Covid-19 and Antimicrobial Resistance in East Africa

CARE is an 18-month study that seeks to investigate the extent to which COVID-19 has changed health-seeking behaviour for common bacterial illnesses and the availability and usage of ABs. in East Africa.

There is mounting evidence that COVID-19 prevention measures are changing patient treatment-seeking behaviours for other illnesses. This includes changes in antibiotic (AB) usage which risks driving up antimicrobial resistance (AMR). This is a priority concern within LMIC countries, including those of East Africa, where the circulating pathogen population is responsible for a high burden of infectious disease.

This project will address the knowledge gap of the impact that COVID-19 is having on AB usage and provision, and gather evidence to inform policy and interventions to reduce inappropriate AB usage.

Employing an interdisciplinary approach, we will conduct a program of research in Uganda and Tanzania by targeting three interconnected AMR domains: Landscape – we will investigate the impact of COVID-19 on formal health care providers’ and community drug sellers’ experiences and attitudes to antibiotic provision and response to official COVID-19 advice; Patients – in health clinics we will enrol patients and examine how COVID-19 restrictions are affecting patient treatment seeking, AB use, and understanding of illness, and for a subset we will assess shifts in the AMR profile of urinary pathogens; and Communities – we will investigate how community members have received and responded to health messages on COVID-19 and how perceptions about illness and medications may have altered.

Data will be compared to baseline data from our ongoing study that was collected in the study areas pre-COVID-19 to investigate changes in AB usage and provision and linkage to COVID-19 disease and/or interventions. A synthesis of the findings will be provided to a range of stakeholders from communities to governmental, to help improve AB stewardship activities and messaging as part of the pandemic response in East Africa and beyond.