ArticleWellcome open research2022
Drivers of Resistance in Uganda and Malawi (DRUM): a protocol for the evaluation of One-Health drivers of Extended Spectrum Beta Lactamase (ESBL) resistance in Low-Middle Income Countries (LMICs).
Article in Wellcome open research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Evaluation of detection performance and cost-effectiveness of IDEXX Colilert-18 and ChromAgar for environmental surveillance of extended-spectrum beta-lactamaseMicrobiology spectrum · 2026Article
- Metabolic reprogramming of the infant gut by bifidobacteria-based probiotics drives exclusion of antibiotic-resistant pathobionts.Cell reports. Medicine · 2026Article
- Mapping and quantifying the spatial and temporal composition of waste piles in informal settlements of urban Malawi.Environmental science and pollution research international · 2026Article
- Evolution of technology and disparities in antimicrobial stewardship: a narrative review.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Transmission of extended spectrum β-lactamase-producing Escherichia coli and antimicrobial resistance gene flow across One Health compartments in eastern Africa: a whole-genome sequence analysis from a prospective cohort study.The Lancet. Microbe · 2026Article
- Environmental surveillance of bacteria in a new intensive care unit using plate sweeps.Microbial genomics · 2026Article
- Environmental hazards from pollution of antibiotics and resistance-driving chemicals in an urban river network from Malawi.npj antimicrobials and resistance · 2025Article
- High diversity of Escherichia coli causing invasive disease in neonates in Malawi poses challenges for O-antigen based vaccine approach.Communications medicine · 2025Article
- Strengthening antimicrobial stewardship in public health facilities in Malawi through a participatory epidemiology approach.JAC-antimicrobial resistance · 2025Article
- Risk Perception and Psychosocial Factors Influencing Exposure to Antimicrobial Resistance through Environmental Pathways in Malawi.The American journal of tropical medicine and hygiene · 2025Article
- Simulation based composite likelihood.Statistics and computing · 2025Article
- Transmission dynamics for invasive Non-TyphoidalWellcome open research · 2025Article
- Time to define One Health approaches to tackling antimicrobial resistance.Nature communications · 2024Article
- Key environmental exposure pathways to antimicrobial resistant bacteria in southern Malawi: A SaniPath approach.The Science of the total environment · 2024Article
- Risk Factors, Temporal Dependence, and Seasonality of Human Extended-Spectrum β-Lactamases-Producing Escherichia coli and Klebsiella pneumoniae Colonization in Malawi: A Longitudinal Model-Based Approach.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Investigating One Health risks for human colonisation with extended spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Malawian households: a longitudinal cohort study.The Lancet. Microbe · 2023Article
- Drivers of Resistance in Uganda and Malawi (DRUM): a protocol for the evaluation of One-Health drivers of Extended Spectrum Beta Lactamase (ESBL) resistance in Low-Middle Income Countries (LMICs).Wellcome open research · 2022Article
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21 authors.
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Abstract
In sub-Saharan Africa (sSA), there is high morbidity and mortality from severe bacterial infection and this is compounded by antimicrobial resistance, in particular, resistance to 3rd-generation cephalosporins. This resistance is typically mediated by extended-spectrum beta lactamases (ESBLs). To interrupt ESBL transmission it will be important to investigate how human behaviour, water, sanitation, and hygiene (WASH) practices, environmental contamination, and antibiotic usage in both urban and rural settings interact to contribute to transmission of ESBL E. coli and ESBL K. pneumoniae between humans, animals, and the environment. Here we present the protocol for the Drivers of Resistance in Uganda and Malawi (DRUM) Consortium, in which we will collect demographic, geospatial, clinical, animal husbandry and WASH data from a total of 400 households in Uganda and Malawi. Longitudinal human, animal and environmental sampling at each household will be used to isolate ESBL E. coli and ESBL K. pneumoniae. This will be complimented by a Risks, Attitudes, Norms, Abilities and Self-Regulation (RANAS) survey and structured observations to understand the contextual and psychosocial drivers of regional WASH practices. Bacterial isolates and plate sweeps will be further characterised using a mixture of short-,long-read and metagenomic whole-genome sequencing. These datasets will be integrated into agent-based models to describe the transmission of EBSL resistance in Uganda and Malawi and allow us to inform the design of interventions for interrupting transmission of ESBL-bacteria.
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