Progress made in digitalizing antimicrobial resistance surveillance in a One Health approach in Kenya

Abstract

Background: Antimicrobial resistance (AMR) is a major threat to global public health, affecting human and animal health, agriculture, food safety, and the environment. The control of AMR is often challenging, particularly when data are scanty or siloed in individual sectors. To develop evidence-based control policies for AMR, an electronic information system that integrates AMR data from various sectors, in a One Health approach, is critical.

Methodology: Acknowledging the interconnectedness of AMR in humans, animals, and the environment and the need to assess the AMR burden using a One Health approach, Kenya's National Antimicrobial Stewardship Interagency Committee (NASIC), with support from FIND, integrated human and animal health AMR data at the national AMR data repository and developed the One Health AMR Surveillance System (OHAMRS). The OHAMRS comprises two core digital components: interoperability middleware for integrating data from various sources and a DHIS2 web portal for the analysis and visualization of AMR surveillance data from the human and animal health sectors. These components are scalable for future inclusion of data from other One Health sectors, e.g., the environment, food/feed, and aquaculture sectors.

Results: The OHAMRS has 42 dashboards that facilitate the presentation, interpretation, and dissemination of actionable information relating to AMR, including 17 dashboards for human and animal health priority pathogens and 8 for drug-resistance indicators. The priority pathogen dashboards provide visualization of antimicrobial susceptibility patterns, resistance and susceptibility trends, resistance tables, and geospatial susceptibility maps. Other dashboards include surveillance sites and specimen reports, data completeness, data reconciliation, sample testing workload, a One Health intersectoral dashboard, and other reporting tools for diverse stakeholders.

Discussion: Digitalizing AMR surveillance through a One Health lens is pivotal to understand AMR prevalence and patterns across various sectors. The OHAMRS provides comprehensive data analysis and presentation, informing policymaking on AMR control. Digital tools such as the OHAMRS are vital in facilitating the availability of data and actionable information on AMR required to address the AMR crisis in Kenya.

Keywords: One Health; antimicrobial resistance; digital health; interoperability; surveillance.

Figure 1

Map of Kenya showing the distribution of current AMR surveillance sites in the human and animal health sectors.

Figure 2

Data flow from human and animal surveillance sites to the One Health AMR Surveillance System (AH, animal health; HH, human health).

Figure 3

Screenshots of some of the One Health AMR Surveillance System dashboards.