One Health Drivers of Antibacterial Resistance in Thailand

Lead Research Organisation: University of Bristol
Department Name: Cellular and Molecular Medicine

Abstract

Antibacterial Resistance (ABR) is a significant source of excess mortality in Overseas Development Assistance (ODA) countries and constitutes a major, increasing threat to wellbeing and economic development. Antimicrobial Resistance (AMR), predominantly ABR, is estimated to have caused 38,000 deaths and an economic loss of 1.2 billion US$ in Thailand in 2010. Because of good record keeping and surveillance, Thailand has been used as an exemplar for characteristics of ABR in ODA countries. ABR is common in human, environmental and animal bacterial isolates. However, ABR has mostly been studied separately in discrete sectors (e.g. hospital patients or poultry). The key drivers of ABR relevant to human health cannot be pinpointed in this way because the selection and transmission of ABR results from interactions between humans, animals, and the environment. A "One Health" approach to the problem is required.

During this consortium project, we will study the Enterobacteriaceae family bacteria Klebsiella pneumoniae (Kp) and Escherichia coli (Ec), which reside in the human and animal gut, are common in environments contaminated with faeces, are are considered a significant threat to human health in Thailand. They are commonly carbapenem- and/or 3rd-generation cephalosporin-resistant (3GCR), which are drugs commonly used for serious infections. Carbapenem-resistant Enterobacteriaceae (CRE) are also recognised by WHO as one of the highest priority pathogens globally for which new ABs are urgently needed. Ec and Kp cause a range of infections in hospitalized patients (e.g. surgical site, intra-abdominal, pneumonia, sepsis) and serious community-acquired infections (e.g. complicated urinary tract infection, pyogenic liver abscess, meningitis). The prevalence of 3GCR Kp and Ec in human infections in Thailand has been increasing from less than 10% in 1999 to 50% in 2016, and of carbapenem-resistant Kp from none prior to 2010 to 10%-20% in 2016.

Our consortium's vision is to build a holistic picture of the drivers of ABR in Thailand and to use this information to benefit the Thai people, and as an exemplar for other ODA countries. The term "driver" may refer to: 1) a material condition or substance, such as a chemical (e.g. an Antibiotic), which, at a particular concentration, selects for the increased prevalence of ABR bacteria; 2) an action, such as exposing bacteria to that chemical by taking an antibiotic; or 3) a socioeconomic condition or circumstance which accounts for that action (e.g. the economic necessity to keep working in the face of illness). A full understanding of ABR drivers at every level is important for the design of effective and appropriate interventions to limit ABR. Hence, this interdisciplinary consortium will investigate them all.

Our study area will be the Mae Klong-Ta Chin Basin, which covers an area of 80x80 km in the central and western part of Thailand. This is the area where the Mae Klong and Ta Chin rivers run from their mountain sources along the Thai-Myanmar border (Mae Klong river) and upper central Thailand (Ta Chin river) down to the Gulf of Thailand. The study area includes districts spread over five provinces (Karnchanaburi, Ratchaburi, Samut Songkram, Samut Sakorn and Nakornprathom). Both rivers enter the study site and run through areas where there are numerous factories, animal farms, rice fields, fruit orchards and communities, allowing multiple possible drivers to be considered in our work.

Our work will run alongside Thailand's National Strategic Plan on AMR, giving us a perfect opportunity to embed our findings in annual reviews of the Strategic Plan, influencing policy and having a relatively short term and direct impact on human health in Thailand. Our engagement and stakeholder activities will also facilitate dissemination of our findings into other countries within the same global region, and comparisons with other projects across the globe will yield added value.

Technical Summary

Our strategy for investigating drivers of antibacterial drug resistance in Thailand will be first to rank the influence of different material substances and actions that drive the increased prevalence of 3rd Generation Cephalosporin resistant Escherichia coli and Klebsiella pneumoniae, and Carbapenem Resistant Enterobacteriaceae in Thailand. We will do this by quantifying these bacteria and also chemicals (including antibacteirals) in humans, animals, and the environment, and ranking how strongly these chemicals can select for antibacterial drug resistance, and how well the various identified bacteria compete with and/or pass their resistance to other bacteria. We will then ascertain the importance of different actions in determining the abundance of the chemicals and bacteria under study. We will do this by ranking the contribution of different possible sources of resistant bacteria, by measuring the scale of antibacterial use in different human and animal populations and by using risk factor analysis to consider the relative importance of different actions as drivers of enteric colonisation of 3rd Generation Cephalosporin resistant Escherichia coli and Klebsiella pneumoniae, and Carbapenem Resistant Enterobacteriaceae. We will then conduct focused social science research to investigate the social, cultural, and economic drivers associated with antibacterial use and with heightened risks of human exposure to resistant bacteria. These diverse types of data will be used to construct a dynamic multilevel model of resistance transmission and containment. This phased approach will enable us to integrate our workstreams and identify antibacterial drug resistance-reducing interventions with the best likelihood of success. At all stages we will engage with Thai stakeholders and policy makers identified during the development phase, increasing impact

