Antimicrobial Resistance Research Hub - Interventions

Testing the use of probiotics to fatten pigs in Quang Ninh province, Vietnam

admin — Fri, 09 Apr 2021 07:52:00 +0000

Testing the use of probiotics to fatten pigs in Quang Ninh province, Vietnam

The International Livestock Research Institute led an on-farm experimental study in Quang Ninh province of Vietnam to evaluate the effectiveness of using probiotics in pig feed to improve the fattening and health of pigs.

The four-month study was conducted in partnership with Thai Nguyen University of Agriculture and Fishery, Hanoi University of Public Health and private sector partners Bio Spring and Green Farm.

Pillar

Interventions

Country

Vietnam

Region

Asia, Southeast Asia

Contacts

Addressing antibiotic resistance in the Jordan Valley

admin — Mon, 28 Sep 2020 12:03:52 +0000

Addressing antibiotic resistance in the Jordan Valley

The goal of this project is to expand the safe reuse of water in the Middle East and North Africa region.

Drawing on experience with water reuse strategies already developed in the region, the project identifies promising innovations and validated reuse models, with the aim of resolving past management bottlenecks. These include cultural barriers, institutional fragmentation, inappropriate regulations and lack of financial models for cost recovery.

With a focus on Egypt, Jordan and Lebanon, the project facilitates inclusive and participatory engagement with stakeholders, to support the development and uptake of project results.

The project is led by the International Water Management Institute.

More information

Starting date

January 1, 2018

Ending data

December 31, 2022

Pillar

Interventions

Country

Egypt, Jordan, Lebanon

Region

North Africa, Middle East

Contacts

Donors/Investors

Evidence for action: a One Health learning platform on interventions to tackle antimicrobial resistance

Ekta Patel — Tue, 01 Sep 2020 19:17:12 +0000

Fundamental gaps in knowledge hinder action against antimicrobial resistance, but the limitations of research into interventions for antimicrobial resistance serve as even bigger obstacles. Although systematic reviews have synthesised the effectiveness of some types of these interventions,a broder search and assessment of published interventions for antimicrobial resistance provides insights into the current state of knowledge

Contact details:

Dr Didier Wernli, Geneva Transformative Governance Lab, Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland didier.wernli@unige.ch

Background

Improving evidence for action is crucial to tackle antimicrobial resistance. The number of interventions for antimicrobial resistance is increasing but current research has major limitations in terms of efforts, methods, scope, quality, and reporting. Moving the agenda forwards requires an improved understanding of the diversity of interventions, their feasibility and cost–benefit, the implementation factors that shape and underpin their effectiveness, and the ways in which individual interventions might interact synergistically or antagonistically to influence actions against antimicrobial resistance in different contexts. Within the efforts to strengthen the global governance of antimicrobial resistance, we advocate for the creation of an international One Health platform for online learning. The platform will synthesise the evidence for actions on antimicrobial resistance into a fully accessible database; generate new scientific insights into the design, implementation, evaluation, and reporting of the broad range of interventions relevant to addressing antimicrobial resistance; and ultimately contribute to the goal of building societal resilience to this central challenge of the 21st century.

Project overview

Fundamental gaps in knowledge hinder effective action against antimicrobial resistance, but the limitations of research on interventions serve as even bigger obstacles. Moving the agenda forward requires a better understanding of the diversity of interventions for antimicrobial resistance, their feasibility and cost–benefit, and the factors that shape and underpin their effectiveness.
To foster learning across goals, regions, levels, and sectors, information about interventions for antimicrobial resistance can be consolidated into a fully accessible and continuously updated One Health online platform. Its main added value would be to provide searchable evidence about what works, for whom, and under what conditions.
An open access learning platform on interventions for antimicrobial resistance should be useful to a broad range of stakeholders, including health-care professionals, public health practitioners, policy makers, industries, and consumer groups. It would not only provide the possibility of complementing published sources with new information, but also enable the exchange of ideas through online community tools
By working towards amplifying the generation of science-based and actionable knowledge, the platform would be a timely contribution to the goal of building societal resilience to the complex challenge of antimicrobial resistance. The integration of the One Health learning platform within the governance mechanism will help to maximise its usefulness and sustainability.

