“If you do not take the medicine and complete the dose…it could cause you more trouble”: bringing awareness, local knowledge and experience into antimicrobial stewardship in Tanzania

Virhia, J. et al. (2023) “If you do not take the medicine and complete the dose…it could cause you more trouble”: bringing awareness, local knowledge and experience into antimicrobial stewardship in Tanzania. Antibiotics, 12(2), 243. (doi: 10.3390/antibiotics12020243) (PMID:36830154) (PMCID:PMC9952761)

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Antimicrobial resistance (AMR) is a global health issue disproportionately affecting low- and middle-income countries. In Tanzania, multi-drug-resistant bacteria (MDR) are highly prevalent in clinical and community settings, inhibiting effective treatment and recovery from infection. The burden of AMR can be alleviated if antimicrobial stewardship (AMS) programs are coordinated and incorporate local knowledge and systemic factors. AMS includes the education of health providers to optimise antimicrobial use to improve patient outcomes while minimising AMR risks. For programmes to succeed, it is essential to understand not just the awareness of and receptiveness to AMR education, but also the opportunities and challenges facing health professionals. We conducted in-depth interviews (n = 44) with animal and human health providers in rural northern Tanzania in order to understand their experiences around AMR. In doing so, we aimed to assess the contextual factors surrounding their practices that might enable or impede the translation of knowledge into action. Specifically, we explored their motivations, training, understanding of infections and AMR, and constraints in daily practice. While providers were motivated in supporting their communities, clear issues emerged regarding training and understanding of AMR. Community health workers and retail drug dispensers exhibited the most variation in training. Inconsistencies in understandings of AMR and its drivers were apparent. Providers cited the actions of patients and other providers as contributing to AMR, perpetuating narratives of blame. Challenges related to AMR included infrastructural constraints, such as a lack of diagnostic testing. While health and AMR-specific training would be beneficial to address awareness, equally important, if not more critical, is tackling the challenges providers face in turning knowledge into action.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Mutua, Dr Edna and Gilmour, Ms Molly and MMBAGA, Professor Blandina Theoph and Russell, Dr Cairistiona and Lembo, Dr Tiziana and Davis, Dr Alicia and Virhia, Miss Jennika and Dunlea, Ms Torre
Authors: Virhia, J., Gilmour, M., Russell, C., Mutua, E., Nasuwa, F., Mmbaga, B. T., Mshana, S. E., Dunlea, T., Shirima, G., Seni, J., Lembo, T., and Davis, A.
College/School:College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:Antibiotics
ISSN (Online):2079-6382
Published Online:25 January 2023
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in Antibiotics 12(2): 243
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303374Supporting the National Action Plan for Antimicrobial Resistance (SNAP-AMR) in TanzaniaShona HiltonMedical Research Council (MRC)MR/S004815/1Institute of Biodiversity, Animal Health and Comparative Medicine