1
|
Tegegne HA, Freeth FT, Bogaardt C, Taylor E, Reinhardt J, Collineau L, Prada JM, Hénaux V. Implementation of One Health surveillance systems: Opportunities and challenges - lessons learned from the OH-EpiCap application. One Health 2024; 18:100704. [PMID: 38496337 PMCID: PMC10940803 DOI: 10.1016/j.onehlt.2024.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
As the complexity of health systems has increased over time, there is an urgent need for developing multi-sectoral and multi-disciplinary collaborations within the domain of One Health (OH). Despite the efforts to promote collaboration in health surveillance and overcome professional silos, implementing OH surveillance systems in practice remains challenging for multiple reasons. In this study, we describe the lessons learned from the evaluation of OH surveillance using OH-EpiCap (an online evaluation tool for One Health epidemiological surveillance capacities and capabilities), the challenges identified with the implementation of OH surveillance, and the main barriers that contribute to its sub-optimal functioning, as well as possible solutions to address them. We conducted eleven case studies targeting the multi-sectoral surveillance systems for antimicrobial resistance in Portugal and France, Salmonella in France, Germany, and the Netherlands, Listeria in The Netherlands, Finland and Norway, Campylobacter in Norway and Sweden, and psittacosis in Denmark. These evaluations facilitated the identification of common strengths and weaknesses, focusing on the organization and functioning of existing collaborations and their impacts on the surveillance system. Lack of operational and shared leadership, adherence to FAIR data principles, sharing of techniques, and harmonized indicators led to poor organization and sub-optimal functioning of OH surveillance systems. In the majority of studied systems, the effectiveness, operational costs, behavioral changes, and population health outcomes brought by the OH surveillance over traditional surveillance (i.e. compartmentalized into sectors) have not been evaluated. To this end, the establishment of a formal governance body with representatives from each sector could assist in overcoming long-standing barriers. Moreover, demonstrating the impacts of OH-ness of surveillance may facilitate the implementation of OH surveillance systems.
Collapse
Affiliation(s)
- Henok Ayalew Tegegne
- University of Lyon - ANSES, Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, 69007 Lyon, France
| | - Frederick T.A. Freeth
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Carlijn Bogaardt
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Emma Taylor
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Johana Reinhardt
- ANSES, Risk Assessment Department, Animal Health, Welfare, Feed and Vectors Risk Assessment Unit, 94700 Maisons-Alfort, France
| | - Lucie Collineau
- University of Lyon - ANSES, Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, 69007 Lyon, France
| | - Joaquin M. Prada
- University of Surrey, School of Veterinary Medicine, Guildford, GU2 7XH Surrey, United Kingdom
| | - Viviane Hénaux
- University of Lyon - ANSES, Laboratory of Lyon, Epidemiology and Support to Surveillance Unit, 69007 Lyon, France
| |
Collapse
|
2
|
Moura P, Borck Høg B, Alban L, Sönksen UW, Ribeiro Duarte AS, Sandberg M. Evaluating the OH-EpiCap tool using the Danish integrated surveillance program for AMU and AMR as a case study. Front Public Health 2023; 11:1127701. [PMID: 38054067 PMCID: PMC10694429 DOI: 10.3389/fpubh.2023.1127701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
Antimicrobial resistance (AMR) is considered a One Health (OH) challenge, ideally demanding concerted efforts from the animal, human and environmental side. DANMAP, the Danish Integrated Antimicrobial Resistance Monitoring and Research Program, is monitoring AMR and antimicrobial use in animals and humans. OH-EpiCap is an evaluation tool, developed to address essential elements in OH surveillance systems, such as the dimensions of the organization, operational activities and the impact of the surveillance activities. We aimed to evaluate DANMAP using OH-EpiCap and hereby assessed the suitability of OH-EpiCap to evaluate integrated AMR surveillance systems. During the evaluation, the strengths and weaknesses of DANMAP concerning the "OH-ness" of the program were discussed. Furthermore, possible adaptations of the standard operating procedures and governance structure were addressed. Attention was paid to the ability and easiness of DANMAP to cope with current and future challenges connected to integrated AMR surveillance. It was concluded that DANMAP has a strong OH approach covering relevant aspects for humans and animals, whereas environmental aspects are missing. OH-EpiCap proved to be straightforward to use and provided valuable insights. The authors recommend OH-EpiCap to be used by health authorities and stakeholders. It is not suitable for the technical evaluation of a surveillance program.
