CASAMS Study

CASAMS study

Study period:Ongoing.

World Health Organization (WHO) recommends implementation of Medicines and Therapeutic Committees (MTCs) as an intervention to improve medicine management, optimize medicine use and as such contribute to reducing the development and spread of antimicrobial resistance.

Currently, there is limited information on the composition structure, activities and functions of these committees. The role of these MTCs in implementing antimicrobial stewardship programs in Uganda and other low- and middle-income countries has remained unknown or under-characterized, so are the necessary enablers, barriers and the role of contextual factors in hospitals in Uganda. Despite the importance and prospects of antimicrobial interventions in preventing, slowing down and curing antimicrobial resistance, the evidence base on how to successfully implement antibiotic stewardship in African hospitals is thin.

With support from the Commonwealth Partnership for AMS scheme, our health partnership that includes Makerere University Pharmacy Department (MakPD), Infectious Disease Research Collaboration (IDRC), London School of Hygiene and Tropical Medicine (LSHTM), University College London NHS Foundation Hospitals (UCLH), and the Manchester Exchange (TCE) will conduct a situational analysis of patterns of use antimicrobial use and assess the feasibility of and contextual factors influencing the implementation of antimicrobial stewardship interventions at Jinja hospital.

Aim:
To strengthen the antimicrobial stewardship roles and responsibility of the medicine and therapeutic committee at Jinja regional referral hospital and develop its capacity to optimize antimicrobial treatment and clinical outcomes, and infection prevention and control at patient and health facility level.

Objectives:

1. To assess the existing capacity (knowledge, behaviors, processes) and practices of antimicrobial stewardship and infection prevention and control interventions at Jinja regional referral hospital.
2. To describe patterns of use of antimicrobials and characterize antimicrobial prescription, dispensing and administration at Jinja hospital in Uganda.
3. To determine the trend of annual antibiotic consumption using DDD per 1000 inhabitants per day and hospital activity units.
4. To assess the feasibility of and the contextual factors that enable or challenge implementation of antimicrobial stewardship interventions in Uganda.

 

 

Methods:
Jinja hospital is one of sixteen regional referral hospitals in Uganda. It is a tertiary level hospital with bed capacity of 474. It is located on two campuses about a kilometer apart with the main hospital on Narambai road and pediatric hospital at Nalufenya on Jinja – Kampala highway.
Broadly, it will be a mixed-methods observational study employing quantitative surveys and a qualitative case study.

Principal Investigators-Uganda: Dr Fred Kitutu (Makerere University Pharmacy Department and IDRC).
Principal Investigators-London: Dr Clare Chandler (London School of Hygiene and Tropical Medicine.