Point-of-care diagnostic tests to guide reductions in unnecessary antibiotic use and antibiotic resistance in the community in Indonesia, Nepal, and Vietnam (CRP-AMR)

Principal Investigator(s):  Dr Sabina Dongol

Funder(s):  OUCRU Vietnam

Location(s):  Indonesia, Vietnam and Nepal

This is a multi-country, community-based study that aims to generate comprehensive evidence to inform rational antibiotic use and guide the implementation of point-of-care CRP testing in South and Southeast Asia. The study will be conducted by collecting community-based data on illness symptoms, medicine use, and healthcare sources through citizen-science digital surveillance. It also includes analyzing electronic health records to understand prescribing patterns in primary healthcare and exploring social drivers that shape healthcare-seeking pathways and antibiotic use. Interviews and discussions will be done to assess pharmacy dispensing practices and willingness to pay for POC-CRP testing; examining community acceptability, appropriateness, and demand for POC CRP testing across diverse settings. The study will also engage policymakers to align regulatory environments and national policies for sustainable implementation.

This study uses a mixed-methods approach to better understand how people experience illness, their health seeking pathways and treatment options in community settings.

One of the component of the study is a citizen-science digital surveillance system called ChatSci. This chatbot-based tool, integrated within widely used platforms like Facebook Messenger and WhatsApp, allows community members to easily report symptoms, treatments, and care-seeking behaviour through simple, conversational interactions in local languages.

In addition, the study analyses anonymised electronic health records from health facilities to examine prescribing practices, with a focus on antibiotic use and its appropriateness. To complement this, in-depth interviews with community members explore healthcare-seeking pathways, perceptions of illness, and understanding of antibiotics and antimicrobial resistance.

The project also includes surveys with pharmacy clients to assess treatment choices and willingness to pay for C-reactive protein (CRP) rapid diagnostic testing, which can help guide appropriate antibiotic use. Further qualitative research, through focus groups and interviews examines the acceptability and demand for point-of-care CRP testing among patients, providers, and pharmacy staff.

Finally, policy workshops will be held in each country to engage key stakeholders, explore regulatory considerations, and identify opportunities to integrate CRP testing into national health strategies and efforts to combat antimicrobial resistance.

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