Planned Impact

Health and Welfare of the Thai people, and those from other countries.
There is a significant burden of disease and economic cost of antibacterial drug resistance (ABR) in Thailand; estimated as 38,000 extra deaths and 1.2 billion US dollars of economic cost in 2010. Since ABR has risen world-wide since that time, inevitably the health and well-being cost of ABR in Thailand will also have risen and is set to rise further in future. Rates of carriage of resistance to last resort antibacterial drugs has risen, and some key first-line drugs have been rendered essentially useless. Our aim is to understand the drivers of ABR selection and spread in a One Health context, and uncover interventions designed to reduce ABR, and/or the incidence of infection. This would have a potentially transformative effect on healthcare in Thailand. It is likely that what we learn will be transferable to other countries, particularly neighbouring countries where ABR is also a significant burden, but where a response to the threat of ABR is less developed. In order to meet this challenge and improve human health, we need to have impact in Policy Engagement and Public Engagement, at all levels from our study site to the entire South East Asia region. One major advantage of the timing of our proposed work is that it is framed by the implementation and review of Thailand's National Strategic Plan on Antimicrobial Resistance, which has set key targets for reducing infection, reducing antimicrobial usage in humans and animals, and reducing the burdon of resistance. Our work will synergise with Thai and WHO surveillance work, and our synthesis will be extremely valuable both in bench-marking success and informing modification of the Strategic Plan.

Farming/Veterinary Industry.
Over-use of antibacterial drugs and other polluting chemical in Thai agriculture may reduce its economic efficiency. Better farm management practices would not only reduce the reliance on chemicals, but they would improve agricultural yields and so economic growth. Our anthropological work and engagement and training events will uncover farm management practices, and potential leverage points that might be used to encourage more efficient practice, whether this is to reduce ABR or not.
 
Title Introduction to OH-DART video 
Description This video was filmed as an introduction to the aims, methods and people involved in the project. 
Type Of Art Artefact (including digital) 
Year Produced 2019 
Impact This film was initially shown at the project launch event, initially to the guests and stakeholders and then to the media representatives as part of the press conference. It has been used widely in project publicity, for example in the Antibiotic Awareness Week publicity for OH-DART in the UK. It has also been disseminated via Thai social media, both by the study team and other individuals with an interest in AMR reporting. As such it has increased awareness of the project while it is in progress. 
URL https://www.youtube.com/watch?v=ko4TH3PAGWY&feature=youtu.be&fbclid=IwAR0dcEM9l1oQeSe1RabKO689QUvEmG...
 
Description FARMS-SAFE: Future-proofing Antibacterial resistance Risk Management Surveillance and Stewardship in the Argentinian Farming Environment
Amount £989,327 (GBP)
Funding ID BB/T004592/1 
Organisation Biotechnology and Biological Sciences Research Council (BBSRC) 
Sector Public
Country United Kingdom
Start 07/2019 
End 05/2022
 
Description AMR Force (Reyher) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Exploration of collaboration opportunities with VMD, Langford
Year(s) Of Engagement Activity 2019,2020
 
Description Article in Bangkok Post 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The Bangkok Post is an English-language daily newspaper published in Bangkok, Thailand. It is published in broadsheet and digital formats. Information about the launch of OH-DART project was published. In addition to presenting news of the project launch, these activities also present project information and the importance of antibiotic resistance studies in Thailand.
Year(s) Of Engagement Activity 2019
URL https://www.bangkokpost.com/thailand/general/1820759/experts-fret-about-overuse-of-antibiotics?fbcli...
 
