Collaborative research

on acute respiratory infections, tuberculosis, antimicrobial resistance, and emerging pathogens.

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Research & AMR

Data center for antimicrobial resistance (AMR) in Madagascar and in Burkina Faso

Types:

Research & AMR

Region/Countries:

Global – Burkina Faso, France & Madagascar

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Context

Antimicrobial resistance (AMR) is a global threat, and public health interventions based on data are one of the cornerstones of the WHO’s action plan for dealing with AMR. Bearing in mind that passive surveillance forms the basis of all national action plans thanks to the regular collection of data on antimicrobial resistance during diagnosis, two partners of the international GABRIEL network – the CICM at the University of Antananarivo in Madagascar and the Souro Sanou university hospital at Nazi Boni University in Burkina Faso – have also set up active surveillance with the support of the Mérieux Foundation and using the “TRIcycle” protocol developed by the WHO.

However, there are still some serious shortcomings in the introduction of surveillance based on data and in the efficient governance of this data in the two countries. The aim is to supply factual results allowing stakeholders and decision-makers to adapt national action plans. Some standardized collection software, such as WHONET and the GLASS system, is an important part of passive surveillance. However, this type of software is not suitable for collecting data obtained from active surveillance, such as sequencing data. This active surveillance is confronted with: (i) the non-use of effective software for electronic data collection, (ii) the low quality of collected data or the difficulty of transcribing this data into an electronic format, (iii) non-standardized passive surveillance and research data collected from individual projects. This results in a patchwork of databases that cannot be shared or used on a wider scale by decision-makers, stakeholders, and scientists, (iv) a lack of staff experienced in statistics and the visualization of results. This leads to delays in the analysis of this data and in the sharing of results with decision-makers and stakeholders. This is a key stage for defining the relevant strategic indicators that will allow the impact of these measures on public health to be monitored, (v) the absence of these strategic indicators, which leads to the absence of any decision making by those involved in governance, (vi) the low quality of results and of their visualization for decision-makers and health authorities.

Objectives

The objective of this collaborative project is to reinforce the active surveillance of antimicrobial resistance carried out in Madagascar (TRIcycle and TRIuMPH) and in Burkina Faso (FASO-AMR) by constructing a data science center equipped with robust tools for the collection, analysis, and sharing of data and the publication of analysis results obtained through active surveillance.

Activities

  • Establish data governance to reinforce the active surveillance of AMR and the sharing of research data with and for stakeholders in Madagascar and Burkina Faso (such as the Ministry of Health, the Ministry of Water, Sanitation and Hygiene, the Ministry of Livestock, the Ministry of Agriculture, the WHO, and the OIE).
  • Set up a new generation of data centers in Madagascar and in Burkina Faso, with the development of SOPs and the use of CDISC (Clinical Data Interchange Standards Consortium) standards, for systems used for electronic data collection, data storage, analysis, and interpretation, for and with the various parties.
  • Introduce a management system for the security, evaluation, and validation of this software to help AMR surveillance.
  • Make use of the available studies (TRIcycle and TRIuMPH in Madagascar and FASO-AMR in Burkina Faso) for developing and refining the process for sharing data (detection of Escherichia Coli ESBL and Carbapenemase-producing Enterobacteriaceae in the human, animal, and environmental sectors).

Impact of the project

This project will make an effective contribution towards:

  • Analyzing, in real time, the prevalence of E. coli ESBL and CPE in the human, animal, and environmental sectors, at a national level and in the two countries concerned.
  • Supporting the evaluation of interventions introduced through national action plans for combating AMR and, as a result, the marketing campaigns and requisite political measures in the three sectors.
  • Combining surveillance data with the data collected on the use of antimicrobials in the human and animal sectors.
  • Replicating this project in low and middle income countries (LMICs) introducing AMR surveillance activities such as TRIcycle.

Promoter

  • Bill & Melinda Gates Foundation with the call for projects to participate in the “Grand Challenges 2022 – Strengthening Data Science Capacity and the Ecosystem: Enabling Data-Centered Public Health Interventions”

Partners

  • Charles Mérieux Center for Infectious Disease (CICM), Madagascar
    Souro Sanou university hospital at Nazi Boni University, Burkina Faso, in partnership with the Muraz Center, Burkina Faso
  • Mérieux Foundation, France