Use history of diagnosis, purchasing & medication data as surveillance

Using history of diagnosis, purchasing & medication data of antimicrobials as surveillance from small-scale commercial poultry farmers.We use this data to detect misuse and overuse of antimicrobial cases for decision making, predict  antimicrobial resistance before it occurs, testing poultry manure and design simple manure processing technologies to mitigate environmental risks

Vicent Temba: Team lead and One Health Surveillance Specialist. He is responsible for supervising the collection and analysis of surveillance data from small-scale commercial farmers, reported by the farmers themselves.

Tanzania is improving antimicrobial stewardship by collecting national-level datasets primarily focused on antimicrobial sales data. However, such datasets cannot inform surveillance. These Antimicrobial sales datasets lack essential contextual information for how the antimicrobials are being used, diagnosis history, and specific regimen components such as dose, route, age of animals at onset of treatment, duration, and farmers behavior. It is therefore unclear how national antimicrobial sales data alone are useful in assisting with antimicrobial resistance surveillance. Currently Small-scale commercial poultry farmers in Tanzania are using pen and paper to record and track diagnosis history, purchasing data,  antimicrobial medication doses that are used for treatment for poultry in their farms which  is difficult to detect overuse and misuse of antibacterial doses, allocation of resources and decision making for surveillance. As a result, the most substantial consumption of antimicrobials occurs in poultry farms. Evidence show antimicrobials (70-90%) are excreted in manure either parent compounds or metabolized products. Poultry manure contains the antimicrobials poured in the environment, which goes in environment such as water, soil and even to the short cycle food crops. Currently there is a high shortage of simple poultry manure processing technologies that reduce the spread of antimicrobials in the environment

Small scale commercial poultry farmers:  They are report data to provide the granularity necessary for evaluation of the patterns and trends of on-farm antimicrobial use. These data include the diseases being treated, age at onset of disease, duration, and the number of prescriptions. Small scale commercial poultry farmers directly benefit from community surveillance by receiving required veterinary care for their poultry. Additionally, they administer necessary medications to safeguard their poultry from diseases by disrupting the transmission cycle in humans, animals, and the environment.

Local livestock officials: These are responsible for anti-microbial resistance surveillance, receive considerably more relevant data to better do their jobs.  They can monitor the uses of data on antimicrobial doses that were used at the time of medication for poultry in the farms by farmers to detect cases of misuse and overuse opportunities for antimicrobial resistance.

Local communities: The remedy for antimicrobial resistance challenges requires One Health approach to ensure health and wellbeing of humans, animals, and the environment. The community are the longer-term beneficiaries as they are protected from potential misuse and overuse of antimicrobial.

One of our outputs is to deliver free to use simple and cost-effective manure processing technologies that will aid in treating manure processes. This will be designed by farmers themselves with collaboration of experts to reduce the spread of antimicrobials in the environment, by disrupting the transmission cycle in humans, animals, and the environment. This will lead to safer fertilizer for organic and non-organic products, and ultimately safer food products. It is expected to have an added benefit of creating employment opportunities for small businesses for manure composting and fertilizer sales.

We will evaluate and write the peer-review publication on the impact of the manure processing technology on employment/income, manure quality and value, and reduced antimicrobial resistant contamination. We will assess, together with private companies, how different ways of composting poultry manure can reduce antimicrobial residues and resistant microorganisms. Treated and quality manure fertilizer is in demand for farmers producing high value crops, and in particular, organic farmers. It is expected to have an added benefit of creating employment opportunities for small businesses for manure composting and fertilizer sales. To strengthen existing public regulatory frameworks that support increased uptake of processed and safe use of manure from commercial poultry farms.

Input –We are giving small-scale commercial poultry farmers digital tools to monitor the history of diagnosis, purchasing & medication data of antimicrobials of their poultry are the best way to stop antibacterial resistance before they  occur into animal, humans, and environment. We provide small-scale commercial poultry farmers with technology to detect misuse and overuse of antimicrobial cases for decision making, testing poultry manure for antimicrobial resistance and design simple manure processing technologies to mitigate environmental spread of antimicrobials. 

Output: We aim to improve and sustain the appropriate use of antimicrobial among small-scale commercial poultry farmers for their poultry, and the health official receiving just-in-time data directly from the source of a potential antimicrobial resistance. Optimize poultry manure processing technology for mitigating antimicrobial residues.
Outcome: We want fewer cases of antimicrobial resistance because one local health officials can detect misuse and overuse of antimicrobial cases for decision making, respond rapidly before it creates resistance and identify prioritized areas for elimination efforts. The remedy for AMR challenges requires a One Health approach to ensure the health and wellbeing of humans, animals, and the environment. The use of simple manure treating technologies provides an opportunity to use safe poultry manure for safe food.

