Community engagement: The key to tackling Antimicrobial Resistance (AMR) across a One Health context?

Mitchell, Jessica; Cooke, Paul; Ahorlu, Collins; Arjyal, Abriti; Baral, Sushil; Carter, Laura J.; Dasgupta, Rajib; Fieroze, Fariza; Braga, Mariana Fonseca; Huque, Rumana; Lewycka, Sonia; Kalpana, Pachillu; Saxena, Deepak; Tomley, Fiona M.; Tsekleves, Emmanuel; Quynh, Gioa Vu Thi; King, Rebecca

doi:10.1080/17441692.2021.2003839

Cited by 35 publications

(30 citation statements)

References 69 publications

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“…Our series of conversations confirmed some of the problem and drivers of AMR already known from other studies and the Thai national household surveys, for example that antimicrobials are still widely available including ‘ yaa chud ’ 15 30-32 , and that there is still quite a lot of misunderstanding around antimicrobials 16 17 23 31 32 . Our findings, in line with other studies, demonstrate the importance of community involvement and co-production in developing and implementing strategies to tackle AMR at a local level and promote community ownership 31 33 .…”

Section: Discussionsupporting

confidence: 91%

Embedding community and public voices in co-created solutions to mitigate antimicrobial resistance (AMR) in Thailand using the ‘Responsive Dialogues’ public engagement framework

Poomchaichote,

Kiatying-Angsulee,

Boonthaworn

et al. 2023

Preprint

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The use of antimicrobials in Thailand has been reported as one of the highest in the world in human and animal sectors. Our engagement project aimed to improve our understanding of the issue of antimicrobial use and antimicrobial resistance (AMR) among adult Thai communities, and to co-create locally relevant solutions to AMR, especially those focusing on raising awareness to improve related policies in Thailand.We conducted a series of online and in-person ‘conversations’ according to Wellcome’s ‘Responsive Dialogues’ engagement approach, designed to bring together different voices to solve complex problems such as AMR. This approach enabled key AMR stakeholders and policy makers to hear directly from communities and members of the public, and vice versa. Conversations events took place between 25 November 2020 and 8 July 2022, and we engaged 179 AMR key stakeholders and members of the public across Thailand.The issues we found were: there were quite a lot of misunderstandings around antimicrobials and AMR; participants felt that communications and engagement around antimicrobial resistance had limited reach and impact; asking for and taking antibiotics for self-limiting ailments is a social norm in Thailand; and there appeared to be a wide availability of cheap antimicrobials. To mitigate the spread of AMR, participants suggested that the messages around AMR should be tailored to the target audience, there should be more initiatives to increase general health literacy, there should be increased availability of AMR related information at the local level and there should be increased local leadership of AMR mitigation efforts.Thaiclinicaltrials.org registrationTCTR20210528003 (28/05/2021)KEY MESSAGESWhat is already known on this topic⇒Antimicrobial resistance (AMR) is a complex and systemic problem, which will require collaboration from many sectors. Any policies and interventions to address AMR need to be specific to the local context, ethical, and consider the affected communities.What this study adds⇒The regional spread and the depth of our community ‘conversations’ (e.g. 2.5-3 days for in-person ‘conversations’) enabled us to explore topics and important elements of solutions around AMR, summarise common themes, and compare views across different regions and communities in Thailand.How this study might affect research, practice or policy⇒Our project revealed some important ‘building blocks’ or elements for AMR-related policy, in particular relating to communications and engagement: messages around AMR should be tailored to the target audience, there should be more initiatives to increase general health literacy, there should be increased availability of AMR related information at the local level and there should be increased local leadership of AMR mitigation efforts.

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Section: Discussionsupporting

confidence: 91%

Embedding community and public voices in co-created solutions to mitigate antimicrobial resistance (AMR) in Thailand using the ‘Responsive Dialogues’ public engagement framework

Poomchaichote,

Kiatying-Angsulee,

Boonthaworn

et al. 2023

Preprint

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“…AMR is defined as the ability of microorganisms to become resistant to an antimicrobial to which they were initially susceptible and is a consequence of the natural selection of genetic mutations or acquired resistance genes via horizontal gene transfer. Although it is a natural phenomenon of microbial communities, AMR has emerged as a global health crisis due to the imprudent use and overuse of antimicrobials in the medical, veterinary, and agriculture sectors [ 5 , 6 , 7 , 8 ].…”

Section: Antimicrobial Resistance As a Public Health Concernmentioning

confidence: 99%

Building an International One Health Strain Level Database to Characterise the Epidemiology of AMR Threats: ESBL—AmpC Producing E. coli as An Example—Challenges and Perspectives

et al. 2023

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Antimicrobial resistance (AMR) is one of the top public health threats nowadays. Among the most important AMR pathogens, Escherichia coli resistant to extended spectrum cephalosporins (ESC-EC) is a perfect example of the One Health problem due to its global distribution in animal, human, and environmental sources and its resistant phenotype, derived from the carriage of plasmid-borne extended-spectrum and AmpC β-lactamases, which limits the choice of effective antimicrobial therapies. The epidemiology of ESC-EC infection is complex as a result of the multiple possible sources involved in its transmission, and its study would require databases ideally comprising information from animal (livestock, companion, wildlife), human, and environmental sources. Here, we present the steps taken to assemble a database with phenotypic and genetic information on 10,763 ESC-EC isolates retrieved from multiple sources provided by 13 partners located in eight European countries, in the frame of the DiSCoVeR Joint Research project funded by the One Health European Joint Programme (OH-EJP), along with its strengths and limitations. This database represents a first step to help in the assessment of different geographical and temporal trends and transmission dynamics in animals and humans. The work performed highlights aspects that should be considered in future international efforts, such as the one presented here.

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“…The European Center for Disease Control (ECDC) and the European Food Standards Agency (EFSA) publish an annual report on antimicrobial resistance. ESVAC (European Surveillance of Veterinary Antimicrobial Consumption) is an agency responsible for the European Union and the European Economic Area [ 31 ].…”

Section: Antimicrobial Resistant Bacteria and Protection Of One Healthmentioning

confidence: 99%

Post-treatment disinfection technologies for sustainable removal of antibiotic residues and antimicrobial resistance bacteria from hospital wastewater

Werkneh¹,

Islam²

2023

Heliyon

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Community engagement: The key to tackling Antimicrobial Resistance (AMR) across a One Health context?

Cited by 35 publications

References 69 publications

Embedding community and public voices in co-created solutions to mitigate antimicrobial resistance (AMR) in Thailand using the ‘Responsive Dialogues’ public engagement framework

Embedding community and public voices in co-created solutions to mitigate antimicrobial resistance (AMR) in Thailand using the ‘Responsive Dialogues’ public engagement framework

Building an International One Health Strain Level Database to Characterise the Epidemiology of AMR Threats: ESBL—AmpC Producing E. coli as An Example—Challenges and Perspectives

Post-treatment disinfection technologies for sustainable removal of antibiotic residues and antimicrobial resistance bacteria from hospital wastewater

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