Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021
Background: The surveillance of antimicrobial consumption (AMC) is critical to developing appropriate antimicrobial stewardship interventions. It is a key component of World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance and the Uganda Antimicrobial Resistance National Ac...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Infection and Public Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034123003672 |
| _version_ | 1827687011981459456 |
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| author | Marion Murungi Helen Byomire Ndagije Reuben Kiggundu Diana Nakitto Kesi JP Waswa Kalidi Rajab Mark Barigye Allan Serwanga Leonard Manirakiza Hassan Kasujja Ddembe Kaweesi Mohan P. Joshi Juliet Namugambe Niranjan Konduri |
| author_facet | Marion Murungi Helen Byomire Ndagije Reuben Kiggundu Diana Nakitto Kesi JP Waswa Kalidi Rajab Mark Barigye Allan Serwanga Leonard Manirakiza Hassan Kasujja Ddembe Kaweesi Mohan P. Joshi Juliet Namugambe Niranjan Konduri |
| author_sort | Marion Murungi |
| collection | DOAJ |
| description | Background: The surveillance of antimicrobial consumption (AMC) is critical to developing appropriate antimicrobial stewardship interventions. It is a key component of World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance and the Uganda Antimicrobial Resistance National Action Plan 2018–2023. Our study’s objective was to determine the national consumption of all antimicrobials. Methods: Data on all imported antimicrobials were retrieved from paper-based records and entered in the web-based National Drug Authority (NDA) management information system from 2021. The import data for the year is a proxy for nationwide consumption because they account for 95% of all medical products. The NDA authorizes all imports to the country regardless of final distribution in the supply chain. The data were analyzed in accordance with WHO Anatomical Therapeutic Chemical codes and defined daily dose (DDD) methodology. We also retrieved consumption data for 2018, 2019, and 2020 that were previously submitted by Uganda to WHO’s Global Antimicrobial Resistance and Use Surveillance System. Results: In 2021, the average DDD per 1000 inhabitants was 29.02 for all antimicrobials; 80.7% of antimicrobials consumed were oral. Penicillins (27.6%) were the most consumed antimicrobial class, followed by sulfonamides and trimethoprim (15.5%). Based on WHO’s Access, Watch, and Reserve (AWaRe) antibiotic classification, 62.91% of AMC was from the access class, with watch class averaging 14.51% in the period 2018–2021. Watch class AMC spiked in 2021 (34.2%) during COVID-19 pandemic compared to 2020 (24.29%). Azithromycin and ciprofloxacin were the most consumed watch class antimicrobials in 2021. Conclusions: The relatively high consumption of injectable antimicrobials and year over year increase in watch class AMC requires urgent stewardship interventions. Further work is needed to establish a system for longitudinal AMC surveillance that is well resourced and funded to overcome the challenges of estimation and provide more accurate data on consumption and use patterns. |
| first_indexed | 2024-03-10T09:26:39Z |
| format | Article |
| id | doaj.art-75c44cd93fc643f2b58c25b176ef2723 |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-03-10T09:26:39Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-75c44cd93fc643f2b58c25b176ef27232023-11-22T04:47:04ZengElsevierJournal of Infection and Public Health1876-03412023-12-01164551Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021Marion Murungi0Helen Byomire Ndagije1Reuben Kiggundu2Diana Nakitto Kesi3JP Waswa4Kalidi Rajab5Mark Barigye6Allan Serwanga7Leonard Manirakiza8Hassan Kasujja9Ddembe Kaweesi10Mohan P. Joshi11Juliet Namugambe12Niranjan Konduri13USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, UgandaNational Drug Authority, Kampala, UgandaUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, UgandaNational Drug Authority, Kampala, UgandaUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, UgandaDepartment of Pharmacy, Makerere University College of Health Sciences, Kampala, UgandaNational Drug Authority, Kampala, UgandaNational Drug Authority, Kampala, UgandaDepartment of Corporate Planning, Uganda National Bureau of Standards, Kampala, UgandaUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, UgandaUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, UgandaUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA, USALondon School of Hygiene and Tropical Medicine, London, United KingdomUSAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA, USA; Corresponding author.Background: The surveillance of antimicrobial consumption (AMC) is critical to developing appropriate antimicrobial stewardship interventions. It is a key component of World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance and the Uganda Antimicrobial Resistance National Action Plan 2018–2023. Our study’s objective was to determine the national consumption of all antimicrobials. Methods: Data on all imported antimicrobials were retrieved from paper-based records and entered in the web-based National Drug Authority (NDA) management information system from 2021. The import data for the year is a proxy for nationwide consumption because they account for 95% of all medical products. The NDA authorizes all imports to the country regardless of final distribution in the supply chain. The data were analyzed in accordance with WHO Anatomical Therapeutic Chemical codes and defined daily dose (DDD) methodology. We also retrieved consumption data for 2018, 2019, and 2020 that were previously submitted by Uganda to WHO’s Global Antimicrobial Resistance and Use Surveillance System. Results: In 2021, the average DDD per 1000 inhabitants was 29.02 for all antimicrobials; 80.7% of antimicrobials consumed were oral. Penicillins (27.6%) were the most consumed antimicrobial class, followed by sulfonamides and trimethoprim (15.5%). Based on WHO’s Access, Watch, and Reserve (AWaRe) antibiotic classification, 62.91% of AMC was from the access class, with watch class averaging 14.51% in the period 2018–2021. Watch class AMC spiked in 2021 (34.2%) during COVID-19 pandemic compared to 2020 (24.29%). Azithromycin and ciprofloxacin were the most consumed watch class antimicrobials in 2021. Conclusions: The relatively high consumption of injectable antimicrobials and year over year increase in watch class AMC requires urgent stewardship interventions. Further work is needed to establish a system for longitudinal AMC surveillance that is well resourced and funded to overcome the challenges of estimation and provide more accurate data on consumption and use patterns.http://www.sciencedirect.com/science/article/pii/S1876034123003672Antimicrobial consumptionAntibiotic consumptionAntimicrobial use surveillanceAntimicrobial resistanceUgandaDefined daily dose |
| spellingShingle | Marion Murungi Helen Byomire Ndagije Reuben Kiggundu Diana Nakitto Kesi JP Waswa Kalidi Rajab Mark Barigye Allan Serwanga Leonard Manirakiza Hassan Kasujja Ddembe Kaweesi Mohan P. Joshi Juliet Namugambe Niranjan Konduri Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021 Journal of Infection and Public Health Antimicrobial consumption Antibiotic consumption Antimicrobial use surveillance Antimicrobial resistance Uganda Defined daily dose |
| title | Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021 |
| title_full | Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021 |
| title_fullStr | Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021 |
| title_full_unstemmed | Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021 |
| title_short | Antimicrobial consumption surveillance in Uganda: Results from an analysis of national import data for the human health sector, 2018–2021 |
| title_sort | antimicrobial consumption surveillance in uganda results from an analysis of national import data for the human health sector 2018 2021 |
| topic | Antimicrobial consumption Antibiotic consumption Antimicrobial use surveillance Antimicrobial resistance Uganda Defined daily dose |
| url | http://www.sciencedirect.com/science/article/pii/S1876034123003672 |
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