Postgraduate Diploma Research Project by Catherine Wangu Shitemi
W61/8791/2016
University of Nairobi
ABSTRACT
Background: Antimicrobial Resistance
has been described as a public health emergency. Antimicrobial stewardship
programs have been recommended as one of the ways of combating AMR. Stewardship
Programs have been implemented and studied in many parts of the world. We found
no studies in literature documenting antimicrobial stewardship in Kenya.
Objective:
The study sought to identify existing antimicrobial
stewardship guidelines in Kenya; and to appraise antimicrobial stewardship at
Mbagathi County Referral Hospital in Nairobi City County, Kenya.
Methodology: This was a cross-sectional mixed methods survey conducted
among health practitioners who prescribe, dispense or administer antimicrobials
at the Mbagathi County Referral Hospital. It included a preliminary
quantitative followed by a qualitative phase. A self-administered questionnaire
was used to collect quantitative data. Qualitative data was collected through key
informant interviews.
Descriptive data analysis was done. Variables were analyzed using counts and percentages and results presented using tables and graphs. Audio records of the interviews were transcribed. The data was analyzed using the content analysis approach. Codes were identified and extracted from the transcripts.
The codes were used to build themes on the respondents' views on guidelines, stewardship practices, challenges and opportunities for antimicrobial stewardship.
Descriptive data analysis was done. Variables were analyzed using counts and percentages and results presented using tables and graphs. Audio records of the interviews were transcribed. The data was analyzed using the content analysis approach. Codes were identified and extracted from the transcripts.
The codes were used to build themes on the respondents' views on guidelines, stewardship practices, challenges and opportunities for antimicrobial stewardship.
Results:
A total of 171 respondents filled the questionnaire from the
242 that were distributed. Standard documentation of antibiotic prescriptions
in patient charts was the most widely used stewardship activity at Mbagathi
County Referral Hospital.
Conclusion
and recommendations: We found no formal stewardship structure or local policy
document available to guide antimicrobial use at the facility. Challenges to be
addressed include laboratory capacity for microbiological diagnosis, drug
supply and training. We recommend the establishment of an antimicrobial
stewardship team to spearhead antimicrobial stewardship at Mbagathi County
Referral Hospital.
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