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; Sammarro, Melodie; Chidziwisano, Kondwani; Elviss, Nicola; Jacob, Shevin T.; Kajumbula, Henry; Mugisha, Lawrence; Musoke, David; Musicha, Patrick; Roberts, Adam P.; Rowlingson, Barry; Singer, Andrew C. ORCID: https://orcid.org/0000-0003-4705-6063; Byrne, Rachel L.; Edwards, Thomas; Lester, Rebecca; Wilson, Catherine N.; Hollihead, Beth; Thomson, Nicholas R.; Jewell, Christopher P.; Morse, Tracy; Feasey, Nicholas A.. 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, 55. 31, pp. https://doi.org/10.12688/wellcomeopenres.17581.2

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Official URL: https://doi.org/10.12688/wellcomeopenres.17581.2

Abstract/Summary

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. 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. 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.

Item Type:	Publication - Article
Digital Object Identifier (DOI):	https://doi.org/10.12688/wellcomeopenres.17581.2
UKCEH and CEH Sections/Science Areas:	Pollution (Science Area 2017-)
ISSN:	2398-502X
Additional Information. Not used in RCUK Gateway to Research.:	Open Access paper - full text available via Official URL link.
Additional Keywords:	antimicrobial resistance, Africa, One Health, environment
NORA Subject Terms:	Health
Date made live:	20 Jul 2022 10:08 +0 (UTC)
URI:	https://nora.nerc.ac.uk/id/eprint/532951

Item Type:

Publication - Article

Digital Object Identifier (DOI):

https://doi.org/10.12688/wellcomeopenres.17581.2

UKCEH and CEH Sections/Science Areas:

Pollution (Science Area 2017-)

ISSN:

2398-502X

Additional Information. Not used in RCUK Gateway to Research.:

Open Access paper - full text available via Official URL link.

Additional Keywords:

antimicrobial resistance, Africa, One Health, environment