ICT Solutions for Real-Time Electronic Monitoring of Antimicrobial Use & Resistance in the One Health Approach

Lead Research Organisation: Public Health England

Abstract

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Technical Summary

Adopting a ""One Health"" approach, this project will explore information and communication technology (ICT) solutions to create an electronic platform to holistically monitor antimicrobialuse and resistance in real time using ""big data"" from a range of surveillance systems on antimicrobial use and resistance in the human,(food) animal and environmental sectors in the UMgungundlovu district in KwaZulu-Natal, South Africa. The project will compare and contrast different surveillance systems in terms oftechnical feasibility and cost effective delineation of robust,representative surveillance data in addition to creating the electronic platform. The ""big data"" generated from the three sectors will be triangulated by adapting one or more of the open source software solutions: (1) WHONET and (2) ""Suite for Automated Global Electronic bioSurveillance"" (SAGES} which will allow analysis and visualization within and between sectors at district level. The real-time data on phenotypic trends in antimicrobial resistance (AMR) in correlation with antimicrobial use/exposure are expected to:
1. Assess the reliability, representivity and financial and technical feasibility of generating
antimicrobial use and resistance data from:
a. Point prevalence surveys,passive,laboratory-based,sentinel surveillance,and, active,disease-based, comprehensive surveillance in human health,
b. The implementation of integrated,""farm-to-fork"" surveillance in animal health, and,
c. Water-based surveillance systems in environmental health.
2. Allow early identification of emerging/escalating resistance within and between sectors,
3. Establish a database for evidence-based treatment guidelines and associated essential medicines lists for the optimal management of infections in humans and (food) animals,
4. Ascertain whether the surveillance of AMR in human sludge,animal manure-based
fertilizers and water sources could serve as suitable proxies for AMR in human,animal and environmental health using Escherichia coli and Enterococcus spp. as indicator organisms,and,
5. Provide ""information for action"" by the various sectors and their regulatory authorities.

Publications

10 25 50
 
Description 1. Essack, S.Y. Antibiotic Resistance and One Health. Presented at the 9th Annual Coalition of Universities for Global Health Conference, New York, USA, March 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 1. Essack, S.Y. Antibiotic Resistance and One Health. Presented at the 9th Annual Coalition of Universities for Global Health Conference, New York, USA, March 2018.
Year(s) Of Engagement Activity 2018
 
Description 2. Essack S.Y., Abia-Akebe, L.K., Amoako, D., McIver, K., Molechan, C., Pillay, S. & Ramtahal, M. Triangulation of Antibiotic Resistance from Humans, the Food Chain and Associated Environments - A One Health Project. Presented at 8th Meeting of the Advisory Group of Integrated Surveillance of Antimicrobial Resistance Utrecht, The Netherlands, November 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Essack S.Y., Abia-Akebe, L.K., Amoako, D., McIver, K., Molechan, C., Pillay, S. & Ramtahal, M. Triangulation of Antibiotic Resistance from Humans, the Food Chain and Associated Environments - A One Health Project. Presented at 8th Meeting of the Advisory Group of Integrated Surveillance of Antimicrobial Resistance Utrecht, The Netherlands, November 2018.
Year(s) Of Engagement Activity 2018
 
Description Guest invited seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Invited guest lecture (1h) delivered by Neil Woodford at the Westville Campus of University of KwaZulu Natal. Global aspects of AMR
Year(s) Of Engagement Activity 2018
 
Description Interactive tutorial with research group 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact 2 h interactive session with students from Prof Essack's AMR team, discussing their research.
Year(s) Of Engagement Activity 2018
 
Description Site visit to Bruntville Community Health Centre 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I visited Bruntville with Prof Sabiha Essack and members of her team from University of KwaZulu Natal. I spoke for 30 minutes on International aspects of AMR, and Sabiha spoke about the specifics of the project. There was excellent engagement and willingness from the practitioners in this community health centre to participate in our project.
Year(s) Of Engagement Activity 2018
 
Description Site visit to Edendale Hospital 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I visited Edendale with Prof Sabiha Essack and members of her team from University of KwaZulu Natal. I spoke for 30 minutes on International aspects of AMR, and Sabiha spoke about the specifics of the project. There was excellent engagement and willingness from the practitioners in this hospital to participate in our project.
Year(s) Of Engagement Activity 2018