September 2022: Fleming Fund fellows from Malawi have successfully completed data collection from poultry, humans, and the environment as part of the One Health approach. As part of their fellowships, Fleming Fund fellows in Malawi collaborated with the University of Edinburgh to develop a project to characterise resistance patterns and AMR drivers in Escherichia coli isolated from poultry farms in the central region of Malawi. Samples were collected from poultry, farm workers and environmental sources to help build up a true One Health picture of the levels of antimicrobial resistance in the poultry farming sector. Linked with the bacterial sampling, the team also surveyed farm workers about their knowledge, attitudes, and practices (KAP) of antibiotic use on poultry farms. Image Smallholder black Australorp chicken farm in Malawi. Project overview The study was conducted in all nine districts of the central region of Malawi. Samples were collected at three different levels of the breeding bird pyramid. The fellows selected one large scale public breeding farm, 27 multiplier farms in each of the nine districts, and several hundred at various smallholder farms to participate in the study. At each farm, workers were asked to complete the KAP questionnaire. A team of research assistants worked alongside the fellows for 50 days to collect and then process almost 2000 samples at the National Microbiological Reference Laboratory in Lilongwe. The work was completed at the end of September 2022. Image Research assistant collecting cloacal swabs during on-site sampling. Challenges in data collection During the sample collection, the fellows faced some challenges. Poor power supply to the hatcheries and heating of the chickens in several of the multiplier farms initially identified for the study, was thought to have contributed to loss of flocks on these farms. This meant that new farms had to be recruited into the study. Malawi also experienced a significant shortage of fuel during data collection, making it difficult for research teams to travel to study sites to collect data. Image L to R: Williams Mwantoma, three research assistants, and Catherine Kamwana gathering specimens from a multiplier farm. The next steps The data sets produced by the project are a very rich source of information. In the coming weeks, mentor Dr Stella Mazeri from the University of Edinburgh, who was instrumental in the collaborative project, will set up online sessions to help the fellows analyse the data. Image Williams Mwantoma along with laboratory assistants at the National Microbiological Reference Laboratory (NMRL) in Lilongwe during sample processing. Our human and animal health fellows from Malawi who contributed in this study, which is one of the first systematic One Health studies on AMR in the poultry sector, hope that the results of their study will contribute to robust surveillance in their country. Despite the enormous workload we have had, we have successfully managed to collect and analyse all specimens to the intended quality, and we can not wait to see the results of our AMR data analysis. Harry MilalaAMR Laboratory Human Health fellow and Laboratory Technician at the National Microbiology Reference Laboratory at the Ministry of Health, Malawi The collaborative project is a great opportunity for the fellows to put their new skills into action. It has been a pleasure to work with them in the design, planning, and implementation of the study, and it has been very inspiring to see how they have contributed to the success of this project with hard work and a spirit of cooperation. Dr. Stella MazeriChancellor's Fellow of the University of Edinburgh and Fleming Fund Mentor The collaborative project provides Fleming Fellows the unique opportunity to reflect and implement a one health AMR surveillance plan. The result is a blueprint for integrated surveillance that is unique to their country. Dr. Adrian MuwongeCo-director of the University of Edinburgh Fleming Fund fellowship schemes Related Links Fleming Fund Fellowship Scheme Dr Adrian Muwonge profile Dr. Stella Mazeri profile Publication date 20 Oct, 2022
