Antimicrobial stewardship situation analysis in selected hospitals in Zambia: findings and implications from a national survey.


Journal

Frontiers in public health
ISSN: 2296-2565
Titre abrégé: Front Public Health
Pays: Switzerland
ID NLM: 101616579

Informations de publication

Date de publication:
2024
Historique:
received: 09 01 2024
accepted: 13 09 2024
medline: 14 10 2024
pubmed: 14 10 2024
entrez: 14 10 2024
Statut: epublish

Résumé

Antimicrobial stewardship (AMS) programs are critical in combating antimicrobial resistance (AMR). In Zambia, there is little information regarding the capacity of hospitals to establish and implement AMS programs. The objective of this study was to conduct a baseline assessment of WHO core elements for an AMS program implementation in eight hospitals in Zambia. We conducted an exploratory cross-sectional study from September 2023 to December 2023 using a self-scoring Periodic National and Healthcare Facility Assessment Tool from the World Health Organization (WHO) policy guidance on integrated AMS activities in human health. Eight public hospitals were surveyed across the five provinces of Zambia. Data was analyzed using the WHO self-scoring tool and thematic analysis. Overall, 62.5% (6/8) of the facilities scored low (below 60%) in implementing AMS programs. Most facilities had challenges with reporting AMS feedback within the hospital (average score = 46%), Drugs and Therapeutics Committee (DTC) functionality (average score = 49%), AMS actions (average score = 50%), education and training (average score = 54%), and leadership commitment to AMS activities (average score = 56%). The overall score for all AMS core elements was average (56%). All the hospitals (100%) did not have an allocated budget for AMS programs. Finally, there were neither antibiograms to guide antimicrobial utilization nor AMS-trained staff in more than 50% of the hospitals surveyed. This study found low AMS implementation in these public hospitals, especially where DTCs were non-functional. The identified challenges and gaps require urgent attention for sustainable multidisciplinary AMS programs.

Sections du résumé

Background UNASSIGNED
Antimicrobial stewardship (AMS) programs are critical in combating antimicrobial resistance (AMR). In Zambia, there is little information regarding the capacity of hospitals to establish and implement AMS programs. The objective of this study was to conduct a baseline assessment of WHO core elements for an AMS program implementation in eight hospitals in Zambia.
Materials and methods UNASSIGNED
We conducted an exploratory cross-sectional study from September 2023 to December 2023 using a self-scoring Periodic National and Healthcare Facility Assessment Tool from the World Health Organization (WHO) policy guidance on integrated AMS activities in human health. Eight public hospitals were surveyed across the five provinces of Zambia. Data was analyzed using the WHO self-scoring tool and thematic analysis.
Results UNASSIGNED
Overall, 62.5% (6/8) of the facilities scored low (below 60%) in implementing AMS programs. Most facilities had challenges with reporting AMS feedback within the hospital (average score = 46%), Drugs and Therapeutics Committee (DTC) functionality (average score = 49%), AMS actions (average score = 50%), education and training (average score = 54%), and leadership commitment to AMS activities (average score = 56%). The overall score for all AMS core elements was average (56%). All the hospitals (100%) did not have an allocated budget for AMS programs. Finally, there were neither antibiograms to guide antimicrobial utilization nor AMS-trained staff in more than 50% of the hospitals surveyed.
Conclusion UNASSIGNED
This study found low AMS implementation in these public hospitals, especially where DTCs were non-functional. The identified challenges and gaps require urgent attention for sustainable multidisciplinary AMS programs.

Identifiants

pubmed: 39399696
doi: 10.3389/fpubh.2024.1367703
pmc: PMC11466898
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1367703

Informations de copyright

Copyright © 2024 Chizimu, Mudenda, Yamba, Lukwesa, Chanda, Nakazwe, Simunyola, Shawa, Kalungia, Chanda, Chola, Mateele, Thapa, Kapolowe, Mazaba, Mpundu, Masaninga, Azam, Nakajima, Suzuki, Bakyaita, Wesangula, Matu and Chilengi.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Joseph Yamweka Chizimu (JY)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia.
Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan.

Steward Mudenda (S)

Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Kaunda Yamba (K)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia.

Chileshe Lukwesa (C)

Lusaka District Health Office, Lusaka, Zambia.

Raphael Chanda (R)

University Teaching Hospitals, Lusaka, Zambia.

Ruth Nakazwe (R)

University Teaching Hospitals, Lusaka, Zambia.

Bwalya Simunyola (B)

Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.

Misheck Shawa (M)

Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.
Department of Pharmacy, Ministry of Health, Lusaka, Zambia.

Aubrey Chichonyi Kalungia (AC)

Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia.

Duncan Chanda (D)

University Teaching Hospitals, Lusaka, Zambia.

Uchizi Chola (U)

University Teaching Hospitals, Lusaka, Zambia.

Tebuho Mateele (T)

Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia.

Jeewan Thapa (J)

Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan.

Kenneth Kapolowe (K)

University Teaching Hospitals, Lusaka, Zambia.

Mazyanga Lucy Mazaba (ML)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia.
Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Kita-ku, Sapporo, Hokkaido, Japan.

Mirfin Mpundu (M)

Action on Antibiotic Resistance (ReAct) Africa, Lusaka, Zambia.

Freddie Masaninga (F)

World Health Organization, Lusaka, Zambia.

Khalid Azam (K)

Strengthening Pandemic Preparedness, Eastern, Central, and Southern Africa Health Community, Arusha, Tanzania.

Chie Nakajima (C)

Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan.
Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Kita-ku, Sapporo, Hokkaido, Japan.
International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan.

Yasuhiko Suzuki (Y)

Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan.
Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Kita-ku, Sapporo, Hokkaido, Japan.
International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo, Japan.

Nathan Nsubuga Bakyaita (NN)

Division of Research Support, Hokkaido University Institute for Vaccine Research and Development, Kita-ku, Sapporo, Hokkaido, Japan.

Evelyn Wesangula (E)

Strengthening Pandemic Preparedness, Eastern, Central, and Southern Africa Health Community, Arusha, Tanzania.

Martin Matu (M)

Strengthening Pandemic Preparedness, Eastern, Central, and Southern Africa Health Community, Arusha, Tanzania.

Roma Chilengi (R)

Antimicrobial Resistance Coordinating Committee (AMRCC), Zambia National Public Health Institute, Lusaka, Zambia.

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