Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 24:8:611931.
doi: 10.3389/fvets.2021.611931. eCollection 2021.

Evaluating the Integration of One Health in Surveillance Systems for Antimicrobial Use and Resistance: A Conceptual Framework

Cécile Aenishaenslin  1   2 , Barbara Häsler  3 , André Ravel  1   2 , E Jane Parmley  4   5 , Sarah Mediouni  1   2 , Houda Bennani  3 , Katharina D C Stärk  6 , David L Buckeridge  7
Affiliations

Evaluating the Integration of One Health in Surveillance Systems for Antimicrobial Use and Resistance: A Conceptual Framework

Cécile Aenishaenslin et al. Front Vet Sci. .

Abstract

It is now widely acknowledged that surveillance of antimicrobial resistance (AMR) must adopt a "One Health" (OH) approach to successfully address the significant threats this global public health issue poses to humans, animals, and the environment. While many protocols exist for the evaluation of surveillance, the specific aspect of the integration of a OH approach into surveillance systems for AMR and antimicrobial Use (AMU), suffers from a lack of common and accepted guidelines and metrics for its monitoring and evaluation functions. This article presents a conceptual framework to evaluate the integration of OH in surveillance systems for AMR and AMU, named the Integrated Surveillance System Evaluation framework (ISSE framework). The ISSE framework aims to assist stakeholders and researchers who design an overall evaluation plan to select the relevant evaluation questions and tools. The framework was developed in partnership with the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). It consists of five evaluation components, which consider the capacity of the system to: [1] integrate a OH approach, [2] produce OH information and expertise, [3] generate actionable knowledge, [4] influence decision-making, and [5] positively impact outcomes. For each component, a set of evaluation questions is defined, and links to other available evaluation tools are shown. The ISSE framework helps evaluators to systematically assess the different OH aspects of a surveillance system, to gain comprehensive information on the performance and value of these integrated efforts, and to use the evaluation results to refine and improve the surveillance of AMR and AMU globally.

Keywords: One Health; antimicrobial resistance; evaluation; framework; integrated surveillance; methodology; surveillance.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Methodological approach for the development of the ISSE framework.
Figure 2
Figure 2
Final ISSE framework. The figure on the left describes a logic model for the integrated OH surveillance systems for AMR and the figure on the right describes five evaluation levels with the respective set of evaluation questions (suggested methodology for each question is presented in parenthesis).
See this image and copyright information in PMC

Comment in

References

    1. Interagency Coordination Group on Antimicrobial Resistance . No Time to Wait: Securing the Future From Drug-Resistant Infections. World Health Organization. (2019). Available online at: http://www.who.int/antimicrobial-resistance/interagency-coordination-gro... (accessed June 25, 2020).
    1. Holmes AH, Moore LSP, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, et al. . Understanding the mechanisms and drivers of antimicrobial resistance. Lancet. (2016) 387:176–87. 10.1016/S0140-6736(15)00473-0 - DOI - PubMed
    1. Tang KL, Caffrey NP, Nóbrega DB, Cork SC, Ronksley PE, Barkema HW, et al. . Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis. Lancet Planet Health. (2017) 1:e316–27. 10.1016/S2542-5196(17)30141-9 - DOI - PMC - PubMed
    1. Singer AC, Shaw H, Rhodes V, Hart A. Review of antimicrobial resistance in the environment and its relevance to environmental regulators. Front Microbiol. (2016) 7:1728. 10.3389/fmicb.2016.01728 - DOI - PMC - PubMed
    1. Allen HK, Donato J, Wang HH, Cloud-Hansen KA, Davies J, Handelsman J. Call of the wild: antibiotic resistance genes in natural environments. Nat Rev Microbiol. (2010) 8:25–9. 10.1038/nrmicro2312 - DOI - PubMed

LinkOut - more resources