Researchers

Wernli, D., Jørgensen, P.S., Parmley, E.J., Troell, M., Majowicz, S., Harbarth, S., Léger, A., Lambraki, I., Graells, T., Henriksson, P.J.G., Carson, C., Cousins, M., Ståhlgren, G.S., Mohan, C.V., Simpson, A.J.H., Wieland, B., Pedersen, K., Schneider, A., Chandy, S.J., Wijayathilaka, T.P., Delamare-Deboutteville, J., Vila, J., Lundborg, C.S. and Pittet, D.

Institutions involved

Geneva Transformative Governance Lab, Global Studies Institute and Infection Control Program and World Health Organization Collaborating Centre on Patient Safety, University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China, Global Economic Dynamics and the Biosphere and Beijer Institute of Ecological Economics, The Royal Swedish Academy of Sciences, Stockholm, Sweden; Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada, WorldFish, Penang, Malaysia, Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, ON, Canada, Unit for Antibiotics and Infection Control, The Public Health Agency of Sweden, Solna, Sweden,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, UK, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos , International Livestock Research Institute, Nairobi, Kenya, National Veterinary Institute, Uppsala, Sweden, Department of Clinical, Educational and Health Psychology, University College London, London, UK, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, India, World Organisation for Animal Health, OIE Sub-Regional Representation for South East Asia, Bangkok, Thailand, Department of Clinical Microbiology, Biomedical Diagnostic Center, Hospital Clinic School of Medicine and Barcelona Institute for Global Health, University of Barcelona, Barcelona Spain and Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden

Research Subject Area(s)

One Health, Human health, Public health, Antimicrobial Use (AMU), Antimicrobial Resistance (AMR)

Funding

Swedish Research Council; Canadian Institutes of Health Research; Swiss National Science Foundation

Relevant information

Full publication available here: https://hdl.handle.net/10568/109151

Using phages to replace antibiotics and reduce drug-resistant non-typhoidal Salmonella in poultry farms in Kenya

admin — Tue, 10 Mar 2020 07:46:38 +0000

Using phages to replace antibiotics and reduce drug-resistant non-typhoidal Salmonella in poultry farms in Kenya

The goal of this project is to investigate bacteriophage-based solutions to kill Salmonella strains isolated from poultry farms in Kenya.

The project collects Salmonella samples from poultry farms and slaughterhouses in Kenya and types strains for antibiotic resistance genes.

Known bacteriophages are then tested for their capacity to disintegrate selected Salmonella strains, and new bacteriophages with lytic activity towards Salmonella strains isolated.

Researchers then test combinations of bacteriophages in a Salmonella infection model in chickens, conduct field trials using bacteriophages in selected smallholder farms, and assess the impact of bacteriophage technology and adoption by women chicken farmers.

The project includes new commercial products that are alternatives to antibiotics for the prevention and control of infections that could be adopted by the poultry industry in Kenya.

Starting date

March 1, 2020

Ending data

November 30, 2022

Pillar

Interventions

Country

Kenya

Region

Africa, Eastern and Southern Africa

Contacts

Donors/Investors

Partners

International Livestock Research Institute

Laval University

A community-based intervention to mitigate risks of antimicrobial resistance in the Ethiopian highlands

Ekta Patel — Sun, 01 Mar 2020 10:47:30 +0000

Contact details:

Barbara Wieland (b.wieland@cgiar.org). Team leader herd health, International Livestock Research Institute (ILRI), Ethiopia.

Background

Community-based strategies have been increasingly recommended when implementing interventions directed to raise awareness about different health issues affecting communities, and promote a behavioural change amongst community members. These types of strategies are founded on the needs and concerns of community members, men and women, directly engaging the community in the research process. The CRP Livestock has successfully tested the use of community conversations as a gender transformative approach in small ruminant production systems, focussing on the division of labour and exposure risk to zoonoses for different household members.

Many communities in Ethiopia are engaged in animal production, as it is their main source of subsistence. In this regard, antimicrobial resistance (AMR) becomes an important issue as it threatens the ability of community members to care for their animals, and more importantly increases the risk of treatment failure in people.

