26. April 2022

Optimisation of antimicrobial use in BSIs and UTIs in various health sector settings in Zambia

Facts

Region: Africa Sector: Humans Country: Zambia Project type: Demonstration project Country partners: Ministry of Health, University of Zambia Teaching Hospital, Zambia National Public Health Institute Timescale: 1 February 2022 – 31 January 2025 ICARS funding: 550,000 USD

Context

Zambia is a country in Southern Central Africa, a landlocked country with a population of about 18.3 million people. It has a centralized government and healthcare is provided by the government, faith-based organizations and the private sectors. Like most LMICs, it faces similar challenges like weak health systems, chronic stock-outs of diagnostics and medicines including antibiotics. It depends on almost 100% importation of its medical and diagnostic needs.

Problem

Antimicrobial resistance is a global concern and a serious risk to public health. In clinical practice worldwide and Zambia in particular, urinary tract infections (UTIs) and bloodstream infections (BSIs) are clinical syndromes associated with indiscriminate use of antibiotics leading to antibiotic resistance (ABR). The consequences of ABR include:

  • prolonged hospitalization
  • mortality
  • increased healthcare cost.

This is made worse with institutions that do not have AMS programs.

“This project is timely in Zambia as we seek to develop evidence-based treatment guidelines for common syndromes we struggle with, claiming many lives and causing more morbidities.”  – Professor Lloyd Mulenga, University of Zambia

Project overview

This project aims to improve the appropriate use of antibiotics for BSIs and UTIs by 20% by all prescribers across the continuum care within 2 years, by introducing an antimicrobial stewardship (AMS) programme in selected Zambian healthcare facilities. Blood stream infections (BSIs) and urinary tract infections (UTIs) will be used as proxies along the continuum of care.

Outcomes

Successful implementation of this project should lead to strengthening of the antimicrobial stewardship (AMS) programmes in participating health facilities in Zambia including:

  • evidence-based management of UTIs and BSIs
  • increased compliance to treatment guidelines
  • appropriate antimicrobial usage (AMU): drug choice dose, route, duration, dosing frequency in BSIs and UTIs
  • reduction in antibiotic use
  • education in both healthcare delivery cost and utilisation cost
  • sustainable AMS programs at all levels of healthcare
Supporting activity
Zambia
One Health

Supporting National Action Plans on AMR in Africa through contextualised tools for Implementation Research

Demonstration Project
Georgia
Humans

Optimising use of antibiotics for Surgical Antibiotic Prophylaxis (SAP)