Assessing barriers and opportunities for the improvement of laboratory performance and robust surveillance of antimicrobial resistance in Nigeria- a quantitative study.

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Obiageli J Okolie, Sanda U Ismail, Uzoma Igwe, Emmanuel C Adukwu
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引用次数: 0

Abstract

Background: Good quality data is essential in optimising containment strategies for antimicrobial resistance, a global public health threat estimated to cause around 10 million deaths yearly and up-to 5% loss in GDP by 2050 if left unaddressed. The laboratory system plays an important role in the collection of high-quality data as well as ensuring validity, reliability and timeliness of data. However, in many low-medium income countries including Nigeria, the technical capacity of the laboratory for fulfilling these responsibilities is unknown. This paucity of information limits piloting of strategies to complement existing surveillance and planning improvement of subsequent laboratory iterations into the surveillance system. The focus of this study was to assess the gaps, vulnerabilities and enablers of laboratory strengthening processes in the scope of technical capacity for clinical and public health functions and to provide a roadmap for improved surveillance of antimicrobial resistance in Nigeria.

Methods: A cross-sectional study design utilising structured questionnaire administered online via Qualtrics and reported in accordance with strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Data analysis involved descriptive and inferential statistics as well as bivariate and multivariate logistics to test predictive analysis of relationship between variables.

Results: A total of 302 laboratories completed the questionnaire, 107 (53.4%) government laboratories and 195 (64.6%) private sector laboratories. 18.2% reported excellent knowledge, 25.5% has excellent capacity, 7.3% are fully ready for surveillance, 12.3% are participating in some surveillance, and 1.0% record important microbiological data that correlates with epidemiological information.

Conclusion: Tertiary laboratories reported highest performance across all surveillance quality indicators (SQIs). AMR surveillance is skewed toward government and tertiary laboratories, leaving lower-level and rural facilities underutilized despite their potential. This results in missing community-level data and undermines the representativeness of surveillance. The study identifies gaps in recruitment, assessment, and oversight but also offers strategies to address these issues.

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评估尼日利亚改进实验室性能和加强抗微生物药物耐药性监测的障碍和机会——一项定量研究。
背景:高质量的数据对于优化抗微生物药物耐药性控制战略至关重要。抗微生物药物耐药性是一种全球公共卫生威胁,如果不加以解决,估计每年将导致约1000万人死亡,到2050年国内生产总值损失高达5%。实验室系统在收集高质量数据以及保证数据的有效性、可靠性和及时性方面起着重要作用。然而,在包括尼日利亚在内的许多中低收入国家,实验室履行这些职责的技术能力尚不清楚。这种信息的缺乏限制了为补充现有监测和计划改进监测系统后续实验室迭代而进行的战略试点。这项研究的重点是评估临床和公共卫生职能技术能力范围内实验室加强进程的差距、脆弱性和推动因素,并为改进尼日利亚抗菌素耐药性监测提供路线图。方法:采用横断面研究设计,采用结构化的在线问卷调查,并根据加强流行病学观察性研究报告(STROBE)指南进行报告。数据分析包括描述性和推断性统计,以及双变量和多变量物流,以检验变量之间关系的预测分析。结果:共302个实验室完成问卷调查,其中政府实验室107个(53.4%),私营实验室195个(64.6%)。18.2%报告知识过硬,25.5%报告能力过硬,7.3%报告做好了监测准备,12.3%报告正在参加部分监测,1.0%报告了与流行病学信息相关的重要微生物数据。结论:三级实验室报告了所有监测质量指标(SQIs)的最高绩效。抗菌素耐药性监测偏向于政府和三级实验室,使较低层次和农村的设施尽管具有潜力,但未得到充分利用。这导致缺少社区一级的数据,并破坏了监测的代表性。该研究指出了招聘、评估和监督方面的差距,但也提出了解决这些问题的策略。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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