Description Article in Daily News 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Dailynews is a daily newspaper in Thai published in Bangkok and distributed nationwide. It is published in broadsheet and digital formats. IIn addition to presenting news of the project launch, these activities also present project information and the importance of antibiotic resistance studies in Thailand. The outcome of these activities is to disseminate information of the project and information about antibiotic resistance.
Year(s) Of Engagement Activity 2019
URL http://www.dailynews.co.th/article/748841?fbclid=IwAR070yLRRmjqq4Ff0JHdsZc-hKZBCyCOlMJMP8tJGahgDqI_q...
 
Description Article in Thairath newspaper 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Thairath is a daily newspaper in Thai published in Bangkok and distributed nationwide. It is published in broadsheet and digital formats. In addition to presenting news of the project launch,there is information about the importance of antibiotic resistance studies in Thailand.
Year(s) Of Engagement Activity 2019
URL https://www.thairath.co.th/news/society/1731143?fbclid=IwAR2ELeWVR161ZXtggn9WYlUfK-boOPLTyNxOakXg6lL...
 
Description Article in the Phuket News 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The Phuket News is a weekly English language newspaper that covers news, events and happenings in Phuket and the Andaman region. It also contains an extensive section of Asian and international news. The newspaper is published weekly and distributed in and around Phuket island and in Bangkok and Krabi airports. The article about the project launch and the importance of studies on antibiotic research in Thailand was published in print and online.
Year(s) Of Engagement Activity 2019
URL https://www.thephuketnews.com/experts-fret-about-overuse-of-antibiotics-74085.php
 
Description Bristol AMR/Colston Research Symposium. The Antibiotic Age: The End or a New Beginning? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Gave a speech entitled: 'Antibiotics Anonymous - Antimicrobial stewardship and voluntary reduction across the UK livestock sectors' and networked with conference attendees
Year(s) Of Engagement Activity 2019
URL https://www.bristol.ac.uk/amr/events/2019/colston-research-society-symposium.html
 
Description Bristol, North Somerset, South Gloucestershire CCG, One Health AMR meeting (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Meeting of the Bristol, North Somerset, South Gloucestershire Clincial Commissioning Group One Health AMR meeting at Bristol Royal Infirmary
Year(s) Of Engagement Activity 2019
 
Description CHAWG AMU Steering group (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Cattle Health and Welfare Group, Antimicrobial Use Group steering group committee meeting in London
Year(s) Of Engagement Activity 2019
 
Description CRI team meeting with Thai FDA representative 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Thai OH-DART team members from the Chulabhorn Research Institute presented the plans and aims of the OH-DART project at a meeting organised by the Food and Drug Administration focussing on updates to feed into the National AMR strategy. Participants from multiple sectors in Thailand attended, as well as representatives of the WHO and FAO. The FDA were very interested in the project due to this being the first study of AMR in Thailand to include human, animal, environment, and social science aspects together. The team will be included in all future relevant meetings, and have requested updates on the results from the project.
Year(s) Of Engagement Activity 2019
 
Description CRI team meeting with factory owners 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Industry/Business
Results and Impact The CRI team met with local factory owners to discuss taking samples from their sites for microbiology and metals residue testing. They were very interested in the project and willing to allow access to the study team and sample collectors. They have asked if it is possible to have the results particularly from the metals testing. This will also benefit future research as this will facilitate access to their workforce as well as the factory environment.
Year(s) Of Engagement Activity 2019
 
Description Capacity Building Workshop for FARMS-SAFE research group 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Postgraduate students
Results and Impact The Capacity Building Workshop was held at the Faculty of Veterinary Medicine of University of La Plata from 3rd to 7th February 2020. The workshop was facilitated by the UK & Argentine PIs and CoIs to learn more about farm systems and the data that exists in Argentina, especially in La Plata and Cordoba.
By adopting a participatory approach SOPs were designed for data and sample collection for: i) drafting a national survey & tools for WS1 and WS2, ii) AMU and AMR for WS3, iv) AMR and AM/chemical contamination for WS4 and v) developing a risk-based approach to targeting AMR for WS5. National Autorities from SENASA, academics and postgraduate students from UNLP and Rio Cuarto as well as the team from UoB participated in the meeting.
During the workshop farm visits were organised for both the UK and Argentine colleagues to interview and participatorily observe and analyse the different farming practices among dairy and pig farms around La Plata.
Year(s) Of Engagement Activity 2020
 
