Wellcome to National Portal
বাংলাদেশ জাতীয় তথ্য বাতায়ন
মেনু নির্বাচন করুন
Text size A A A
Color C C C C

সর্ব-শেষ হাল-নাগাদ: ২০ মে ২০২৪

About AMR

National Antimicrobial Resistance (AMR) Surveillance Report Bangladesh

Antimicrobial resistance (AMR) is a global public health problem. WHO has declared AMR as one of the top 10 global public health threats facing humanity. Research shows in 2019, AMR was directly responsible for 1.27 million deaths. In May 2015, the 68th World Health Assembly adopted the Global Action Plan on AMR and all countries were requested to come forth with their own national action plan. Therefore “National Action Plan for Containment of Antimicrobial Resistance in Bangladesh 2017-2022  has been prepared and later updated. In addition to that, “The National Antimicrobial Resistance (AMR) Surveillance Strategy of Bangladesh 2020-2025” has also been prepared and in action.

 

Institute of Epidemiology, Disease Control and Research (IEDCR) has been conducting AMR surveillance since 2016 to determine the status of Antimicrobial Resistance among common pathogens in Bangladesh and improve the capacity of the sentinel site laboratories so that they can act as regional laboratories. In February 2020, Director General of Health Services, Ministry of Health and Family Welfare of Bangladesh nominated IEDCR as “Sectoral AMR Surveillance Coordination Center for Human Health” and the Microbiology Laboratory as the “National Reference Laboratory (NRL) for AMR surveillance”.

 

At present AMR surveillance is ongoing in 10 Government and Private Medical colleges and one Infectious Disease hospital covering the geographical area of Bangladesh. This case-based surveillance is unique in a way that it also includes epidemiological data which enables more scientific horizons for research and new perspectives. In 2022, twenty-one branches of different laboratories (mainly private) have been included in passive surveillance to obtain laboratory-based data. This inclusion has given access to most AMR data from even more geographical locations of the country up to the district level.

 

The updated AMR surveillance data is available in AMR dashboard. Moreover, data is being regularly uploaded in WHO platform - Global Antimicrobial Resistance and Use Surveillance System (GLASS) since 2019.

 

AMR surveillance co-ordination Committee is the administrative authority of AMR surveillance centrally. AMR surveillance coordination subcommittee consists of Epidemiologists, Laboratory personnel, AMR Surveillance Consultant, representative from CDC, DGHS and representatives from donor agency lead by Director IEDCR. This team is supported by IT experts, data management assistant and medical technologists and AMR surveillance lab consultant.  The team meeting of this committee is held weekly and when required.

Activities of Central Surveillance Team

The central team at IEDCR provides guidance and coordinates all the activities of the sentinel sites. They collaborate and communicate with national and international agencies. They arrange training and refresher training for the sentinel site physicians, nurses, microbiologists, and technologists. They conduct monitoring and evaluation visits to the sites to assess their activities and progress. They give technical support to the sentinel site laboratories and maintain the logistic supply chain. They perform data cleaning, analysis, review, and feedback.

Surveillance team at sentinel sites has Surveillance physicians and nurses, microbiologists and medical technologists, lab attendant and cleaner from the respective medical college, and an IEDCR appointed coordinator, designated as Project Facilitator (PF). The PF regularly communicates, coordinates and collect the data and send to the central hub for analysis. This team is headed by Head of Microbiology department.

NRL at IEDCR is equipped with automated identification system (VITEK-2, VITEK MS). Laboratory activities in the sites are done following the SOPs of NRL including IQC.
Bacterial isolates from the sentinel sites are regularly sent to the central repository at NRL, IEDCR.
Quarterly 5-10% of isolates are retested at NRL, root cause analysis is done and discussed with the sites. NRL and sometimes the sentinel site laboratories participate in international EQA program provided by CAP (College of American Pathologists), WHO collaborating center at Thailand. Recently NRL has participated in consecutive six EQA program of EQAsia of Fleming fund.

The National AMR Surveillance conducted in Bangladesh is a combination of both case-based active and lab-based passive surveillance. The surveillance data is managed by software that manages data sending from the sentinel site to data visualization, downloading, monitoring, cleaning and maintaining a dashboard.

The future vision of this surveillance is to include fungal pathogens, especially the candida spp. in bloodstream infections, which is a growing threat to public health, especially the immunocompromised patients. Moreover, improving molecular diagnostic capacity and genome sequencing and more engagement and support in AMR research is the future commitment of the NRL. For the improvement of the laboratory quality of the sentinel site NRL is building its capacity to conduct EQA of the sites.

The National AMR Surveillance System receives support from various entities, including the US-CDC, WHO, and the Fleming Fund at different times and in various capacities.