USAID Medicines, Technologies, and Pharmaceutical Services Program, Management Sciences for Health, Kampala, Uganda.
USAID Medicines, Technologies, and Pharmaceutical Services Program, Management Sciences for Health, Arlington, Virginia.
J Glob Antimicrob Resist. 2023 Sep;34:145-149. doi: 10.1016/j.jgar.2023.07.003. Epub 2023 Jul 7.
An appropriate antimicrobial use (AMU) surveillance system provides critical data and evidence on which antimicrobial stewardship interventions are based. However, Uganda and most other low- and middle-income countries (LMICs) lack efficient systems for monitoring AMU due to unique health system challenges.
We reviewed the key tools available for AMU surveillance in health facilities. Based on our implementation experience, we present arguments on the need for country authorities to adapt a customized and standardized tool for national uses.
Despite ongoing efforts to set up AMU surveillance programs in Uganda, AMU data remain sparse, with most of the available data collected through antimicrobial stewardship related continuous quality improvement efforts implemented by global AMR control programs. There is variability in the interpretation of available AMU surveillance tools and a need to identify the most appropriate AMU surveillance methodologies and tools for Uganda and other LMICs. Data fields for sex and gender are incorrectly categorized and there is no tool that records pregnancy variable. Based on the past four years of practical implementation experience since the launch of the World Health Organization's Point Prevalence Survey methodology in 2018 for inpatient settings, we believe that the tool should be modified in cognizance of existing capacity and priorities in resource-constrained settings.
The World Health Organization, regional experts, ministry of health authorities, and other stakeholders should urgently review available tools with a view to adopting a customized and standardized facility AMU surveillance methodology suitable for national-level rollout in LMICs.
适当的抗菌药物使用（AMU）监测系统提供了关键的数据和证据，为抗菌药物管理干预措施提供了依据。然而，由于独特的卫生系统挑战，乌干达和大多数其他中低收入国家（LMICs）缺乏有效的监测 AMU 的系统。
我们回顾了卫生设施中用于 AMU 监测的主要工具。根据我们的实施经验，我们提出了关于国家当局需要为国家用途定制和标准化工具的论点。
尽管乌干达一直在努力建立 AMU 监测计划，但 AMU 数据仍然很少，大多数可用数据是通过全球 AMR 控制计划实施的抗菌药物管理相关持续质量改进工作收集的。现有的 AMU 监测工具的解释存在差异，需要确定最适合乌干达和其他 LMICs 的 AMU 监测方法和工具。性别数据字段被错误分类，并且没有工具可以记录妊娠变量。基于 2018 年世界卫生组织推出的住院患者时点患病率调查方法以来的过去四年的实际实施经验，我们认为该工具应在认识到资源有限环境下的现有能力和优先事项的基础上进行修改。
世界卫生组织、区域专家、卫生部当局和其他利益攸关方应紧急审查现有工具，以采用适合在 LMICs 国家层面推出的定制化和标准化的医疗机构 AMU 监测方法。
