Akinyele Ayodele, Olamijuwon Emmanuel, Adeniyi Abeeb A, Kazeem Oluwatobiloba S, Popoola Michael, Agboeze Tochukwu C, Okeke Iruka N
Department of Pharmaceutical Microbiology, Global Health Research Unit for Genomic Surveillance of Antimicrobial Resistance, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria.
School of Geography and Sustainable Development, University of St Andrews, Scotland, United Kingdom.
PLOS Glob Public Health. 2025 Jul 23;5(7):e0004894. doi: 10.1371/journal.pgph.0004894. eCollection 2025.
The systematic collection, analysis, and interpretation of antimicrobial resistance (AMR) data are imperative to quantify the AMR burden, monitor and identify emerging AMR, and inform global, international, and national health strategies and guidelines. Despite ongoing global efforts to improve surveillance capacities across Nigeria and other African countries, laboratory information management systems (LIMS) that could improve data quality, and completeness remain underutilized. We used a participatory research approach, drawing on the unique experiences of various stakeholders, such as data analysts, laboratory scientists, infection prevention and control specialists, medical doctors, and representatives from the National Coordinating Center in Nigeria. Over two phases of evidence synthesis, involving in-depth interviews and a participatory co-design workshop, we sought to understand the experiences of key stakeholders in using the LIMS tool, WHONET, for AMR surveillance, and co-develop solutions and priorities to address the challenges they experience. We identified a complex interplay of systemic/political factors and structural/user-related factors that influence the use of WHONET as a LIMS. Key areas for intervention identified by stakeholders include addressing infrastructural deficits, enhancing stakeholder engagement, and improving the perceived usefulness of the system, as well as the need for management support. Stakeholders also identified 18 potential solutions to tackle key challenges, ten of which require low effort and have a high influence on LIMS use behaviors. Our study highlights the multifaceted challenges affecting the effective utilization of WHONET for AMR surveillance in Nigeria. The co-developed solutions provide a roadmap for targeted interventions to strengthen AMR surveillance capacity and inform evidence-based public health strategies.
对抗菌药物耐药性（AMR）数据进行系统收集、分析和解读，对于量化AMR负担、监测和识别新出现的AMR以及为全球、国际和国家卫生战略及指南提供信息至关重要。尽管全球一直在努力提高尼日利亚和其他非洲国家的监测能力，但能够提高数据质量和完整性的实验室信息管理系统（LIMS）仍未得到充分利用。我们采用了参与式研究方法，借鉴了数据分析师、实验室科学家、感染预防与控制专家、医生以及尼日利亚国家协调中心代表等各利益相关方的独特经验。在两个阶段的证据综合过程中，包括深入访谈和参与式共同设计研讨会，我们试图了解关键利益相关方在使用LIMS工具WHONET进行AMR监测方面的经验，并共同制定解决方案和优先事项，以应对他们所面临的挑战。我们发现了影响将WHONET用作LIMS的系统/政治因素和结构/用户相关因素之间的复杂相互作用。利益相关方确定的关键干预领域包括解决基础设施不足问题、加强利益相关方参与、提高系统的感知有用性以及获得管理支持的必要性。利益相关方还确定了18个应对关键挑战的潜在解决方案，其中10个需要付出较少努力且对LIMS使用行为有很大影响。我们的研究突出了影响在尼日利亚有效利用WHONET进行AMR监测的多方面挑战。共同制定的解决方案为有针对性的干预措施提供了路线图，以加强AMR监测能力并为基于证据的公共卫生战略提供信息。
