Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2022 May 10;17(5):e0268032. doi: 10.1371/journal.pone.0268032. eCollection 2022.
While interest in antimicrobial stewardship programmes (ASPs) is growing in most low- and middle-income countries (LMICs), there is a paucity of information on their adoption or implementation in Africa, particularly Uganda. The study assessed the presence and characteristics of ASPs, implemented antimicrobial stewardship (AMS) strategies and the challenges to their implementation in hospitals in Uganda. We conducted a cross-sectional study among heads of infection prevention committees (IPCs) in regional referral hospitals, general hospitals, and private-not-for-profit (PNFP) hospitals from November 2019 to February 2020. An interviewer-administered questionnaire was used to collect data. We analysed data using descriptive statistics. A total of 32 heads of IPCs were enrolled in the study. Of these, eight were from regional referral hospitals, 21 were from general hospitals, and three were from PNFPs. Most heads of IPC were pharmacists (17/32, 53.1%) with a mean age and standard deviation (sd) of 36.1 (±1.1) years. A formal ASP was adopted or implemented in 14 out of the 32 (44%, 95% CI 26-62) studied hospitals. Thirty out of 32 hospitals implemented at least one type of AMS strategy. Sixty-eight percent (22/32) of the hospitals implemented pre-authorisation and approval as their primary AMS core strategy to optimise antibacterial use. The most commonly reported challenges to the implementation of ASP across all 32 hospitals (with or without ASP) were lack of time for the ASP team (29/32, 90.6%) and lack of allocated funding for antimicrobial stewardship team (29/32, 90.6%). In this study, most hospitals in Uganda implemented at least one AMS strategy despite the low implementation of ASPs in hospitals. The ministry of health needs to sensitise and support the establishment of ASP in hospitals across the country.
虽然在大多数中低收入国家（LMICs）中，对抗菌药物管理计划（ASPs）的兴趣日益浓厚，但关于它们在非洲，尤其是在乌干达的采用或实施情况的信息却很少。本研究评估了乌干达医院 ASP 的存在和特征、实施抗菌药物管理（AMS）策略及其实施面临的挑战。我们于 2019 年 11 月至 2020 年 2 月期间在地区转诊医院、综合医院和私立非营利性（PNFP）医院的感染预防委员会（IPC）负责人中进行了一项横断面研究。采用访谈式问卷收集数据。我们使用描述性统计分析数据。共有 32 名 IPC 负责人参与了这项研究。其中，8 名来自地区转诊医院，21 名来自综合医院，3 名来自 PNFPs。IPC 负责人多数为药剂师（17/32，53.1%），平均年龄和标准差（SD）为 36.1（±1.1）岁。在所研究的 32 家医院中，有 14 家（44%，95%置信区间 26-62）采用或实施了正式的 ASP。32 家医院中有 30 家实施了至少一种 AMS 策略。68%（22/32）的医院将授权和审批作为优化抗菌药物使用的主要 AMS 核心策略。在所有 32 家医院（无论是否实施 ASP）中，实施 ASP 面临的最常见挑战是 ASP 团队缺乏时间（29/32，90.6%）和抗菌药物管理团队缺乏分配资金（29/32，90.6%）。在这项研究中，尽管医院的 ASP 实施率较低，但乌干达的大多数医院都实施了至少一种 AMS 策略。卫生部需要提高认识并支持在全国医院建立 ASP。