It has been demonstrated that in many rural communities, women spend much of their time in livestock production, having a central role in caring for sick animals and their families and potentially play an important role in the decision-making process around use of antimicrobials in people and livestock. Given their roles and responsibilities in livestock keeping, it has been proposed that AMR in rural communities could exacerbate gender inequality, as women and girls may face a heavy burden as primary caregivers for family members and animals as a result of antimicrobial resistant infections.

Project overview

This research aims to increase community member awareness about how the misuse of antimicrobials in animal production can be harmful to the community’s health, and to understand the level of women’s participation in rational antimicrobial use (AMU) and the implications for gender relations in AMU and AMR. The ultimate goal is to induce a change in community attitudes, perceptions and practices towards rational use of antimicrobials.

For this activity, community conversations on AMU/AMR and related links of women’s involvement in agriculture and livestock production will be carried out in three sites: Menz (highland), Doyogena (midland) and Bonga (midland). Community conversations will be centred around three main topics: antimicrobial use in animal production, antimicrobial resistance, and women’s involvement in livestock production. Communities are invited to participate in meetings to encourage conversations and discussions and to document community members’ perceptions and attitudes about the use of antimicrobials. Knowledge, Attitude, Skills and Practice (KASP) baseline about AMU and AMR will be established by administering pre- and post-training KASP assessments, using a semi-structured questionnaire and level of use will be quantified and assessed with the AMUSE livestock tool. Checklists of observation of behavioural change will be developed. Storyboards will be used for capturing stories of changes at the household and community level. Monitoring of change will be done through repeated visits (at least 3 visits per community during the project).

Research impact

By increasing awareness of AMU and AMR and highlighting gender relations to these topics, we will contribute to reducing the use of antimicrobials and the burden of antimicrobial resistant infections, and promoting positive changes towards the role of women in agriculture in these communities. Moreover, we will propose research-based policy recommendations on how to improve the use of antimicrobials in rural communities.

Researchers

Barbara Wieland¹, Annet Mulema¹,Mamusha Lemma Woldegioris¹,Wole Kinati².

Institutions involved

International Livestock Research Institute (ILRI).
International Center for Agriculture in Dry Areas (ICARDA).
Southern Agriculture Research Institute SARI, Ethiopia.
Debre Birhan Agricultural Research Centre, Ethiopia.

Research Subject Area(s)

Gender, Human health, Public health, Animal Health, Antimicrobial Use (AMU), Antimicrobial Resistance (AMR)

Funding

o CGIAR research program on Livestock.

Relevant information

Alemu, B., Desta, H., Alemayehu, G. and Wieland, B. 2017. Responsible use of antimicrobials in small ruminants. SmaRT Ethiopia intervention factsheet 22. Addis Ababa: ICARDA. Available at: https://cgspace.cgiar.org/bitstream/handle/10568/80954/Smart%20intervention22.pdf?sequence=1&isAllowed=y
Lemma, M., Kinati, W., Mulema, A.A., Bassa, Z., Tigabe, A., Desta, H., Mekonnen, M. and Asfaw, T. 2018. Report of community conversations about gender roles in livestock. Nairobi, Kenya: ILRI. Available at: https://cgspace.cgiar.org/bitstream/handle/10568/99316/conversation_gender_roles.pdf?sequence=6&isAllowed=y
World Bank, & FAO. (2016). World Feminization of Agriculture in the Context of Rural Transformations: What is the Evidence?Available at: http://documents.worldbank.org/curated/en/790991487093210959/pdf/ACS20815-WP-PUBLIC-Feminization-of-AgricultureWorld-BankFAO-FINAL.pdf
Gemeda BA, Amenu K, Magnusson U, Dohoo I, Hallenberg GS, Alemayehu G, Desta H, Wieland B 2020. Antimicrobial Use in Extensive Smallholder Livestock Farming Systems in Ethiopia: Knowledge, Attitudes, and Practices of Livestock Keepers Front Vet Science.
Alemu, B., Lemma, M., Magnusson, U., Wieland, B., Mekonnen, M. and Mulema, A. 2019. Community conversations on antimicrobial use and resistance in livestock. Nairobi, Kenya: ILRI
Lemma, M., Alemu, B., Mekonnen, M. and Wieland, B. 2019. REPORT: Community conversations on antimicrobial use and resistance. Nairobi, Kenya: ILRI.

