Promoting Anti-Microbial Stewardship in Low- and Middle-Income Countries: A Case Study on Maternal Sepsis in Uganda

This project sought to identify ways of optimising the use of available antibiotics in a Ugandan Regional Referral Hospital in order to reduce the high level of maternal sepsis and associated mortality. Significant reductions in both mortality and hospital costs were achieved through a complex intervention combining:

• Attention to Infection-Prevention- Control
• Improvements in Wound Care including the use of honey dressings (and supported by Virtual Wound Clinics)
• Greater involvement of Pharmacists in clinical decision-making
• The development of an antibiogram to support evidence-based prescribing

Funder

Tropical Health and Education Trust (For both the AMR project and the Virtual Wound Care Clinics).

The Commonwealth Professional Fellowship Scheme funded fellowships at the University to support work on wound care for Rachel Namiiro and Hannah Kemiyondo.

Publications

Ackers, H.L., Ackers-Johnson, G., Welsh, J., Kibombo, D. and Opio, S. (2020) AMR in Global Perspective, Palgrave.

Ackers, H.L., Ackers-Johnson, G., Seekles, M. and Opio, S. (2020) Opportunities and Challenges for Improving Anti-Microbial Stewardship in LMICs; Antibiotics 2020, 9, 315; doi:10.3390/antibiotics9060315

Ackers-Johnson, G., Kibombo, D., Kusiima, B., Moses L. Nsubuga, M.L., Kigozi, E., Kajumbula, H.M., Kateete, D.P., Walwema, R., Ackers, H.L., Goodhead, I., Birtles, R.J. and James, C.E. (2021) Antibiotic resistance profiles and population structure of disease-associated Staphylococcus aureus infecting patients in Fort Portal Regional Referral Hospital, Western Uganda, Microbiology 2021;167:001000 DOI 10.1099/mic.0.001000

Welsh, J. and Ackers, H.L. (2022) An exploration of midwives’ understanding of antibiotic resistance and stewardship in Uganda, African Journal of Midwifery and Women’s Health (16) 2:1-10.

Stephens, M., Wynn, M., Pradeep. S. and Ackers, H.L. (2023) Frugal Innovation in wound care: the five Rs. British Journal of Healthcare Management. https://doi. org/10.12968/bjhc.2023.0061

This Work formed the basis of a 2021 REF Impact Case Study.

Professor Ackers is a Consultant on the WHO’s SORT IT program promoting impact in AMR research.

Team

Louise Ackers

Chloe James

Richard Birtles

Ian Goodhead

Melanie Stephens

Dr Gavin Ackers-Johnson, Liverpool School of Tropical Medicine

Allan Ndawula and Rachel Namiiro, Knowledge For Change, Uganda.

Hannah Kemiyondo, For Portal Regional Referral Hospital, Uganda

For Information Contact Professor Louise Ackers