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. 2022 Jun 20;11(1):1476.
doi: 10.4102/ajlm.v11i1.1476. eCollection 2022.

Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Kenya

André Trollip  1 , Renuka Gadde  2 , Tjeerd Datema  3 , Kamau Gatwechi  4 , Linda Oskam  3 , Zachary Katz  5 , Andrew Whitelaw  6   7 , Peter Kinyanjui  8 , Patrick Njukeng  9 , Dawit A Wendifraw  10 , Ibrahimm Mugerwa  11 , Grace Najjuka  12 , Nicholas Dayie  13 , Japheth A Opintan  13 , Heidi Albert  1
Affiliations

Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Kenya

André Trollip et al. Afr J Lab Med. .

Abstract

Background: In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures.

Objective: To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.

Methods: Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.

Results: Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.

Conclusion: Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.

Keywords: antimicrobial resistance; blood; clinical; faeces; laboratory; urine.

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Conflict of interest statement

The authors have the following competing interests: Becton Dickinson and FIND provided support for this study in the form of salaries for employees and financial support to the partner organisations and assessors. Foundation for Innovative New Diagnostics and Becton Dickinson jointly developed the AMR Scorecard. Foundation for Innovative New Diagnostics has partnership agreements with various diagnostic manufacturers for the development and implementation of AMR diagnostic tools. Foundation for Innovative New Diagnostics receives funding from multiple public and private donors for tuberculosis projects in technology development and clinical research. Limited funding is occasionally provided by industry partners; acceptance of these funds is subject to review by an independent Scientific Advisory Committee or another independent review body. Becton Dickinson is a global medical technology company that manufactures and supplies products and solutions pertaining to medical discovery, diagnostics, and the delivery of care. Becton Dickinson Global Health has longstanding collaborations with health agencies and is currently implementing projects in Africa to strengthen laboratory quality including the use of the AMR Scorecard and improve laboratory capacity, including installation of Becton Dickinson equipment and providing broader systems.

Figures

FIGURE 1
FIGURE 1
Mean performance scores of 11 microbiology laboratories assessed with the antimicrobial resistance laboratory scorecard and SLIPTA in Cameroon, Ethiopia, and Kenya between February 2019 and March 2019.
See this image and copyright information in PMC

References

    1. O’Neill J. Review on antimicrobial resistance: Tackling a crisis for the health and wealth of nations [homepage on the Internet]. 2014. [cited 2020 Nov]. Available from: https://amr-review.org/sites/default/files/AMRReviewPaper-Tacklingacrisi...
    1. Tangcharoensathien V, Chanvatika S, Sommanustweechaia A. Complex determinants of inappropriate use of antibiotics. Bull World Health Organ. 2018;96:141–144. 10.2471/BLT.17.199687 - DOI - PMC - PubMed
    1. Ampaire L, Muhindo A, Orikiriza P, Mwanga-Amumpaire J, Bebell L, Boum Y. A review of antimicrobial resistance in East Africa. Afr J Lab Med. 2016;5(1):432. 10.4102/ajlm.v5i1.432 - DOI - PMC - PubMed
    1. Leopold SJ, Van Leth F, Tarekegn H, Schultsz C. Antimicrobial resistance among clinically relevant bacterial isolates in sub-Saharan Africa: A systematic review. J Antimicrob Chemother. 2014;69(9):2337–2353. 10.1093/jac/dku176 - DOI - PubMed
    1. WHO . Global antimicrobial resistance and use surveillance system (GLASS) report 2021. Geneva: World Health Organization; 2021.

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