Data driven technology with diagnostic approach for AMR study in Nepal

Antimicrobial resistance (AMR) is ranked among the top 10 threats to global health by the WHO.

The overall objective of the study is to collect data of AMR studies in 7 provinces considering 15 districts in Nepal through Diagnostic and survey study using mobile application software approach .

Dr. Prabhat Adhikari is a physician and healthcare  activist with a keen interest in medical IT and research. He has MD in Infectious Disease from USA university.

According to a 2021 study of the Nepal Health Research Council (NHRC), only 32 percent of the doctors and health workers have access to laboratories for antibiotic susceptibility testing. Among them, only 49 percent recommend antibiotic susceptibility testing before prescribing antibiotics. This means that only 16 percent of doctors recommend antibiotics after susceptibility testing.  Also, AMR studies in Nepal have been done in pilot scale, so, the exact data of AMR in Nepal is not available. Our studies in 7 provinces will be provide the exact, accurate data using diagnostic test and software analysis for the period of 5 years .AMR is challenging in Nepal due to poor health facility, over use of antibiotic,lack of adequate information. Through trinity challenge, we address the issue through taking 15,000 to 20,000 sample case studies in 15 districts of Nepal through Diagnostic and  Health data driven  approach. Moreover, we use mobile app health electronic data and along with genomic and microbiological analysis in different community of Nepal in 7 Provinces of 15 Districts.

For example, Create a login and register portal for users to login via email phone or social instant login in the app.

we will create survey questionnaire system .

To protect Nepalese from the health risks related to antimicrobial resistance

• Improve awareness and understanding of AMR through effective communication, education and training.
• Strengthen the knowledge and evidence base through research and surveillance.
• Reduce the incidence of infection through effective hygiene and infection prevention measures.
• Optimize the use of antimicrobial medicines in human and animal health.
• Develop the economic case for sustainable investment that takes account of the needs of all countries, as well as the need for investment in new medicines, diagnostic tools,  and other interventions.

• AWARENESS
  • Antimicrobial resistance (AMR) awareness week will be celebrated every November, acknowledging its global importance and also to raise awareness in Nepalese population, on the problem and ways to address it.
  • Behaviour change and communication messages, targeting rational use of antibiotics will be promoted through appropriate media.
  • Consumer awareness programs on AMR and rational use of antimicrobials will be promoted mobilizing GOs and NGOs.
  • 
    •    Veterinary, livestock and agriculture sectors will be incorporated under national AMR network for monthly reporting of the AMR status in each sector, contributing to one national AMR framework. •    DDA will have a strong regulatory mechanism in place for complete interruption of the non-prescription sale of antibiotics. •  

 AMR is world problems not Nepal problems.
   

  Infection prevention and control measures in health facilities as well as outside (in community) reduce the risk of transmission of infections and minimizes the need for AMs. This reduces the selective pressure and the subsequent emergence of resistant strains. Furthermore, infection prevention and control measures diminish the spread of the resistant microbes once resistance has emerged.

Reduce the incidence of infection through effective sanitation and hygiene  .

      STEWARDSHIP:

ACTION  Optimize the use of antibiotics in human health, animal health and food processing:

ACTION  Minimize the non- therapeutic use of antimicrobial in animals and food items

Target By 2029 A.D:

•    AMR surveillance will be expanded and made mandatory for both public and private sector health care providers. •    Veterinary, livestock and agriculture sectors will be incorporated under national AMR network for monthly reporting of the AMR status in each sector, contributing to one national AMR framework. •    DDA will have a strong regulatory mechanism in place for complete interruption of the non-prescription sale of antibiotics. •    No antibiotics will be distributed/sold without prescription so that over the counter sale of antibiotics is restricted.

Nepgen Clinical research service and solutions is healthcare innovative company which is committed for individual’s health and wellbeing. The company brings their expertise in healthcare and technology to conduct clinical research in Nepal. We are dedicated to conduct clinical research in Nepal and generate evidence for clinical practice. We redefine the future of the healthcare industry and enrich the quality of life. We are elevated towards the overall health performance through various types of research.

The company believes that everyone deserves excellent health care. We also have world-class technology to provide you the best service possible.

Company believes that health and human right are complex and steadily evolving. Today’s cost-sensitive healthcare ecosystem has created a competitive and demanding workplace for a diversified team of clinicians. Nepgen clinical research service and solutions has specialists from all around the world, mostly from Nepal and the United States of America. Company’s dedicated team of researchers, clinicians, pharmacist, public health experts, bio technicians and other health professionals are compassionate about research.   Our team is responsible to handle the project with 100% accuracy rate. We have access to the community at study site in 7 provinces. 

With this funding amount, we plan to study in details considering 15000 to 20,000 samples for the period of 5 years with in 15 districts of each 7 provinces in Nepal. Through our study, we aim to find out the actual antimicrobial resistance of different types of antibiotics over this period and provide actual data and implement the policy to use rationally antibiotics among policy makers, nurses, health assistant, doctors ,pharmacist and general public.

•    The guidelines will include primary, secondary and tertiary line of treatments, along with last resort antibiotics strictly for use under Infectious Disease Physician/expert prescription, based on the evidences for need. Practice of antibiotics use will be solely based on culture and susceptibility testing results from accredited microbiology laboratory.
•    DDA will develop evidence-based legislative framework/act for empowering National regulatory authorities to assure quality, sale and distribution of antibiotic.
•    Veterinary drug use will be efficiently regulated as per existing and updated country regulations.
•    Country regulatory mechanisms and HR capacity will be strengthened, through appropriate trainings in regulating antibiotics production/packaging, buying, selling, supplying, and receiving in donation in human health.

•    AMR surveillance will be expanded and made mandatory for both public and private sector health care provider.

Our approach for this surveillance study in 15 district of 7 Provinces in Nepal is Data driven technology, Health app data and more importantly Data Monitoring Board for Antimicrobial Resistance study will be formed for monitoring and evaluation which include expertise from ethical review Board, Department of Drug administration, Department of Veterinary and many more.

The AMR- IT initiative  will be geared to catalyze the evidence-to-action cycle from defining the most relevant research in countries to ensuring uptake of research findings. The key is to bring together existing – but unpublished – data and information and raise to publication standard. At present, the research findings from the AMR  IT initiative are in phases of advocating and implementing the recommendations at different levels and in respective institutions. ‘The studies will help us better understand the actual situation in Nepal; guide development of national strategies to tackle AMR with a One Health Approach; and address the implementation research gaps in the critical area of containment,’

Participants  will be included doctors, nurses, paramedical officers, and programme officers, often with little or no prior research experience. They will be receiving training while still completing research, often harnessing data which have never been published.

Antimicrobial resistance (AMR) is one of the major global threats to humankind that is projected to cost 10 million lives per year by 2050 if remained unchecked. The burden of antimicrobial resistance is disproportionately higher in developing countries like Nepal where sanitation is poorly managed, surveillance of resistance development is minimal, widespread misuse of antibiotics is high, and effective policies to address the crisis are not enforced. According to 2014 WHO comprehensive report on AMR, bacterial pathogens that are resistant to third-generation cephalosporins and fluoroquinolones are circulating at a high level in the South-East Asia region that is home to a quarter of the world’s population. There is an urgent need for the development of alternative treatment modalities to address the AMR crisis in developing countries and elsewhere.

Budget is main issue of the project. Once the budget is solved the framework for policy and technical study will be done not for three years but for 5 years at data received from the study at community level in Nepal.