DOSA - Diagnostics for One Health and User Driven Solutions for AMR
Lead Research Organisation:
University of Edinburgh
Department Name: Sch of Biomedical Sciences
Abstract
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.
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.
Organisations
- University of Edinburgh (Lead Research Organisation)
- Medical Research Council (Co-funder)
- Economic and Social Research Council (Co-funder)
- Engineering and Physical Sciences Research Council (Co-funder)
- Arts and Humanities Research Council (Co-funder)
- Biotechnology and Biological Sciences Research Council (Co-funder)
Publications

Goel P
(2022)
Spore-based innovative paper-strip biosensor for the rapid detection of ß-lactam group in milk.
in Scientific reports

Hassan S
(2020)
Microfluidics as an Emerging Platform for Tackling Antimicrobial Resistance (AMR): A Review
in Current Analytical Chemistry

Hassan S
(2020)
Glycoprotein- and Lectin-Based Approaches for Detection of Pathogens
in Pathogens

Hassan S
(2019)
"Droplet-Interfaced Separations as an Emerging Tool for High-Throughput Microchip Electrophoresis"
in Research in Medical & Engineering Sciences

Hassan S
(2019)
Droplet-Based Microfluidics: Formation, Detection and Analytical Characterization
in Research & Development in Material Science

Hassan S
(2019)
Droplet-Based Microgels: Attractive Materials for Drug Delivery Systems
in Research & Development in Material Science

Hassan SU
(2020)
Capillary-Driven Flow Microfluidics Combined with Smartphone Detection: An Emerging Tool for Point-of-Care Diagnostics.
in Diagnostics (Basel, Switzerland)

Hassan SU
(2020)
Design and Fabrication of Capillary-Driven Flow Device for Point-Of-Care Diagnostics.
in Biosensors

Hassan SU
(2020)
Design and Fabrication of Optical Flow Cell for Multiplex Detection of ß-lactamase in Microchannels.
in Micromachines