Description Cattle Health and Welfare AMU Steering Group (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact committee meeting of the steering group on Cattle Health and Welfare at Stoneleigh
Year(s) Of Engagement Activity 2019
 
Description Channel 3 news programme 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The 3mitinews is one of Channel 3's news programs which broadcasts rerun news on its YouTube channel. This episode is a presentation of the news of the project launch with further information about the importance of research on antibiotic resistance in Thailand. It also warns agains using inappropriate antibacterial drugs leading to drug resistance. The video has been viewed over 3000 times.
Year(s) Of Engagement Activity 2019
URL https://www.youtube.com/watch?v=fTYYgFLC1Zg
 
Description Chulabhorn Royal Academy (CRA) Visit 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Worked with Bristol Veterinary School to welcome and discuss opportunities for training and research alongside the Chulabhorn Royal Academy in Thailand
Year(s) Of Engagement Activity 2019
 
Description Collaborative meeting with Rothamsted Research 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact North Wyke Farm Platform researchers visiting Langford as a collaborative meeting with Rothamsted Research; talked about potential collaborations and updated on work
Year(s) Of Engagement Activity 2019
 
Description Creation of informal Animal Health Network 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Industry/Business
Results and Impact Over 50 farms are participating in the study with samples being regularly taken from participating duck, chicken, fish and shrimp farms in the Bang Len area. The increased contact, including study questionnaires and interviews led to increased knowledge exchange between the farmers and the study team who are vets based in the Faculty of Veterinary Sciences at Mahidol University, with village heads also taking an active interest. Many of the farmers would not normally meet or use veterinary surgeons, so they were eager to exchange knowledge and ask for general advice around animal health, leading to the formation of an informal group with some farmers talking directly to the study team but with questions also coming from other farms in their network. This may have contributed towards changes in antibiotic use and farm management, but this will not be apparent until the data collection around medicines use is complete and the data analysed.
Year(s) Of Engagement Activity 2019,2020
 
Description Dairy Health Management Continuing Education Programme 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact invited headline presenter as an expert on AMR at Canada's premier training programme for diary veterinarians
Year(s) Of Engagement Activity 2019
URL https://guelphdhmcp.ca/
 
Description Engineering today article 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact Engineering Today is a journal for advancement in engineering and industry. Responding to the consumption of information in the digital economy. Information about the launch of OH-DART project was published online via https://www.engineeringtoday.net. In addition to presenting news of the project launch, these activities also present project information and the importance of antibiotic resistance studies in Thailand. The outcome of these activities is to disseminate information of the project and information about antibiotic resistance.
Year(s) Of Engagement Activity 2019
URL https://www.engineeringtoday.net/%E0%B8%A1%E0%B8%AB%E0%B8%B4%E0%B8%94%E0%B8%A5-%E0%B9%82%E0%B8%84%E0...
 
Description Food Industry Initiative on Antimicrobials Research & Development Committee + Data Committee - Quarterly Meeting (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Quarterly committee meeting of the Food Industry Initiative on Antimicrobials Research & Development Committee + Data Committee
Year(s) Of Engagement Activity 2019
 
Description Gloucestershire One Health AMR group (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Prepared communication plan for Gloucestershire on One Health AMR
Year(s) Of Engagement Activity 2019
 
Description Grant Launch Workshop - UK & Argentina AMR in the environment 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact The Grant Launch Workshop was organised by BBSRC & CONICET. Five projects funded through DoHSC/UKAid (along with BBSRC & NERC) in the UK and CONICET in Argentina presented their workpackages in order to create a collective proposal to develop a Pan-Program Intregration Project (PPIP) and policy translation activities within the Argentine context. A draft PPIP document was gathered from the workshop aiming to:

- Aim 1 Combine expertise and data from all five project teams to provide consistency to (i) the co-design of policy with agricultural livestock sectors (ii) the measurement of antimicriobial use (AMU) and resistance (AMR), and (iii) knowledge exchange messages across all the livestock species and production systems encompassed by the program.
- Aim 2 "A whole that is greater than the sum of its parts" - to generate research outcomes at the level of the program that would not be possible for any one project alone through combining effort and new work in specifically defined areas.

