Community Antibiotic Use, Susceptibility and ResisTance Among Patients With Urinary Tract Infections (CAST-UTI)

NCT ID: NCT07012421

Last Updated: 2025-06-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

3000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-10-06

Study Completion Date

2026-04-30

Brief Summary

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1. General objective

This pilot study aims to compare the prevalence of resistance in bacteria causing UTIs among patients seeking care outside the hospital settings (CDROs) to the WHO-GLASS data.
2. Specific objectives

2-1 Primary objectives:

* Determine the resistance profiles of uropathogens and carriage strains from patients with uncomplicated UTIs attending community drug retail outlets (CDRO's) and in hospitals\*.
* Compare the resistance profiles of the uropathogens from patients with uncomplicated UTIs attending CDROs and hospitals to those in the WHO-GLASS database.
* Explore the patient pathway and its impact on antibiotic use among patients presenting to CDROs and hospitals with uncomplicated UTIs.
* Determine the appropriateness of antimicrobial use in the treatment of uncomplicated UTIs among patients presenting to CDROs and hospitals

2-2 Secondary objectives:

* Compare resistance profiles among the uropathogens from patients from two neighbourhoods in Kampala.
* Examine environmental samples between the study sites to determine the presence of antibiotic residues and AMR two neighbourhoods in Kampala.

Detailed Description

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Conditions

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Urinary Tract Infections (UTIs)

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Namuwongo community

The Namuwongo informal settlement is located in the urban area of Kampala, Uganda. An estimated 70% of residents in the informal settlement routinely (within the last month) use antibiotics. Houses are overcrowded with residents paying to use public toilets.

The investigators are recruiting from community drug retail outlets and the outpatient department of Kitsugu health centre located next to Namuwongo.

No interventions assigned to this group

Muyenga community

The Muyenga and Bukasa neighbourhoods are also located in the urban area of Kampala, Uganda, but is more affluent than the Namuwongo informal settlement. Residents in Muyenga can afford more expensive treatments at community drug retail outlets (CDROs)/clinics.

The investigators are recruiting from community drug retail outlets and the outpatient department of Naguru hospital located next to Muyenga and Bukasa neighbourhoods.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Must have one or more of the following clinical presentations regardless of age:

acute (\< 2 weeks) dysuria. increased urinary urgency and frequency, irritation, discharge. increased lower abdominal pain or discomfort and sometimes gross haematuria.

* In elderly patients with pre-existing urinary symptoms: increased acute urinary changes.

Exclusion Criteria

* People without symptoms of UTI.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Makerere University

OTHER

Sponsor Role collaborator

Infectious Diseases Research Collaboration, Uganda

OTHER

Sponsor Role collaborator

St George's, University of London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Infectious Diseases Research Collaboration (IDRC), Uganda

Kampala, Central Region, Uganda

Site Status RECRUITING

Countries

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Uganda

Central Contacts

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Catrin E Moore, DPhil, MBA, MSc, BSc, FRSB, FI

Role: CONTACT

+44 2087252823

Henry Kajumbula, PhD

Role: CONTACT

+256 41 4530 020

Facility Contacts

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James Kapisi, MD

Role: primary

+256 (0) 312 281 479

Deborah Ekusai-Sebatta, PhD

Role: backup

+256 (0) 312 281 479

References

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Gebremariam G, Legese H, Woldu Y, Araya T, Hagos K, GebreyesusWasihun A. Bacteriological profile, risk factors and antimicrobial susceptibility patterns of symptomatic urinary tract infection among students of Mekelle University, northern Ethiopia. BMC Infect Dis. 2019 Nov 8;19(1):950. doi: 10.1186/s12879-019-4610-2.

Reference Type BACKGROUND
PMID: 31703645 (View on PubMed)

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84. doi: 10.1038/nrmicro3432. Epub 2015 Apr 8.

Reference Type BACKGROUND
PMID: 25853778 (View on PubMed)

Cambaco O, Alonso Menendez Y, Kinsman J, Sigauque B, Wertheim H, Do N, Gyapong M, John-Langba J, Sevene E, Munguambe K. Community knowledge and practices regarding antibiotic use in rural Mozambique: where is the starting point for prevention of antibiotic resistance? BMC Public Health. 2020 Jul 29;20(1):1183. doi: 10.1186/s12889-020-09243-x.

Reference Type BACKGROUND
PMID: 32727445 (View on PubMed)

Mbonye AK, Buregyeya E, Rutebemberwa E, Clarke SE, Lal S, Hansen KS, Magnussen P, LaRussa P. Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda. BMJ Open. 2016 Mar 15;6(3):e010632. doi: 10.1136/bmjopen-2015-010632.

Reference Type BACKGROUND
PMID: 26980439 (View on PubMed)

Frost I, Kapoor G, Craig J, Liu D, Laxminarayan R. Status, challenges and gaps in antimicrobial resistance surveillance around the world. J Glob Antimicrob Resist. 2021 Jun;25:222-226. doi: 10.1016/j.jgar.2021.03.016. Epub 2021 Apr 15. No abstract available.

Reference Type BACKGROUND
PMID: 33845163 (View on PubMed)

Collignon PJ, McEwen SA. One Health-Its Importance in Helping to Better Control Antimicrobial Resistance. Trop Med Infect Dis. 2019 Jan 29;4(1):22. doi: 10.3390/tropicalmed4010022.

Reference Type BACKGROUND
PMID: 30700019 (View on PubMed)

Collignon P, Beggs JJ. Socioeconomic Enablers for Contagion: Factors Impelling the Antimicrobial Resistance Epidemic. Antibiotics (Basel). 2019 Jun 30;8(3):86. doi: 10.3390/antibiotics8030086.

Reference Type BACKGROUND
PMID: 31261988 (View on PubMed)

Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0. Epub 2022 Jan 19.

Reference Type BACKGROUND
PMID: 35065702 (View on PubMed)

Other Identifiers

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226461/Z/22/Z

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2024.0149

Identifier Type: -

Identifier Source: org_study_id

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