GLOBAL HEALTH
Creating National Repositories for Managing AMR Data
By Reshma Kakkar , manager , Global Health Informatics ; Rufus Nyaga , deputy director , Kenya ; Ephrem Mekonnen , specialist , Informatics , Ethiopia ; Kasimona Sichela , lead , Informatics , Zambia ; and Fredrick Mwasekaga , senior technical manager , Tanzania
This poem was presented at the Global Health Security Conference , held in Australia in June 2024 , where attendees were advised they could not use PowerPoint slides for their presentations :
There once was an antibiogram That said all on my own I am I can tell you more about susceptibility And resistance trends are my specialty But without good reporting , I am in a jam
There ’ s data data everywhere But for standards , not many have a care Labs doing manual data entry Often duplicating and a lot of reentry But good AMR data , now that is rare
Along comes APHL ’ s practical approach To support these labs , with no reproach How about a national AMR data repository That doesn ’ t care what systems labs use and is free ! And for missing standards can serve as a coach
LIMS , WHONET , Excel are all welcome Web portals , APIs will all find a home Reporting becomes a piece of cake One point of integration is all it will take AMR repository can help , and then some !
Let ’ s take the case of Ethiopia Using the LIMS for AMR seemed like a utopia But WHONET now , each lab used consistently To enter AMR data and conduct analyses So why not have WHONET be the source here
16 sentinel sites there are With separate WHONET instances , each afar Emailing files to the national lab monthly Some on time , and some , quite tardy Opportunities to harmonize ! And not a high bar
The AMR repository was set up centrally OpenLDR is what it is called colloquially Each lab just used its own WHONET To automatically push data , no need to get Data centralization , therefore , becomes key
Now we look at Zambia Unlimited LIMS licenses , what a great idea Virology , parasitology , micro — you name it The LIMS handled it all , no doubt about it But GLASS reporting was still a dilemma
The lab data repository was well established With reporting of data to it , labs were habituated Now where to fit WHONET in So GLASS reporting can effectively begin This needed to be ruminated
What if we approach the problem differently Labs don ’ t have to change what they do daily The repository generates an Excel file Send speedily to the labs , no waiting a while And Baclink imports the file to WHONET immediately !
Kenya , not to be left behind Centralizing lab data has been on everyone ’ s mind Since the start of the pandemic When testing volume at borders was epic And results reporting had labs in a bind
Kenya too set up a data repository Initially COVID lab data was all it was meant to be But as the Ministry realized its value For AMR reporting this was the clue And soon these data had their own residency
All roads can lead to Rome In OpenLDR , AMR can have a home WHONET and GLASS reporting can be done With standards and data centralization , it doesn ’ t have to take eons And data modernization doesn ’ t become a tome
Zambia now has labs totaling 30 With AMR reporting capability Twenty-three nationally in Kenya Six and growing in Ethiopia Solutions based on opportunity g
GLOSSARY AMR ................... Antimicrobial Resistance GLASS ............... WHO Global Antimicrobial Resistance and Use Surveillance System LIMS ................... Laboratory Information Management System OpenLDR ........... Open Laboratory Data Repository
DIGITAL EXTRA
Read APHL ’ s recent success story about its informatics team in Zambia and how the team helped develop a solution for handling and streamlining AMR data management .
26 LAB MATTERS Winter 2024
PublicHealthLabs @ APHL APHL . org