The aims will be addressed through four work packages. UoB through the FARMS-SAFE project leads Work Package 1 (WP1) - Harmonising antimicrobial use and data collection.
Year(s) Of Engagement Activity 2019
URL https://bbsrc.ukri.org/news/events/2018/1806-argentina-antimicrobial-resistance/
 
Description Host Head of Population Health and Head of Research, Ontario Veterinary College, Guelph University, Ontario, Canada 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Discuss AMR research and possible overlaps in collaborations
Year(s) Of Engagement Activity 2019
 
Description International Antibiotic Usage Forum (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Collaborative catch-up with AMR groups around the world - collaborations and contributions to practice
Year(s) Of Engagement Activity 2019
 
Description Interview for BBC Points West 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Discussed AMR research at the Bristol Veterinary School on 14th November 2019.
Year(s) Of Engagement Activity 2019
 
Description Lecture to vet students - Bristol University 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact Training of practitioners and professionals: Lecture on "Big ideas in veterinary medicine: AMR" to veterinary students
Year(s) Of Engagement Activity 2019
 
Description MOOC, Creating course on antimicrobial stewardship for vets (Reyher) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Discussion about AMR Massive Open Online Course phone meeting re training of practitioners and professionals
Year(s) Of Engagement Activity 2019
 
Description MRC Blog Antimicrobial resistance in Thailand: taking a holistic approach 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Following the launch of the project, Matthew Avison was interviewed by MRC comms and the information used to develop this blog post, which was used in part to advertise MRC investment into the global challenge of AMR, but also to give insight into interdisciplinary working. The release generated considerable social media engagement, and has subsequently been used by MRC in promotional material concerning AMR investment.
Year(s) Of Engagement Activity 2018
URL https://mrc.ukri.org/news/blog/antimicrobial-resistance-in-thailand-taking-a-holistic-approach/?redi...
 
Description Mahidol University newsletter 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Mahidol University published an newsletter article highlighting the project launch and the importance of studies on antibiotic resistance in Thailand. The newsletter is aimed at researchers, university staff and students and the general public.
Year(s) Of Engagement Activity 2019
URL https://mahidol.ac.th/th/2019/sh-one-health/?fbclid=IwAR0iffN4d87zNuxJp2j2WI6XCVWM09HQAg8yXvZB353Zgy...
 
Description Medical Research Foundation AMR PhD student cohort meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact Gave a talk at the training day for PhD students - discussed my background and journey in research and AMR research at Bristol - 15th November 2020.
Year(s) Of Engagement Activity 2019
 
Description Meeting with UN FAO and WHO representatives 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Thai OH-DART team members from the Chulabhorn Research Institute (CRI) met with three representatives of the UN Food and Agriculture Organization and WHO to discuss the plans and aims for the OH-DART project.
All were interested and have asked for updates on the project as results come in.
Year(s) Of Engagement Activity 2019
 
Description Meeting with representatives of the Welsh Government 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Phone meeting with Welsh Government to discuss about AMR
Year(s) Of Engagement Activity 2019
 
Description News NBT Thailand news piece 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The NewsNBT THAILAND is the government-backed National Broadcasting Service for Thailand'. The piece was run on its news program, with rerun news on their YouTube channel.
It ran a piece about the OH-DART launch and antibiotic resistance in Thailand on the news program of 19 December 2019, The outcome of this activity is to disseminate information of the project and information about antibiotic resistance.
Year(s) Of Engagement Activity 2019
URL https://www.youtube.com/watch?v=Rr_z8afj3rk&fbclid=IwAR3SWqO5oPt0SdJVj7OJe7vuLCUQFIZLDucw2QCd4T_aaPz...
 
Description OH-DART launch event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The launch event for the project attracted 70 attendees including executives, policy makers, government agencies, and acadenics. The OH-DART principal and co-investigators and researchers from both Thailand and the UK were also in attendance and available for networking.

Talks and introductions during the event were made by the Vice President for Research and Scientific Affairs of Mahidol University, the Governor of Nakhon Pathom Province, the Deputy Minister of Agriculture and Cooperatives, the Permanent Secretary of Ministry of Higher Education, Science, Research and Innovation. A panel discussion was held with representatives from the Ministry of Public Health, the Chairman of Thailand One Health University Network-National Coordinating Office, and industry and project representatives.

