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Title: Community-level antibiotic access and use (ABACUS) in low- and middle-income countries: Finding targets for social interventions to improve appropriate antimicrobial use - an observational multi-centre study [version 1; referees: 2 approved]
Authors: Heiman F.L. Wertheim
Nguyen Thi Kim Chuc
Sureeporn Punpuing
Wasif Ali Khan
Margaret Gyapong
Kwaku Poku Asante
Khatia Munguambe
F. Xavier Gómez-Olivé
Proochista Ariana
Johannes John-Langba
Betuel Sigauque
Tran Khanh Toan
Stephen Tollman
Amelieke J.H. Cremers
Nga T.T. Do
Behzad Nadjm
H. Rogier van Doorn
John Kinsman
Osman Sankoh
Nuffield Department of Clinical Medicine
Oxford University Clinical Research Unit
Radboud University Nijmegen Medical Centre
Hanoi Medical University
Mahidol University
International Centre for Diarrhoeal Disease Research Bangladesh
Dodowa INDEPTH Site
University of Health and Allied Sciences
Kintampo INDEPTH Site
Manhica Health Research Site
University of Witwatersrand
University of KwaZulu-Natal
Umeå Universitet
Njala University
Keywords: Biochemistry, Genetics and Molecular Biology
Issue Date: 1-Jan-2017
Citation: Wellcome Open Research. Vol.2, (2017)
Abstract: © 2017 Wertheim HFL et al. In many low- and middle-income countries (LMICs), a poor link between antibiotic policies and practices exists. Numerous contextual factors may influence the degree of antibiotic access, appropriateness of antibiotic provision, and actual use in communities. Therefore, improving appropriateness of antibiotic use in different communities in LMICs probably requires interventions tailored to the setting of interest, accounting for cultural context. Here we present the ABACUS study (AntiBiotic ACcess and USe), which employs a unique approach and infrastructure, enabling quantitative validation, contextualization of determinants, and cross-continent comparisons of antibiotic access and use. The community infrastructure for this study is the INDEPTH-Network (International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries), which facilitates health and population research through an established health and demographic surveillance system. After an initial round of formative qualitative research with community members and antibiotic suppliers in three African and three Asian countries, household surveys will assess the appropriateness of antibiotic access, provision and use. Results from this sample will be validated against a systematically conducted inventory of suppliers. All potential antibiotic suppliers will be mapped and characterized. Subsequently, their supply of antibiotics to the community will be measured through customer exit interviews, which tend to be more reliable than bulk purchase or sales data. Discrepancies identified between reported and observed antibiotic practices will be investigated in further qualitative interviews. Amartya Sen's Capability Approach will be employed to identify the conversion factors that determine whether or not, and the extent to which appropriate provision of antibiotics may lead to appropriate access and use of antibiotics. Currently, the study is ongoing and expected to conclude by 2019. ABACUS will provide important new insights into antibiotic practices in LMICs to inform social interventions aimed at promoting optimal antibiotic use, thereby preserving antibiotic effectiveness.
ISSN: 2398502X
Appears in Collections:Scopus 2016-2017

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