OASIS’ activities in the human domain take place in Togo and Burkina Faso.
Participating health facilities will represent typical venues where individuals with signs and symptoms of UTI present themselves in the primary care setting, for example health centers or general outpatient departments from local or district hospitals.
Consecutive individuals presenting themselves to the participating facilities are screened for sign and symptoms of UTI. Those participants with a positive symptom screen are asked to provide a urine specimen for dipstick testing on-site. All urine specimens with a positive dipstick are send for culture. If isolates of Escherichia coli or Klebsiella pneumonia are detected, antibiotic susceptibility testing in a designated study laboratory takes place.
The LQAS approach in the human domain has a dynamic character, in which the classification of “high” or “low” prevalence of AMR is made after each identification of an Escherichia coli or Klebsiella pneumoniae isolate. This has the potential to rapidly stop further inclusion if the threshold for “high” prevalence of AMR is reached early.
This set-up will answer important questions on the feasibility of such a dynamic approach, and on the requirements for scale-up.