Antimicrobial stewardship situation analysis in selected hospitals in Zambia

Findings and implications from a national survey

Bibliographic Data

ID22083020
AuthorsJoseph Yamweka Chizimu (0000-0002-2126-5759, Hokkaido University, corresponding author), Steward Mudenda (0000-0003-1692-8981, University of Zambia), Kaunda Yamba (0000-0003-1777-8305, Zambia National Public Health Institute), Chileshe Lukwesa (National HIV/AIDS/STI/TB Council), Raphael Chanda (University Teaching Hospital), Ruth Nakazwe (University Teaching Hospital), Bwalya Simunyola (University of Zambia), Misheck Shawa (Ministry of Health), Aubrey C Kalungia (0000-0003-2554-1236, University of Zambia), Duncan Chanda (0000-0001-5477-9054, University Teaching Hospital), Uchizi Chola (University Teaching Hospital), Tebuho Mateele (University Teaching Hospital), Jeewan Thapa (0000-0002-3447-6483, Hokkaido University), Kenneth Kapolowe (University Teaching Hospital), Mazyanga L Mazaba (0000-0002-5465-5710, Hokkaido University), Mirfin Mpundu (0000-0001-8863-0995), Freddie Masaninga (0000-0002-4040-1736, World Health Organization - Zambia), Khalid Azam (East, Central and Southern Africa Health Community), Chie Nakajima (0000-0002-9194-1062, Hokkaido University), Yasuhiko Suzuki (0000-0002-1313-1494, Hokkaido University), Nathan Bakyaita (Hokkaido University), Nathan Nsubuga Bakyaita, Evelyn Wesangula (0000-0002-1467-3631, East, Central and Southern Africa Health Community), Martin Matu (East, Central and Southern Africa Health Community), Roma Chilengi (0000-0003-0221-9527, Zambia National Public Health Institute)
Year2024
Volume12
Pages1367703-1367703
Publication date2024-09-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1367703
PMID39399696
OpenAlexW4402933552
LanguageEN
Citations received2
References cited105

Background: Antimicrobial stewardship (AMS) programs are critical in combating antimicrobial resistance (AMR). In Zambia, there is little information regarding the capacity of hospitals to establish and implement AMS programs. The objective of this study was to conduct a baseline assessment of WHO core elements for an AMS program implementation in eight hospitals in Zambia. Materials and methods: We conducted an exploratory cross-sectional study from September 2023 to December 2023 using a self-scoring Periodic National and Healthcare Facility Assessment Tool from the World Health Organization (WHO) policy guidance on integrated AMS activities in human health. Eight public hospitals were surveyed across the five provinces of Zambia. Data was analyzed using the WHO self-scoring tool and thematic analysis. Results: Overall, 62.5% (6/8) of the facilities scored low (below 60%) in implementing AMS programs. Most facilities had challenges with reporting AMS feedback within the hospital (average score = 46%), Drugs and Therapeutics Committee (DTC) functionality (average score = 49%), AMS actions (average score = 50%), education and training (average score = 54%), and leadership commitment to AMS activities (average score = 56%). The overall score for all AMS core elements was average (56%). All the hospitals (100%) did not have an allocated budget for AMS programs. Finally, there were neither antibiograms to guide antimicrobial utilization nor AMS-trained staff in more than 50% of the hospitals surveyed. Conclusion: This study found low AMS implementation in these public hospitals, especially where DTCs were non-functional. The identified challenges and gaps require urgent attention for sustainable multidisciplinary AMS programs

Antibiotic resistance · Antimicrobial stewardship · Environmental health · Family medicine · Health care · Political science · Qualitative research · Thematic analysis · Antibiotic Resistance in Bacteria · Antibiotic Use and Resistance · Global Maternal and Child Health · Medicine