Strengthening Hospital-Based Paediatric AMS in Nigeria: A Multi-Centre Baseline Survey and Intervention Overview

Abstract

Abstract

Background: Antimicrobial abuse drives antimicrobial resistance and is prevalent in low- and middle-income countries. Facility antimicrobial stewardship (AMS) programmes are essential interventions.

Objective: To describe the hospitals' baseline assessment in the Nigerian Society for Paediatric Infectious Diseases (NISPID) AMS programme network and interventions to strengthen/establish paediatric AMS programmes.

Methods: Paediatric Infectious Diseases (ID) leads were invited to the NISPID AMS Programme Network. Baseline assessment of core elements of hospital AMS programmes was conducted with the World Health Organisation tool. The assessment report was used to strengthen/establish the AMS programmes.

Results: Thirteen facilities completed the baseline assessment: 11 Federal and 2 State hospitals, 9 were academic hospitals. The median (range) inpatient bed capacity of hospitals was 600 (300-1000) beds, and all had microbiology laboratories and pharmacies. Thirty-six paediatric ID specialists were involved, a median (range) of two (0-6) per hospital; only two had paediatric ID sub-speciality training. Eleven hospital managements had prioritised AMS, eight had AMS committees and action plans, and none had AMS budget lines. Seven hospitals conducted AMU point prevalence surveys (PPS), three conducted antimicrobial consumption audits, nine conducted AMR surveillance, and only one audited the AMS programme. Two hospitals shared PPS and AMR surveillance reports hospital-wide, and one shared an antibiogram. Centres were trained on establishing a functional AMS Programme, constituting AMS committees, teams, terms of reference and roles of constituent members, developing action plans and carrying out various AMS interventions and surveillance activities.

Conclusion: Resources exist for paediatric AMS programmes in Nigeria, but there is a need for training and support.