By  improve the operational and robust of our surveillance system for  antimicrobial resistance among small scale poultry commercial farmers, our impacts are:

Goals within next year:

• Consolidated our surveillance and operating systems.

• Have enabled over 5000 scale poultry commercial farmers improve the quality and appropriate antibacterial prescription amongst small scale commercial farmers.

• Designing simple and cost-effective poultry manure processing technologies can reduce the spread of antimicrobials in the environment.

• Look to form three technical partnerships with institutions.

• Integrate 50% of women in antimicrobial resistance surveillance through a gender lens

• 60 % scale poultry commercial farmers improve changing feelings, attitudes, behaviors, and practices toward antimicrobial use.

Goals within next three years:

• 15000 small scale poultry commercial farmers

• Designing simple and cost-effective poultry manure processing technologies can reduce the spread of antimicrobials in the environment, by disrupting the transmission cycle in humans, animals, and the environment.

• Look to form seven technical partnerships with institutions.

• Integrate 80% of women in antimicrobial resistance surveillance through a gender lens in poultry production.

• 90 % scale poultry commercial farmers improve changing feelings, attitudes, behaviors, and practices toward antimicrobial use.

1. Quality and appropriate antimicrobial prescription amongst small scale commercial farmers:  How the history of diagnosis, purchasing and medication data as surveillance has the potential to address misuse and overuse of antimicrobial opportunities for antimicrobial resistance while take action to protect people, animals, and the environment. We measure range of metrics time and space of prescription, health status of poultry, animal health advice, age of poultry, leadership, record keeping, accuracy periodically.

2. antimicrobial metrics: Do small scale commercial poultry farmers keep records accurately? How the platform predicts antimicrobial  resistance in humans, environment, and animals before it occurs, are they performing sufficiently well to meet appropriate antibiotic prescription? 
3. We measure small scale commercial farmers engagement and satisfaction with the network across a range of metrics – How we enable to changing feelings, attitudes, behaviors, and practices toward antimicrobial use and AMR in poultry farming in the communities over time?
4. We measure gender equality and social inclusion: How small-scale commercial farmers integrate a gender lens in their work? 
5. Poultry manure processing technologies: How simple and cost-effective poultry manure processing technologies reduce the spread of antimicrobials in the environment, by disrupting  transmission cycle in humans, animals, and the environment

Possible barriers that we can see for next year: -

• Financial –We are looking to raise capital to make our next phase plans reach fruition.
• Product Development – We don’t have many precedents to emulate, so we will be setting our own product benchmarks.
• Government Bureaucracy –One Health sector in Tanzania is tightly controlled central government matter with bureaucracy.
• Outreach –We do recognize the need to tap into newer markets and hence, we need a well-rounded strategy on outreach and product positioning.
 
Possible barriers that we can see for next three years: -
• Adaptability  and Competition –we do see competition in this space heating up as governments see the benefits of investing more into Tech based initiatives in One health space.
How do you plan to overcome these barriers?
• By developing a close working relationship and rapport with governments and personnel in key industries. 
• By staffing our team with the right personnel. 
• By keeping ourselves aware of the peer research and development in this sector. While we shall have confidence in our own capabilities, we shall always keep ourselves aware of the advancements.

We are seeking participation in Trinity Challenge to tap into a valuable community of peers, experts, and partners who can propel the advancement of our initiative. The primary motivation is to gain mentorship and exposure within the extensive MIT network, which opens doors to conversations typically beyond the reach of an average social enterprise. Specifically, we are eager to benefit from the guidance and insights of MIT's community of One health experts, epidemiologists, and technologists. Our objective is to learn how to effectively scale our technology on a national and international level, extending its impact beyond the borders of Tanzania. The SOLVE platform provides a unique opportunity for us to connect with thought leaders and leverage the collective expertise of the MIT community for the strategic growth of antimicrobial surveillance system.

We would like to have partnerships with key organizations including:

Antimicrobial resistance surveillance Technologists:
Collaboration Focus: Expertise in designing animal data collection systems.
One Health Network in Tanzania and East Africa:
Collaboration Focus: Local epidemiological expertise and access to a network of one health officials and small-scale commercial farmers.
Engaging with a diverse group, including provincial livestock officers, public health officers, health professionals, economists, political scientists, and provincial government officials. These strategic partnerships strengthen our project by bringing together a wealth of knowledge, resources, and support from various domains.