Download a pdf version of this project here:

Community_conversations_AMR.pdf

Modelling the impact of antimicrobial resistance interventions in LMICs from a One Health perspective

admin — Wed, 13 Feb 2019 14:31:28 +0000

Contact details:

Nichola Naylor (nichola.naylor@lshtm.ac.uk). Research Fellow, London School of Hygiene and Tropical Medicine, UK.

Background

Antimicrobial resistance (AMR) is an exemplary One Health issue. Antimicrobials are being used in animals and humans for both the treatment and prevention of infectious disease. AMR, a phenomenon thought to be expedited by the overuse and misuse of antimicrobials, is also creating a world with less effective antimicrobials. This has the potential to impact both human and animal health, but also healthcare system costs, agricultural productivity and poverty. In order to evaluate which policies are the most efficient (in terms of providing the most utility or welfare to a population given a certain level of investment), we need to perform quantitative evaluations that compare the costs and effects of interventions.

In health economics, this involves performing cost-utility analyses whereby a cost-per-DALY is estimated. In agricultural economics, this usually consists of performing a cost-benefit analysis with an incremental benefit–costratio estimated. However, the standard for One Health economics analyses has not yet been set. This work hopes to establish a quantitative framework that allows for the comparison of all potential costs and effects associated with different policies that affect both humans and animals. This is applied within the context of AMU and AMR, to attempt efficiently tackle the issue of AMR.

Project overview

This study has two main objectives:

To provide a general framework as to how the impact of antibiotic stewardship policies could be quantitatively evaluated, whilst accounting for policy impact on public health and agriculture.
To construct a quantitative economic evaluation model, based on (1), and apply this model to one specific LMIC country setting.

Initially, a literature review of any previous economic evaluations of policies related to One Health issues (such as climate change) is being conducted to conceptualise an appropriate framework that could be recommended for use in this area. All relevant information related to this topic is being collated and discussed in line with the issue of antimicrobial resistance. This review will offer a conceptual framework for a quantitative evaluation of antimicrobial stewardship policies, describing potential key outputs from microeconomic and macroeconomic perspectives.

The appropriateness of this framework on evaluating AMR related policies impact will be tested by constructing an economic model (in R software). This model will then be applied to one specific LMIC setting. The construction of a quantitative economic model in R will provide indications as to what policies may be most effective in reducing the burden of AMR, and additionally what parameters are important in determining related outcomes.

Research impact

By conducting economic evaluations, our results will contribute to the policymaking decision process in the design of appropriate policies relating to AMR and AMU. Economic evaluations will enable policymakers in already resource-constrained settings to determine which policy options offer the most return across chosen outputs (such as in terms of cost-benefit). Additionally, by applying a One Health approach, this research will enable the inclusion of both the public health impact and the agricultural impact of AMR, which could contribute with national and international policymakers in efficiently tackling AMR.

Researchers

Nichola Naylor¹, Gwen Knight¹, Jo Lines¹, Jeff Waage¹^, 3.

Institutions involved

1. London School of Hygiene and Tropical Medicine, UK.

2. Antimicrobial Resistance Centre - LSHTM, UK.

3. International Livestock Research Institute (ILRI).

Research Subject Area(s)

One Health, Human health, Public health, Antimicrobial Use (AMU), Antimicrobial Resistance (AMR)

Funding

This study is being funded through the Improving Human Health project (LSHTM) - CGIAR research program on Agriculture for Nutrition and Health (A4NH).

Relevant information

Previous work performed before by Nichola (from solely the public health perspective) can feed into the One Health economic evaluations that involve human health outcomes, and is available at:

Naylor, N.R., Atun, R., Zhu, N., Kulasabanathan, K., Silva, S., Chatterjee, A., Knight, G.M. and Robotham, J.V., 2018. Estimating the burden of antimicrobial resistance: a systematic literature review. Antimicrobial Resistance & Infection Control, 7(1). DOI:10.1186/s13756-018-0336-y.
Naylor, N.R., Zhu, N., Hulscher, M., Holmes, A., Ahmad, R. and Robotham, J.V., 2017. Is antimicrobial stewardship cost-effective? A narrative review of the evidence. Clinical Microbiology and Infection, 23(11), pp.806-811. DOI:10.1016/j.cmi.2017.06.011.

Download a pdf version of this project here:

AMR_modelling.pdf