Among those invited were the Director Generals of the Department of Agriculture, Department of Disease Control, Department of Medical Sciences, Department of Environmental Quality Promotion, Department of Health Service Support, Department of Agricultural Extension, Department of Livestock Development, Department of Fisheries, Pollution Control Department, and Department of Public Health, National Health Commission Office, the Permanent Secretaries of Ministry of Industry, and Ministry of Natural Resource and Environment, as well as Universities and the Government Pharmaceutical Organisation, Infectious Disease Association of Thailand, Veterinary Council of Thailand, and Animal Health Products Association.

A press conference was also held on the day, and this led to a number of newspaper articles and news items on television and social media.

The launch of the One Health Drivers of Antibacterial Resistance in Thailand project to the media, civil society and personnel involved in antibiotic resistance contributed towards building a network of academic cooperation in driving drug-resistant infection prevention policies.

The outcome of this project launch is that general public knows the project through mass media and the various sectors involved in addressing the antibiotic resistance problem come together to debate and work on solving problems together. Many of the attendees expressed interest in following the progress of the study during informal discussions with study team members.
Year(s) Of Engagement Activity 2019
 
Description Online News Online broadcast 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The YouTube channe 'Online News Online' ran a piece about Mahidol University launching the project "One Health Drivers of Antibacterial Resistance in Thailand", It is a presentation of the news of the project launch and the presentation of information on the project and importance of studies on the antibiotic resistance in Thailand. The outcome of this activity is to disseminate information of the project and information about antibiotic resistance.
Year(s) Of Engagement Activity 2019
URL https://www.youtube.com/watch?v=ID58M0js0os&fbclid=IwAR2wZXST1BSDyPKfT8Q5k1kpRAY4R8MkX5RUpeF2Le_K24m...
 
Description Press conference and press release at launch event 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact The press conference and press release during the OH-DART launch event was attended by number representatives of newspapers and TV programmes including most prestigious examples The story was published in the Bangkok Post and Phuket other newspapers/magazines as well as featuring in tv programmes and on social media. The study team were available to answer questions and engage in discussion with members of the press.
Year(s) Of Engagement Activity 2019
URL http://www.thephuketnews.com/experts-fret-about-overuse-of-antibiotics-74085.php
 
Description RUMA Independent Scientific Group committee meeting (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Responsible Use of medicines in Agriculture Alliance (RUMA) scientific group meeting in London
Year(s) Of Engagement Activity 2019
 
Description Research meeting with representative from Boehringer Ingelheim 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Research meeting with representative from Boehringer Ingelheim to discuss AMR topics
Year(s) Of Engagement Activity 2019
 
Description Responsible use of medicines in Agriculture Alliance (RUMA) Targets Task Force 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Gave an invited talk to challenge livestock industries in AM stewardship targets in Stoneleigh on 10th September 2019
Year(s) Of Engagement Activity 2019
 
Description Royal Society of Biology meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited by the Royal Society of Biology to talk about AMR research, specifically transmission of AMR - overview of talk will be loaded on their blog
Year(s) Of Engagement Activity 2019
 
Description Speak with BBC Radio4 Costing the Earth 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Phone interview with the BBC Radio4 to discuss AMR research - background information to be used in radio presentation
Year(s) Of Engagement Activity 2020
 
Description Speak with Channel 4 Dispatches 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Phone interview with Channel 4 Dispatches to inform a documentary about food safety
Year(s) Of Engagement Activity 2020
 
Description TC News Station broadcast 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Information about the OH-DART project launch was broadcasted on TC News Station (tcnewsstation.com). In addition to presenting the project information they discussed the importance of antibiotic resistance studies in Thailand. The outcome of these activities is to disseminate information of the project and information about antibiotic resistance.
Year(s) Of Engagement Activity 2019
URL http://www.tcnewsstation.com/?p=43858&fbclid=IwAR3-Tucf-LTk2zNRAdjRLWd-grHRNfM9-E0E8IGSdPKnlYuvTsVVw...
 
