Strengthening antimicrobial resistance diagnostic capacity in rural rwanda : A feasibility assessment
(2021) In Annals of Global Health 87(1). p.1-13- Abstract
Introduction: Antimicrobial resistance (AMR) is a global public health threat. Worse still, there is a paucity of data from low-and middle-income countries to inform rational antibiotic use. Objective: Assess the feasibility of setting up microbiology capacity for AMR testing and estimate the cost of setting up microbiology testing capacity at rural district hospitals in Rwanda. Methods: Laboratory needs assessments were conducted, and based on identified equipment gaps, appropriate requisitions were processed. Laboratory technicians were trained on microbiology testing processes and open wound samples were collected and cultured at the district hospital (DH) laboratories before being transported to the National Reference Laboratory... (More)
Introduction: Antimicrobial resistance (AMR) is a global public health threat. Worse still, there is a paucity of data from low-and middle-income countries to inform rational antibiotic use. Objective: Assess the feasibility of setting up microbiology capacity for AMR testing and estimate the cost of setting up microbiology testing capacity at rural district hospitals in Rwanda. Methods: Laboratory needs assessments were conducted, and based on identified equipment gaps, appropriate requisitions were processed. Laboratory technicians were trained on microbiology testing processes and open wound samples were collected and cultured at the district hospital (DH) laboratories before being transported to the National Reference Laboratory (NRL) for bacterial identification and antibiotic susceptibility testing. Quality control (QC) assessments were performed at the DHs and NRL. We then estimated the cost of three scenarios for implementing a decentralized microbiology diagnostic testing system. Results: There was an eight-month delay from the completion of the laboratory needs assessments to the initiation of sample collection due to the regional unavailability of appropriate supplies and equipment. When comparing study samples processed by study laboratory technicians and QC samples processed by other laboratory staff, there was 85.0% test result concordance for samples testing at the DHs and 90.0% concordance at the NRL. The cost for essential equipment and supplies for the three DHs was $245,871. The estimated costs for processing 600 samples ranged from $29,500 to $92,590. Conclusion: There are major gaps in equipment and supply availability needed to conduct basic microbiology assays at rural DHs. Despite these challenges, we demonstrated that it is feasible to establish microbiological testing capacity in Rwandan DHs. Building microbiological testing capacity is essential for improving clinical care, informing rational antibiotics use, and ultimately, contributing to the establishment of robust national antimicrobial stewardship programs in rural Rwanda and comparable settings.
(Less)
- author
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Global Health
- volume
- 87
- issue
- 1
- article number
- 78
- pages
- 13 pages
- publisher
- Ubiquity Press Ltd.
- external identifiers
-
- scopus:85112574381
- pmid:34430228
- ISSN
- 2214-9996
- DOI
- 10.5334/aogh.3416
- language
- English
- LU publication?
- no
- id
- 003a3913-6e60-4988-add9-624ddc5b54c0
- date added to LUP
- 2021-09-10 11:03:22
- date last changed
- 2024-06-16 18:47:36
@article{003a3913-6e60-4988-add9-624ddc5b54c0,
abstract = {{<p>Introduction: Antimicrobial resistance (AMR) is a global public health threat. Worse still, there is a paucity of data from low-and middle-income countries to inform rational antibiotic use. Objective: Assess the feasibility of setting up microbiology capacity for AMR testing and estimate the cost of setting up microbiology testing capacity at rural district hospitals in Rwanda. Methods: Laboratory needs assessments were conducted, and based on identified equipment gaps, appropriate requisitions were processed. Laboratory technicians were trained on microbiology testing processes and open wound samples were collected and cultured at the district hospital (DH) laboratories before being transported to the National Reference Laboratory (NRL) for bacterial identification and antibiotic susceptibility testing. Quality control (QC) assessments were performed at the DHs and NRL. We then estimated the cost of three scenarios for implementing a decentralized microbiology diagnostic testing system. Results: There was an eight-month delay from the completion of the laboratory needs assessments to the initiation of sample collection due to the regional unavailability of appropriate supplies and equipment. When comparing study samples processed by study laboratory technicians and QC samples processed by other laboratory staff, there was 85.0% test result concordance for samples testing at the DHs and 90.0% concordance at the NRL. The cost for essential equipment and supplies for the three DHs was $245,871. The estimated costs for processing 600 samples ranged from $29,500 to $92,590. Conclusion: There are major gaps in equipment and supply availability needed to conduct basic microbiology assays at rural DHs. Despite these challenges, we demonstrated that it is feasible to establish microbiological testing capacity in Rwandan DHs. Building microbiological testing capacity is essential for improving clinical care, informing rational antibiotics use, and ultimately, contributing to the establishment of robust national antimicrobial stewardship programs in rural Rwanda and comparable settings.</p>}},
author = {{Umutesi, Grace and Velin, Lotta and Muwanguzi, Moses and Faktor, Kara and Mugabo, Carol and Rukundo, Gilbert and Rucogoza, Aniceth and Yankurije, Marthe and Mazimpaka, Christian and Gatete, Jean De Dieu and Shyirambere, Cyprien and Hedt-Gauthier, Bethany and Riviello, Robert and Mpunga, Tharcisse and Mwikarago, Emil Ivan and Kateera, Fredrick}},
issn = {{2214-9996}},
language = {{eng}},
number = {{1}},
pages = {{1--13}},
publisher = {{Ubiquity Press Ltd.}},
series = {{Annals of Global Health}},
title = {{Strengthening antimicrobial resistance diagnostic capacity in rural rwanda : A feasibility assessment}},
url = {{http://dx.doi.org/10.5334/aogh.3416}},
doi = {{10.5334/aogh.3416}},
volume = {{87}},
year = {{2021}},
}