Colonisation dynamics of antimicrobial resistance in schistosomiasis-endemic regions of Malawi: a One Health approach

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T1 - Basic Research T2 - Human/Clinical ResearchAims, objectives and specific research questions:[i] Aims:This project aims to characterise colonisation of AMR bacteria in the guts of human and animals, and in the environment, and to explore associations with schistosomiasis in communities living near freshwater sources in Malawi.[ii] Objectives:- To estimate the prevalence of ESBL-producing Enterobacterales gut colonisation in communities living near freshwater sources where schistosomiasis is endemic.- To highlight associations between AMR gut colonisation, schistosomiasis, and freshwater, in order to propose evidence-based transmission pathways.- To describe the genomic epidemiology of AMR in faecal samples from definitive schistosome hosts (human and animal) and intermediate schistosome hosts (freshwater snails).- To identify novel AMR genes from human, animal, and environmental sources.[iii] Specific research questions:- Are S. mansoni and S. haematobium mono- and co-infections associated with changes in the faecal resistome and the rates of ESBL-producing Enterobacterales gut colonisation in humans?- Is proximity to and/or regularity of contact with freshwater associated with altered ESBL-producing Enterobacterales gut colonisation rates?- Do intermediate schistosome hosts (i.e., Bulinus and Biomphalaria species snails) act as reservoirs for AMR bacteria and genes in freshwater?Expected findings and outputs:The findings of this study are expected to provide AMR surveillance data in Malawi and highlight associations between AMR and schistosomiasis. Alongside the generation of a PhD thesis, results will be presented at conferences, and submitted for publications, with the aim of publishing in high-impact journals in the fields of microbiology and tropical medicine. Results will also be shared and discussed with policy makers in Malawi (e.g., the Ministry for Health and control programme managers).