Description Team member is guest speaker at meeting of National Health Security Office 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Assoc. Prof. Dr. Luechai Sringernyuang was invited as a guest speaker in the meeting to clarify and understand the fund mentor in the management of the Community Health Security Fund for the fiscal year 2020 between 27-28 November 2019. The outcome of speaking is to identify the problem as a system and solve it holistically. As part of his speaking that elaborates on the problem of drug-resistant infection does not just happen when people buy drugs. But the problem is from the enormous animal consumption. Due to the farming system that brought animals in unnatural. It is rooted in the demand for meat of the market, which is driven by advertising that encourages more people to consume, etc. Therefore, it is a systematic problem that requires a new look.
Year(s) Of Engagement Activity 2019
 
Description Team member presented at the Thai AMR Workshop on research mapping 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Nisanart Chareonlap, a team member from the Chulabhorn Research Institute attended the Workshop on AMR research mapping and prioritisation, which will feed in to the National AMR Strategy. Participants were from both government and academic sectors. Nisanart brought forward the need to consider the role of the environment in AMR, which was not considered in the first phase of the strategic plan on AMR. Outcomes: role of the environment will be considered in the upcoming phase and the results from OH-DART will be used to inform decisions around revision of policy.
Year(s) Of Engagement Activity 2019
 
Description Team members co-hosted and presented at the Thai 2nd National Forum on AMR 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact OH-DART was listed as a research partner of the 2nd National Forum on AMR at Rama Garden Hotel, Bangkok, which was co-hosted by CRI. The aims of this forum are to review the outcomes of Thailand's first National Strategic Plan on Antimicrobial Resistance, and to plan for the next round of the strategic plan which begins in 2022. The overall aim of this forum is to facilitate and strengthen multi-sectoral collaboration and practical actions under the One Health approach to support the implementation of Thailand's National Strategic Plan on AMR 2017-2021. The specific objectives are: to reaffirm the political commitment and sustain the high-level policiy momentum to address AMR under the One Health approach, to update the AMR situation, technical matters and important progress addressing AMR challenges that have been done at the global, regional and national levels, to bring together mulitdisciplinary stakeholders and explore opportunities for cooperation and collaboratino to address challenges posed by AMR in Thailand. Professor Emeritus Skorn Mongkolsuk from CRI presented the overview of OH-DART project to participants from government agencies, academia, and private sectors. OH-DARt team members Associate Professor Dr Luechai Sringernyuang, Dr Visanu Thamlikitkul, Assistant Professor Dr Walasinee Sakcamduang and Dr Parntep Ratanakorn all contributed in formal discussion sessions at this event.
Year(s) Of Engagement Activity 2019
 
Description Thai OH-DART team member was Invited Speaker at Regional Workshop on Antimicrobial Resistance in Asia 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Nisanart Charoenlap, who is project manager and researcher on OH-DART based at the Chulabhorn Research Institute, was an invited speaker at the Regional Workshop on Antimicrobial Resistance in Asia (Penang, Malaysia: 24-26 June 2019) on the topic of Potential drivers for AMR. Attendees were mostly key personnel from government sectors of their representative countries who carry responsibility for their national AMR strategies and the focus of discussion was around the different plans to tackle AMR and progress achieved. Nisanart presented work showing the concerns around chemical residues in environments and how OH-DART is aiming to elucidate how they may contribute as drivers of AMR.Outcomes: This led to questions and interest in hearing more about the results.
Year(s) Of Engagement Activity 2019
URL https://twn.my/title2/resurgence/2019/339-340/cover04.htm
 
Description Thai team meeting with orchid farmers 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact Dr Jutamaad Satayavivad and the team from Chulabhorn Research Institute went to the study area to meet a group of orchid farmers and discuss the projects aims and methods. They answered questions and discussed the issues around antibacterial resistance. Farmers agreed to take part in the study and grant access to their farms for sample collection as a result of these discussions.
Year(s) Of Engagement Activity 2019
 
Description Thai team members meeting with Bang Len public health and hospital leaders 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact The Mahidol University social science research team met with the deputy director of Banglen Hospital and relevant public health officials to provide project information and ask for cooperation. They are very interested in the project and are working closely with the team to facilitate collection of faecal samples and provide summaries of medical records and other data to the research teams, as well as allowing access to staff for field research. Further meetings are planned to discuss for example what statistical analyses of the provided data the hospital team would like performed. There is also much interest in the results.
In a further meeting, the social science researchers from Mahidol University met with the director, deputy director, and health staff of Bang Len hospital to discuss some research findings and interview the director about the health situation of people in Bang Len. The outcome of meeting is to return some research data to Bang Len Hospital and know the health situation of Bang Len people.
Year(s) Of Engagement Activity 2019
 
Description Thai team members meeting with the Bang Len Sheriff and District Health Officer 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact The social science researchers from Mahidol University met with the Bang Len Sheriff and Bang Len District Health Officer.to provide project information and ask for cooperation in conducting such research projects in the future. The outcome of meeting was cooperation and assistance in conducting research in Bang Len District from various parts, whether it is the public health department and the administrative department of the district. In Thailand this type of support is essential.
Year(s) Of Engagement Activity 2019
 
