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Preventing antimicrobial resistance together: Collaborative research partnerships in Zimbabwe

Antimicrobial resistance (AMR) is a growing public health threat causing an estimated 1.2 million deaths globally in 2019, with a particularly high burden in sub-Saharan Africa.
Rudo Chingono and Justin Dixon (THRU-ZIM)

The Health Research Unit Zimbabwe (THRU ZIM) at the Biomedical Research and Training Institute is a multidisciplinary and collaborative centre conducting public health research of relevance to Zimbabwe and the African region – including addressing AMR as an adverse threat to global health and development. 

There are several ongoing research projects improving awareness and understanding of AMR pioneered by THRU ZIM, in collaboration with researchers at LSHTM. These include ‘Febrile Illness Evaluation in a Broad Range of Endemicities’ (FIEBRE), ‘Antimicrobial Resistance in Gram-negative bacteria from Urinary Specimens’ (ARGUS), and ‘Impact of a Typhoid Conjugate Vaccine Campaign on Antimicrobial Prescribing in Harare, Zimbabwe’ (TAZ). 

On World Antimicrobial Awareness Week, we’re showcasing these cross-cutting projects led by colleagues in Zimbabwe, highlighting the importance of collaborative, interdisciplinary research to combat AMR. 

What is the extent of the problem of AMR in Zimbabwe? 

Ioana Olaru is the PI for the ARGUS project, working on determining the underlying molecular mechanisms of Gram-negative urinary tract infections in Zimbabwe. This project provides valuable information to inform local treatment guidelines and AMR prevention strategies.

She explains how antibiotic misuse is a big issue in Harare, Zimbabwe: “Two thirds of children and half of adults presenting to primary care are prescribed antibiotics. Even though, the most common diagnosis are gastroenteritis and acute respiratory infections, which are often viral or require only symptomatic treatment.”

“Similar to other many low- and -middle- income countries (LMICs), the high burden of infections and diagnostic uncertainties lead to considerable antimicrobial prescribing, further exacerbating the problem of AMR.” 

What factors are influencing AMR in Zimbabwe? 

Rudo Chingono and Justin Dixon are Co-PIs of the TAZ project, which investigates the social factors influencing antimicrobial prescribing by healthcare workers, to give a better understanding of the impact of disease prevention measures, such as typhoid vaccines, at the community-level. 

They said: “Antimicrobial prescribing for febrile illness in Zimbabwe is influenced by a range of socio-economic and health system factors, including a lack of diagnostics and antibiotics, overburdened facilities, as well as patient poverty and vulnerability to bacterial infections.”

“Optimising antibiotic use and reducing AMR means looking beyond prescriber behaviour to implementing broad-based prevention efforts including vaccination, health system strengthening, and improved water and sanitation hygiene infrastructure.” 

Why is interdisciplinary research so important for AMR?

Katharina Kranzer, the newest member of the AMR Centre’s Steering Committee and Co-Director of THRU ZIM, said: “Work across disciplines including social sciences, epidemiology, phenotypic and molecular microbiology and bioinformatics is extremely important to understand AMR and develop context-relevant interventions.”

“Interdisciplinary work is particularly rewarding when researchers from different settings and geographical regions collaborate. Truly equitable partnerships both with regards to resources, ownership and academic outputs are paramount to make such collaborations a success.”

Find out more about the ongoing research at THRU-ZIM.
 

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