Background
Antimicrobial resistance, (AMR) which includes antibiotic resistance, is not a commonly crossed topic in Rwanda, despite being a crucial topic which concerns keeping antibiotics working whenever needed. Together with the University of Manchester, we organized the 30 Days of Antibiotic Stewardship Competition. This is a campaign that was to mobilize the public to make better use of antibiotics, including activities to prevent infection, the appropriate use of antibiotics, and seeking help for prudent use. This were done using an open-access, free, online course where people were called to join a game of recommending fellows to take “Antibiotics and you” https://bit.ly/33iAWuE where the winner was considered to be the one who strived to recommended it to many people and undertake the course.
Methodology
To encourage awareness and uptake of the free course, we initiated open randomised competition on Twitter. Everyone from the Twitter community were able to compete or support of competitor of choice. Those who chose to compete shared us their certificates to be posted. The main task was to mobilise people to take the course and post their certificate as reply to the tweet of chosen competitor. Supporters were requested to post their certificates with the following Hash tags: #StopTheBugs #KeepAntibioticsWorking #StopSuperBugs. Note: Why not the LIKES JUDGING Methodology? Many online competitions analyse the number of likes and retweets to determine a winner. Anyway, we found this methodology ineffective, as many people are likely to like or retweet without even appreciating the content. Thus we preferably took a new strategy to count the number of certificates, i.e.: Who can recommend the course to many people, the people who do the course and submit their certificates on twitter with similar harsh tags. This enabled people to join regardless of their celebrity on social media and prevented the fake likes to influence winning likelihood.
Content:
Along the competition, we kept raising awareness about basic actions to #KeepAntibioticsWorking. We had a single topic per a week, and each was featured with a poster: Wash your hands, never use antibiotics for colds, never self-prescribe antibiotics, not them but we are all at risk and Drug resistance is every body’s problem – including you.
Selection:
We had 5 days of competitors’ application acceptance with expectation of 10 competitors but we reached 7 within the period, after which we closed competitor’s application acceptance. More interested people were asked to join as supporters.
The competition winner, also named the Rwandan Antibiotic Steward, had to mobilise more than 100 people to take the course. More than 1 competitor may hit the minimum but the one with more certificates is the one to be named as a winner.
Impact
Through this period of 30 days, Rwandans got interested to work on Antimicrobial resistance to a level we didn’t expect. Notably 6 students from university of Rwanda texted Oazis Health requesting further community work on the topic. 2 of them are current active tweeters of AMR whereas other 3 are working on AMR initiatives to be launched. Moreover, two of our promoted Hashtags were registered as Health Hashtags on https://bit.ly/2I8ELvU and https://www.symplur.com/healthcare-hashtags/stopthebugs/
Twitter engagement along the 30 days of antibiotic stewardship have dramatically increased, where OazisHealth tweets impressions in October increased from 6.4K (September) to 26.1K in October. Competitor tweets details summarized as follow:
Way forward
We are aiming to keep Antimicrobial Awareness topic a trending one in Rwanda so that government officials, Academicians, policy makers and general community cannot sleep while people still misuse antibiotics. We are aiming at developing our website into a regionally recognised platform with full range AMR articles as we also strive to partner with popular newspapers in Rwanda including the New Times, The campus Rwanda, Planet Wizard Africa and institutions like Girl Guides Rwanda, Apex Biotech ltd. Etc.
Moreover, we aim to establish Oazis Health Antimicrobial Stewardship Hub as a regional AMR center of excellence. This will be a self-sustaining initiative creating a community of AMR Stewards though providing excellent AMR patient education, developing responsible young pharmacists and creating a prudent use generation through awareness raising.
Our special thanks goes the Roger Harrison, for his mentorship and support from the foundation of Oazis Health and along this campaign to make it a success. Without him, Antimicrobial Resistance would remain a regional untold story despite the fact of undermining modern medicine. We also express our gratitude to Girls Guides Rwanda for their local collaboration along this competition and looking forward to doing much more with them in future of AMR in Rwanda.
We cannot forget to appreciate NAHIMANA Felix, (Competitor 2), a Doc 2 Medical student at university of Rwanda who strived to influence 115 individuals to take Antibiotic and you course within 30 days. We recognise his passion and willingness to spearhead Rwandan AMR social media. In his words said: “I have never recognised the deadliness of AMR through my 4 years of medical studies until I walked through the Antibiotics and you course, I will cease not to use my effort to super bugs using social media”