Collapse
Affiliation(s)
- Pedro Moura
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Birgitte Borck Høg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - 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
| | | | | | - Marianne Sandberg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| |
Collapse
|
3
|
Norström M, Simonsen GS, Slettemeås JS, Furberg AS, Urdahl AM. Evaluation of the One Health-Ness of 20 Years of Antimicrobial Resistance Surveillance in Norway. Antibiotics (Basel) 2023; 12:1080. [PMID: 37508176 PMCID: PMC10376192 DOI: 10.3390/antibiotics12071080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
We evaluated the One Health-ness (OH-ness) of the surveillance system for antimicrobial resistance (AMR) in Norway by using the recently developed "Evaluation tool for One Health epidemiological surveillance capacities and capabilities" (OH-EpiCap tool). First, we defined the Norwegian AMR surveillance system that we would evaluate. The tool was applied by a group of stakeholders (key persons in the Norwegian AMR surveillance programmes and authors of this paper). The evaluation was performed using a consensus approach. The evaluation resulted in an overall OH-ness score of 68% across all three dimensions included in the tool: Organisation, Operation, and Impact. Suggestions for improvement were only indicated within the areas of internal evaluation and operational costs, whereas most of the indicators included in the tool showed good adherence to the One Health principles. By performing this internal evaluation, we recognized that AMR surveillance in the environment needs to be included in a more systematic and standardized way to improve the OH-ness as defined by the quadripartite organisations. Last but not least, it was beneficial to bring key stakeholders together to conduct the evaluation. It increased a joint perception of the OH-ness of AMR surveillance in Norway and encouraged further collaboration in the future.
Collapse
Affiliation(s)
| | - Gunnar Skov Simonsen
- Department of Microbiology and Infection Control, University Hospital of North Norway, N-9038 Tromsø, Norway
- Faculty of Health Sciences, UiT-The Arctic University of Norway, N-9038 Tromsø, Norway
| | | | - Anne-Sofie Furberg
- Department of Microbiology and Infection Control, University Hospital of North Norway, N-9038 Tromsø, Norway
- Faculty of Health Sciences, UiT-The Arctic University of Norway, N-9038 Tromsø, Norway
| | | |
Collapse
|
4
|
Moura P, Collineau L, Sandberg M, Tomassone L, De Meneghi D, Norström M, Bennani H, Häsler B, Colomb-Cotinat M, Bourély C, Filippitzi ME, Mediouni S, Boriani E, Asaduzzaman M, Caniça M, Aenishaenslin C, Alban L. Users' perception of the OH-EpiCap evaluation tool based on its application to nine national antimicrobial resistance surveillance systems. Front Public Health 2023; 11:1138645. [PMID: 37404278 PMCID: PMC10315896 DOI: 10.3389/fpubh.2023.1138645] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction Antimicrobial resistance (AMR) is a One Health (OH) challenge. To achieve or maintain an effective and efficient AMR surveillance system, it is crucial to evaluate its performance in meeting the proposed objectives, while complying with resource restrictions. The OH-EpiCap tool was created to evaluate the degree of compliance of hazard surveillance activities with essential OH concepts across the following dimensions: organization, operational activities, and impact of the surveillance system. We present feedback on the application of the OH-EpiCap tool from a user's perspective, based on the use of the tool to evaluate nine national AMR surveillance systems, each with different contexts and objectives. Methods The OH-EpiCap was assessed using the updated CoEvalAMR methodology. This methodology allows the evaluation of the content themes and functional aspects of the tool and captures the user's subjective experiences via a strengths, weaknesses, opportunities, and threats (SWOT) approach. Results and Discussion The results of the evaluation of the OH-EpiCap are presented and discussed. The OH-EpiCap is an easy-to-use tool, which can facilitate a fast macro-overview of the application of the OH concept to AMR surveillance. When used by specialists in the matter, an evaluation using OH-EpiCap can serve as a basis for the discussion of possible adaptations of AMR surveillance activities or targeting areas that may be further investigated using other evaluation tools.
Collapse
Affiliation(s)
- Pedro Moura
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Lucie Collineau
- University of Lyon - French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Epidemiology and Surveillance Support Unit, Lyon, France
| | - Marianne Sandberg
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Laura Tomassone
- Department of Veterinary Sciences, University of Turin, AgroVet campus, Grugliasco-Turin, Italy
| | - Daniele De Meneghi
- Department of Veterinary Sciences, University of Turin, AgroVet campus, Grugliasco-Turin, Italy
| | | | - Houda Bennani
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Barbara Häsler
- Veterinary Epidemiology Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | | | - Clémence Bourély
- French Ministry of Agriculture and Food, General Directorate for Food, Animal Health Unit, Paris, France
| | - Maria-Eleni Filippitzi
- Laboratory of Animal Health Economics, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Veterinary Epidemiology Unit, Sciensano, Brussels, Belgium
| | - Sarah Mediouni
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | | | - Muhammad Asaduzzaman
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cécile Aenishaenslin
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Lis Alban
- Department of 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
| |
Collapse
|