Antimicrobial resistance (AMR) threatens modern medicine and the ability to provide an effective public health response to the ongoing threat from infectious diseases. Systematic misuse and overuse of effective antimicrobial drugs in human medicine and food production have put us all at risk, and there are few alternatives in the pharmaceutical pipeline.

Researchers at the Centre for Tropical Medicine are surveying nearly 5,000 people in almost 70 villages with access limited by unmapped roads as well as natural features like mountainous terrain and shallow river crossings. Without careful prior planning, visiting villages and choosing a selection of representative households to be surveyed for the purposes of scientific study can be costly and time-consuming – if traditional survey methods are used. But the researchers have hit upon a cheaper alternative: satellites.

The researchers are examining satellite images that are freely available online. The images help them identify representative clusters of houses where people can be approached to take part in field surveys, and to plot the most convenient and time-saving routes in to villages through often difficult and unmapped terrain. This sampling approach requires no specialised software knowledge or professional equipment to locate households. Basic off-the-shelf laptop computers, low-cost smartphones, printed maps and browser-based map services are all that is needed to select a survey sample and carry out an investigation. The research team estimates that it’s cutting the survey cost and duration by 25%.

This research is part of a project funded by the Global Challenges Research Fund, supported by the UK research councils.

AMR is being tackled worldwide through a wide range of policies and interventions, such as awareness-raising campaigns and tests to help doctors and nurses in prescribing antibiotics. The investigation in Thailand and Laos aims to complement these activities by exploring people's problems in accessing health services and medicine. It also studies how new ideas about AMR can (or cannot) spread in village communities. This understanding of health behaviour informs existing interventions and helps design new ones for people who are often excluded from regular healthcare.

Lead researcher Dr Marco J Haenssgen said: "Finding a solution to AMR is a global health priority and not just a medical problem; especially in low and middle-income countries. We need original solutions to problematic antimicrobial drug use that do not merely address people's awareness but that also appreciate problems like poverty and discrimination when accessing health services. Support for our research reflects a growing recognition that social, economic, and political problems surround people's use of medicines. Satellite-based sampling is one way to track the behaviour and networks of otherwise excluded populations and social research of this kind will ultimately help us to tackle the superbug crisis more effectively."

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