Description Thai team members meeting with the Bang Len district village headmen. 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact The social science researchers from Mahidol University attended the monthly meetings of the village headmen of Bang Len District to provide project information and ask for cooperation in conducting such research projects in the future. The outcome of meeting is cooperation and assistance in conducting research in Bang Len District.
Year(s) Of Engagement Activity 2019
 
Description Thai team members meeting with the Chief of the Bang Len district 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Thai members of the OH-DART team from CRI met with the chief of the Bang Len district, Mr. Yuttana Pothiwihok, to discuss the plans for the project and establish routes of communication and cooperation. They were joined by the district head of the Livestock Division, a nurse, and a representative of the provincial public health authority to join the meeting. The OH-DART team described the scope of the project and the involvement of the agricultural, aquacultural and environmental sectors as well as clinical and farm sectors. Outcomes: The Chief was very interested and has been supportive of the project. This meeting led to permission to approach the local hospital, markets and factories, as well as orchid and other agricultural sites. This kind of support from local leaders in Thailand is essential for projects to succeed.
Year(s) Of Engagement Activity 2019
 
Description Thai team members participation in Think Tank first meeting twoards shaping the next National Strategy on AMR 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact OH-DART co-investigators Dr Walasinee Sakcamduang. from the Mahidol University Faculty of Veterinary Sciences, Dr Luechai Sringernyuang from the Faculty of Social Sciences and Dr Visanu Thamlikitkul from the Faculty of Medicine are members of the National Sub-committee on AMR,
The first Think Tank meeting around shaping the next National Action Plan on AMR was held in September 2020. The agenda for discussion focussed on process of developing the second National Action Plan on AMR, including the contents of the NAP-AMR and potential critical questions for development of the NAP-AMR.

The meetings aims included gathering a full spectrum of views on AMR- related situations and challenges in Thailand. Specifically, it aimed to dig deep enough to get all the facts surrounding the situations before taking further action or developing the second National Strategic Plan on AMR (NAP-AMR).The evidence for a decrease in AMU in the animal sector by about 8% from baseline was presented, while the first NAP-AMR aimed to decreased AMU in animal sector by 20%. There was a trend of decreasing but not reaching the goal. However, the amount of consumption may not cover all species of animals as data comes mostly from swine and poultry. Dr Walasinee was able to present the aims of OH-DART, including the quantitative and qualitative work being carried out in participating farms which includes both measuring AMU and exploring attitudes, beliefs and behaviours around use of AMU in these poultry and aquaculture farms. Dr Luechai shared the social science perspective on AMR to policymakers.
There was much interest in this work and requests for the results from this study to be presented when available.
Year(s) Of Engagement Activity 2019
 
Description Thai team members presentation at FDA National AMR planning meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Team members from the Chulabhorn Research Institute presented the plans and aims of the OH-DART project at a meeting organised by the Food and Drug Administration focussing on updates to feed into the National AMR strategy. Participants from multiple sectors in Thailand attended, as well as representatives of the WHO and FAO.Outcomes: The FDA were very interested in the project due to this being the first study of AMR in Thailand to include human, animal, environment, and social science aspects together. The team will be included in all future relevant meetings, and have requested updates on the results from the project
Year(s) Of Engagement Activity 2019
 
Description Training of researchers in Epicollect5 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Three Thai researchers working on the project visited Bristol Vet School to work with Bristol researchers on developing study questionnaires using the data collection tool Epicollect5, an open source data collection tool developed and hosted by Oxford's Big Data Institute. During this visit they met UK members of the study team, and worked closely with the project manager to learn how to use Epicollect and how to set up user-friendly data collection forms, as well as developing skills in questionnaire design. As a result of this visit, the Thai teams were able to design forms for their researchers and sample collectors to use, as well as disseminating information and training around Epicollect5 to other research groups in their institutions so that it is now being used for other projects.
Year(s) Of Engagement Activity 2019
 
Description Veterinary Schools Council AMR (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact phone meeting
Year(s) Of Engagement Activity 2019
 
Description Veterinary Schools Council, AMR (Reyher) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Phone meeting with committee
Year(s) Of Engagement Activity 2019