Evidence map›Paper›PMID 40867989›Full record

ArticleAntibiotics (Basel, Switzerland)2025

Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi.

Ana C Barbosa de Lima, Kwame Ohene Buabeng, Mavis Sakyi, Hope Michael Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui and 3 more

Abstract read
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In one paragraph

Article in Antibiotics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ana C Barbosa de LimaECHO Institute, University of New Mexico Health Sciences Center, 1650 University Blvd. NE, Albuquerque, NM 87102, USA.
Kwame Ohene BuabengDepartment of Pharmacy Practice, School of Pharmacy, University of Health and Allied Sciences, Ho PMB 31, Ghana.ORCID 0000-0001-7944-2255
Mavis SakyiTechnical Coordination Directorate, Ministry of Health, Accra P.O. Box M-44, Ghana.
Hope Michael ChadwalaMinistry of Health, Lilongwe 3 P.O. Box 30377, Malawi.ORCID 0009-0004-3290-2241
Nicole DevereauxECHO Institute, University of New Mexico Health Sciences Center, 1650 University Blvd. NE, Albuquerque, NM 87102, USA.
Collins MitamboMinistry of Health, Lilongwe 3 P.O. Box 30377, Malawi.
Christine Mugo-SitatiECHO Africa, University of New Mexico Health Sciences Center, Nairobi 00200, Kenya.
Jennifer NjuhiguMinistry of Health, Nairobi P.O. Box 30016, Kenya.
Gunturu RevathiDepartment of Pathology, Aga Khan University, Nairobi P.O. Box 30270-00100, Kenya.ORCID 0000-0002-6938-8387
Emmanuel TanuiMinistry of Health, Nairobi P.O. Box 30016, Kenya.
Jutta LehmerECHO Institute, University of New Mexico Health Sciences Center, 1650 University Blvd. NE, Albuquerque, NM 87102, USA.
Jorge MeraECHO Institute, University of New Mexico Health Sciences Center, 1650 University Blvd. NE, Albuquerque, NM 87102, USA.
Amy V GroomECHO Institute, University of New Mexico Health Sciences Center, 1650 University Blvd. NE, Albuquerque, NM 87102, USA.

Funding

Pfizer Inc. Collaboration Agreement
6 · The paper itself

Abstract

BACKGROUND/

objectivesStrengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi.

methodsA mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions.

resultsBetween September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community.

conclusionsOur findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity.

Indexed as

AMRAMScommunity of practicee-learninghealthcare facility assessmentIPCvirtual education

Identifiers

PMID40867989
PMCPMC12383062

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.