Drivers of Resistance in Uganda and Malawi (DRUM): a protocol for the evaluation of One-Health drivers of Extended Spectrum Beta Lactamase (ESBL) resistance in Low-Middle Income Countries (LMICs)


Cocker, Derek ORCID: 0000-0002-6670-2713, Sammarro, Melodie ORCID: 0000-0002-8342-8437, Chidziwisano, Kondwani ORCID: 0000-0002-1755-0469, Elviss, Nicola, Jacob, Shevin T ORCID: 0000-0003-2425-9394, Kajumbula, Henry, Mugisha, Lawrence ORCID: 0000-0003-4932-3356, Musoke, David ORCID: 0000-0003-3262-3918, Musicha, Patrick, Roberts, Adam P ORCID: 0000-0002-0760-3088 et al (show 11 more authors) (2023) Drivers of Resistance in Uganda and Malawi (DRUM): a protocol for the evaluation of One-Health drivers of Extended Spectrum Beta Lactamase (ESBL) resistance in Low-Middle Income Countries (LMICs). Wellcome Open Research, 7. p. 55.

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Abstract

<ns4:p>In sub-Saharan Africa (sSA), there is high morbidity and mortality from severe bacterial infection and this is compounded by antimicrobial resistance, in particular, resistance to 3rd-generation cephalosporins. This resistance is typically mediated by extended-spectrum beta lactamases (ESBLs). To interrupt ESBL transmission it will be important to investigate how human behaviour, water, sanitation, and hygiene (WASH) practices, environmental contamination, and antibiotic usage in both urban and rural settings interact to contribute to transmission of ESBL E. coli and ESBL K. pneumoniae between humans, animals, and the environment.</ns4:p><ns4:p> Here we present the protocol for the Drivers of Resistance in Uganda and Malawi (DRUM) Consortium, in which we will collect demographic, geospatial, clinical, animal husbandry and WASH data from a total of 400 households in Uganda and Malawi. Longitudinal human, animal and environmental sampling at each household will be used to isolate ESBL E. coli and ESBL K. pneumoniae. This will be complimented by a Risks, Attitudes, Norms, Abilities and Self-Regulation (RANAS) survey and structured observations to understand the contextual and psychosocial drivers of regional WASH practices.</ns4:p><ns4:p> Bacterial isolates and plate sweeps will be further characterised using a mixture of short-,long-read and metagenomic whole-genome sequencing. These datasets will be integrated into agent-based models to describe the transmission of EBSL resistance in Uganda and Malawi and allow us to inform the design of interventions for interrupting transmission of ESBL-bacteria.</ns4:p>

Item Type: Article
Uncontrolled Keywords: Vaccine Related, Biodefense, Prevention, Clinical Research, Infectious Diseases, Antimicrobial Resistance, 2.2 Factors relating to the physical environment, 2 Aetiology, Infection, 6 Clean Water and Sanitation, 3 Good Health and Well Being
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 29 Sep 2023 09:21
Last Modified: 26 Apr 2024 08:14
DOI: 10.12688/wellcomeopenres.17581.2
Open Access URL: http://doi.org/10.12688/wellcomeopenres.17581.2
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3173196
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