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Sandberg M, Hesp A, Aenishaenslin C, Bordier M, Bennani H, Bergwerff U, Chantziaras I, De Meneghi D, Ellis-Iversen J, Filippizi ME, Mintiens K, Nielsen LR, Norström M, Tomassone L, van Schaik G, Alban L. Assessment of Evaluation Tools for Integrated Surveillance of Antimicrobial Use and Resistance Based on Selected Case Studies. Front Vet Sci 2021; 8:620998. [PMID: 34307513 PMCID: PMC8298032 DOI: 10.3389/fvets.2021.620998] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/21/2021] [Indexed: 01/18/2023] Open
Abstract
Regular evaluation of integrated surveillance for antimicrobial use (AMU) and resistance (AMR) in animals, humans, and the environment is needed to ensure system effectiveness, but the question is how. In this study, six different evaluation tools were assessed after being applied to AMU and AMR surveillance in eight countries: (1) ATLASS: the Assessment Tool for Laboratories and AMR Surveillance Systems developed by the Food and Agriculture Organization (FAO) of the United Nations, (2) ECoSur: Evaluation of Collaboration for Surveillance tool, (3) ISSEP: Integrated Surveillance System Evaluation Project, (4) NEOH: developed by the EU COST Action "Network for Evaluation of One Health," (5) PMP-AMR: The Progressive Management Pathway tool on AMR developed by the FAO, and (6) SURVTOOLS: developed in the FP7-EU project "RISKSUR." Each tool was scored using (i) 11 pre-defined functional aspects (e.g., workability concerning the need for data, time, and people); (ii) a strengths, weaknesses, opportunities, and threats (SWOT)-like approach of user experiences (e.g., things that I liked or that the tool covered well); and (iii) eight predefined content themes related to scope (e.g., development purpose and collaboration). PMP-AMR, ATLASS, ECoSur, and NEOH are evaluation tools that provide a scoring system to obtain semi-quantitative results, whereas ISSEP and SURVTOOLS will result in a plan for how to conduct evaluation(s). ISSEP, ECoSur, NEOH, and SURVTOOLS allow for in-depth analyses and therefore require more complex data, information, and specific training of evaluator(s). PMP-AMR, ATLASS, and ISSEP were developed specifically for AMR-related activities-only ISSEP included production of a direct measure for "integration" and "impact on decision making." NEOH and ISSEP were perceived as the best tools for evaluation of One Health (OH) aspects, and ECoSur as best for evaluation of the quality of collaboration. PMP-AMR and ATLASS seemed to be the most user-friendly tools, particularly designed for risk managers. ATLASS was the only tool focusing specifically on laboratory activities. Our experience is that adequate resources are needed to perform evaluation(s). In most cases, evaluation would require involvement of several assessors and/or stakeholders, taking from weeks to months to complete. This study can help direct future evaluators of integrated AMU and AMR surveillance toward the most adequate tool for their specific evaluation purpose.
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Affiliation(s)
- Marianne Sandberg
- Department for Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Ayla Hesp
- Department of Bacteriology and Epidemiology, Host Pathogen Interaction and Diagnostics Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
- Department of Infectious Diseases and Immunology, Utrecht University, Utrecht, Netherlands
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Marion Bordier
- UMR Astre, Cirad, INRAE, University of Montpellier, Montpellier, France
| | - Houda Bennani
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Ursula Bergwerff
- Department of Farm Animal Health, Utrecht University, Utrecht, Netherlands
| | - Ilias Chantziaras
- Unit of Animal Science and Unit of Social Science, Flanders Research Institute for Agriculture, Fisheries and Food (ILVO), Merelbeke, Belgium
- Department of Reproduction, Obstetrics and Herd Health, University of Ghent, Ghent, Belgium
| | | | | | - Maria-Eleni Filippizi
- Veterinary Epidemiology Unit, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Koen Mintiens
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Liza R. Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Madelaine Norström
- Department of Epidemiology, Norwegian Veterinary Institute, Oslo, Norway
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - Gerdien van Schaik
- Department of Farm Animal Health, Utrecht University, Utrecht, Netherlands
- Royal GD Animal Health, Deventer, Netherlands
| | - Lis Alban
- Department for Food Safety, Veterinary Issues and Risk Analysis, Danish Agriculture and Food Council, Copenhagen, Denmark
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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