflected in the DOSA motto - Managing AMR Together. We are extremely proud of our large ethnography and baseline teams. They have made a large number of visits to the study sites and engaged with the users extensively to understand their needs. The successful first year of DOSA gives us great confidence to achieve the goals set for the second year aiming at the convergence of the diagnostic innovation and ethnography studies underpinned by the baseline analysis. This will culminate in a major field testing demonstration of the diagnostic devices in Cochin planned for September 2020. Planned as a major review point, this activity will enable us to proceed into the field deployment and trials scheduled for year 3 of DOSA. The DOSA project is an exceptional undertaking and we are deeply grateful for the opportunity the funders gave to our consortium. Especially, we are strongly encouraged by the wide positive feedback we are receiving during our outreach activities. We feel that DOSA will set a leading example for the collaborative effort and partnership of the UK and India to tackle the global threat of Antimicrobial Resistance.
Exploitation Route The project is still active. We expect the findings to be primarily picked up by stakeholders in the community healthcare provision, dairy farms and shrimp farms in India.
Sectors Agriculture, Food and Drink,Communities and Social Services/Policy,Education,Environment,Healthcare,Manufacturing, including Industrial Biotechology,Pharmaceuticals and Medical Biotechnology