A One Health Approach to Strengthening Antimicrobial Stewardship in Wakiso District, Uganda
David Musoke,
Freddy Eric Kitutu,
Lawrence Mugisha,
Saba Amir,
Claire Brandish,
Deborah Ikhile,
Henry Kajumbula,
Ismail Musoke Kizito,
Grace Biyinzika Lubega,
Filimin Niyongabo,
Bee Yean Ng,
Jean O’Driscoll,
Kate Russell-Hobbs,
Jody Winter,
Linda Gibson
Affiliations
David Musoke
Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Freddy Eric Kitutu
Department of Pharmacy, School of Health Sciences, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Lawrence Mugisha
College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, Kampala P.O. Box 7062, Uganda
Saba Amir
School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Nottingham NG25 0QF, UK
Claire Brandish
Buckinghamshire Healthcare NHS Trust, Aylesbury HP21 8AL, UK
Deborah Ikhile
Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham NG1 4FQ, UK
Henry Kajumbula
Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Filimin Niyongabo
Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
Bee Yean Ng
Buckinghamshire Healthcare NHS Trust, Aylesbury HP21 8AL, UK
Jean O’Driscoll
Buckinghamshire Healthcare NHS Trust, Aylesbury HP21 8AL, UK
Kate Russell-Hobbs
Buckinghamshire Healthcare NHS Trust, Aylesbury HP21 8AL, UK
Jody Winter
Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
Linda Gibson
Institute of Health and Allied Professions, School of Social Sciences, Nottingham Trent University, Nottingham NG1 4FQ, UK
Antimicrobial stewardship (AMS), as one of the global strategies to promote responsible use of antimicrobials to prevent antimicrobial resistance (AMR), remains poor in many low-and middle-income countries (LMICs). We implemented a project aimed at strengthening AMS in Wakiso district, Uganda using a One Health approach. A total of 86 health practitioners (HPs), including animal health workers, and 227 community health workers (CHWs) participated in training workshops, and over 300 pupils from primary schools were sensitized on AMR, AMS, and infection prevention and control (IPC). We further established two multidisciplinary online communities of practice (CoPs) for health professionals and students, with a current membership of 321 and 162, respectively. In addition, a Medicine and Therapeutics Committee (MTC) was set up at Entebbe Regional Referral Hospital. The project evaluation, conducted three months after training, revealed that the majority of the HPs (92.2%) and CHWs (90.3%) reported enhanced practices, including improved hand washing (57.3% and 81.0%, respectively). In addition, 51.5% of the HPs reported a reduction in the quantity of unnecessary antibiotics given per patient. This project demonstrates that AMS interventions using a One Health approach can promote understanding of the prudent use of antimicrobials and improve practices at health facilities and in communities.
