Pharmacy and Antimicrobial Stewardship in Kenya

Dr Lindsay Olima is the Secretary of Medicine and Therapeutic Committee at Kakamega County Teaching and Referral Hospital (KCTRH) and the lead pharmacist in the Kakamega-Cambridge Partnership on Antimicrobial Stewardship. Dr Lindsay Olima is the Secretary of Medicine and Therapeutic Committee at Kakamega County Teaching and Referral Hospital (KCTRH) and the lead pharmacist in the Kakamega-Cambridge Partnership on Antimicrobial Stewardship.

This story was written by Dr Francesca Testa, who took part in a taster week with CGHP in March 2022.

How did you get into your chosen profession and into global health work?

Healthcare work has been part of my life since childhood. I grew up in a family of health care professionals, my dad was a surgeon and my mum was a nurse. My siblings also work in healthcare, one as a physician, and one as a general surgeon. Among the different healthcare professions, I loved pharmacy the most. I also wanted to be a bit different from the rest of my family!

I got into global health through a friend who was working as a university lecturer. He introduced me to other professionals who were also passionate about antimicrobial stewardship (AMS). Through other connections, I was then able to liaise with Cambridge Global Health Partnerships (CGHP) and to set up a project on AMS. We applied in June 2021 and in October we were awarded a grant by the Commonwealth Partnerships for Antimicrobial Stewardship Scheme (CwPAMPS) funded through the Tropical Health and Education Trust and the Fleming Fund. Since the beginning of the partnership, most of our meetings with CGHP have been on Zoom due to the pandemic – in March we had our first in person visit!

Can you tell us a bit more about the project?

Our project is called Kakamega-Cambridge AMS Partnership and its objective is to strengthen AMS activities at Kakamega County Teaching and Referral Hospital (KCTRH) and at the Masinde Muliro University of Science and Technology (MMUST). Our team consists of 12 members, some working in MMUST and some in KCTRH.

The project is structured in three phases. The first phase focuses on three major activities:

1. Increase awareness on antibiotic consumption in our Medicine and Therapeutic Committee

2. Obtain data on antimicrobial use and resistance through Global Point Prevalence Survey (GPPS) – which is our goal for the upcoming weeks

3. Provide training on AMS to staff.

The remaining phases focus on interventions to reduce AMR. Right now, we will begin with implementing the outcomes of our activities in our two surgical wards. We hope in the future we may be able to expand our work to the maternity and orthopaedic units, so the project could have a bigger impact in our hospital.

From right Dr Peter Nyongesa, Evelyn Brealey, Dr Lindsay Olima, Cristiano Serra at KCTRH in March 2022

Can you tell us a bit more about the training? What do you hope the impact of the training will be in the hospital?

The training on AMS will be delivered over a few days and will focus on 50 hospital and university staff to build a team of trainers with skills, understanding and confidence to spread AMS awareness across their wards and departments. Before attending the training, we are asking trainees to complete the online course on Future Learn – AMS in Africa. We believe this is an effective way to build a baseline awareness and understanding  for trainees ahead of the focused training session. After successful completion of the training, we expect that trainees will train more members of staff in AMS in both hospital and community settings. We are also delivering the training to staff and medical students enrolled in the MMUST. AMS needs to be fought on all fronts! We are positive that AMS training will have a significant impact on our local healthcare system in the future.

Why are you passionate about AMS?

Before starting the Kakamega-Cambridge AMS Partnership, we had received several reports from our laboratory on microbial cultures and antibiotic sensitivities. The trends were very concerning as they highlighted the presence of pan-resistant bugs in KCTRH. Some microbes isolated in our hospital (such as Pseudomonas) are resistant to most antibiotics available to us. Equally, we have been seeing cases of pan-resistant bugs also in the community. As Secretary of our Medicine and Therapeutic Committee, I find this extremely alarming. We saw the partnership as a gift from God as we were, and remain, extremely worried about the level of antimicrobial resistance we are experiencing.

KCTRH staff at AMS training

What has been achieved so far and what are the next steps for the project?

We have definitely increased awareness on AMS. With CGHP’s help, we have enrolled in CwPAMS with the aim to develop pharmacy expertise on antimicrobial resistance. We have also recently introduced a game on AMS in our pharmacy department. Staff love it! In the process of playing it, they are learning more on AMS and reinforcing their knowledge. The next steps for the project are focussed on building capacity: we would benefit from more partnerships and bidirectional exchange of expertise with higher resource-hospitals, including more in-person visits. Additionally, it’d be extremely helpful if some members of staff could obtain a scholarship to further specialise in AMS-related topics such as infectious diseases. That way, they’d be able to bring the knowledge back and further disseminate it among the team.

CGHP is running an Urgent Appeal in order to fund partnerships such as this. Please consider donating today.