Holger Schulze
(2021)
Label-Free Electrochemical Sensor for Rapid Bacterial Pathogen Detection Using Vancomycin-Modified Highly Branched Polymers
in Sensors
Description | For all 3 settings we have prototype tests and diagnostic services in trials in the community settings and prototype tests are tested in the lab. Due to COVID we experienced significant delays and impact on field work. To progress the project outputs, a policy workshop was held in Delhi on 30 Mar 2022. We have secured fundig from LifeArc for field trials in India. Further, we are in early stage negotiations with a major charitable funder for implementation trials in India following the ongoing field trials. |
Exploitation Route | The project is finished but the consortium 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, see follow on funding comments above. |
Sectors | Agriculture Food and Drink Communities and Social Services/Policy Education Environment Healthcare Manufacturing including Industrial Biotechology Pharmaceuticals and Medical Biotechnology |
URL | http://www.dosa-diagnostics.org |
Description | We were awarded a University of Edinburgh Global Impact Accelerator fund (£34,752, January 2021) for a project titled Performance trial of diagnostic bundle to tackle urinary tract infections and AMR in the community in Assam, India. The DOSA-GIA project developed an implementation roadmap and manufacturing plan for a diagnostic bundle to tackle urinary tract infections in the community. The diagnostic bundle has been developed in the DOSA project and is designed to improve the healthcare in rural and peri-urban communities and reduce antimicrobial resistance in India. The DOSA GIA team hosted three hybrid workshops (3, 7, 10 Sept 2021). The DOSA-GIA workshops dealt with three main objectives: • To review the implementation plan and identify any missed steps stakeholder roles and barriers for successful implementation • To identify an infrastructure for the supply and distribution of the test kit, and the provision of the service to the community members via the ASHAs • To explore potential payment mechanisms and reimbursement schemes for a feasible, impactful and sustainable diagnostics service The DOSA GIA project has paved the way for implementation of the UTI test bundle in the community in Assam by generating the originally targeted outputs, e.g. an in depth understanding of the regulatory pathway. Moreover, the key outcomes of the project can be located in the rising awareness of the UTI problematic amongst the stakeholders. As a result of the GIA project we have established close connections to the key local stakeholders. Most importantly, these stakeholders have offered their support and access to facilities for the next steps, e.g. pilot implementation, health technology assessment and reimbursement. |
First Year Of Impact | 2021 |
Sector | Communities and Social Services/Policy,Healthcare,Manufacturing, including Industrial Biotechology |
Impact Types | Cultural Societal |
Description | Newton Institutional Link, UK-Turkey "Rapid Onsite Tools to Combat Antimicrobial Resistant Mastitis in Dairy Cattle |
Amount | £223,099 (GBP) |
Organisation | Atatürk University |
Sector | Academic/University |
Country | Turkey |
Start | 04/2021 |
End | 05/2023 |
Description | Paper-based platform for onsite, rapid and multiplexed pathogen detection in shrimp farms |
Amount | £252,639 (GBP) |
Funding ID | BB/T012528/1 |
Organisation | Biotechnology and Biological Sciences Research Council (BBSRC) |
Sector | Public |
Country | United Kingdom |
Start | 01/2021 |
End | 09/2022 |
Description | TRANSLATIONAL CHALLENGE Global Health Infections Fund Award Letter |
Amount | £300,000 (GBP) |
Funding ID | Kim 00000350 |
Organisation | LifeArc |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 04/2023 |
End | 10/2024 |
Description | Antimicrobial resistance Dx boot camp IIT Delhi |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | This boot camp was organized with a special focus on researchers involved in AMR research to help them bridge the knowledge gap between clinical research, technology innovation and translation of idea to product. The bootcamp was announced across the country in various research institutes and universities inviting young researchers to a path of innovation |
Year(s) Of Engagement Activity | 2021,2022 |
Description | Antimicrobial resistance Dx boot camp IIT Delhi |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Postgraduate students |
Results and Impact | This boot camp was organized with a special focus on researchers involved in AMR research to help them bridge the knowledge gap between clinical research, technology innovation and translation of idea to product. The bootcamp was announced across the country in various research institutes and universities inviting young researchers to a path of innovation. |
Year(s) Of Engagement Activity | 2020 |
Description | Podcast presented by Uppasala |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | The Uppsala AMR studio focused on the role of service design and co-design when addressing complex global challenges such as as AMR, and how crucial communication in various forms is for interdisciplinary research. This talk explains the contribution of co-design in capturing local knowledge to inform and assist in the development of the DOSA Solution whilst also to bridging different forms of knowledge within the team. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.uac.uu.se/the-amr-studio/episode46 |
Description | Policy workshop program IIT Delhi |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | The key objective of the workshop was to frame the policy context in India for the role of diagnostics in human, dairy, and aquaculture settings and to build local knowledge to manage AMR |
Year(s) Of Engagement Activity | 2022 |
Description | Presentation at the Stockholme Environmental Insitute |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Third sector organisations |
Results and Impact | This event was held at the Stockholm Environmental Institute https://www.sei.org/ who are an international non-profit making policy making organization that tackles environmental and development challenges. In particular they bridge science and policy. Members of their institute were interested in understanding how design and service design can assist their organisation in the delivery of projects with are located throughout the global south. The DOSA human setting work was presented, the session focused on its transdisciplinary nature, the role of co-design in collaborating with the communities and how such projects tackle AMR. The SEI's work spans climate, water, air and land-use issues, governance, the economy, gender and health. The DOSA project opened up discussion on how to undertake a healthcare project with the collaboration of the community. |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.siani.se/sv/event/design-for-development/ |
Description | Workshop Ethnographic assessment & co-design activities in aquaculture settings |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Study participants or study members |
Results and Impact | The objective of engaging the end-users in the designing of a farm-deployable diagnostic for antibiotic residue detection. Program included (a) service co-design sessions with shrimp aquaculture farmers and exporters, and (b) interactions with officials of Department of Fisheries, Govt. of Kerala and Coastal Aquaculture Authority (CAA), Chennai. |
Year(s) Of Engagement Activity | 2020 |
Description | Workshop User mapping study and Rapid Ethnographic Assessment in aquaculture settings of Kerala |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Study participants or study members |
Results and Impact | In connection with this, our ethnography team visited various farms, hatcheries and shrimp processing plants and interactions were held with workers and officials. Farmers were interviewed to gain insight into routine farming activities, testing practices, disease management strategies etc. Concerning AMR, farmers were given awareness on the importance of regulating the usage of antibiotics in the farms. |
Year(s) Of Engagement Activity | 2019 |