Diagnostic and Antibiotic Stewardship for Urinary Tract Infections Using Fit-for-Purpose Diagnostic Tools

Urinary Tract Infections (UTIs) and antimicrobial resistance (AMR) pose significant global health threats, characterised by high incidence and mortality. However, in Sub-Saharan Africa (SSA), there is often a lack of accessible diagnostics to guide proper treatment and therapy monitoring. Our objectives are as follows: (1) Develop and validate a two-tier diagnostic toolbox: (a) Implement a Lateral Flow Test (LFT) for detecting urinary biomarkers at primary care for triage; (b) Deploy a compact, portable Point-of-Care (POC) instrument for secondary care (hospitals, clinics), integrating pathogen detection via isothermal nucleic acid amplification and host-response biomarker quantification for evidence-based therapy and antibiotic prescription; (c) Introduce novel (self)-sampling cards for transport without the need for a cold chain; (d) Establish a digital health platform for clinical decision support. (2) Evaluate the toolbox's field deployability, acceptance, usability, and integration into clinical practice. (3) Maximise the adoption, implementation, and accessibility of the proposed diagnostic toolbox. (4) Prepare for post-project regulatory approval and market launch. (5) Enhance capacity building and surveillance structures through local manufacturing transfer and improvement of the supply chain and logistics. We will recruit diverse patient groups, including under-represented segments of society, from various African settings to ensure the broad applicability, sustainability, and customisability of our solutions. This project is expected to have a significant impact, improving the quality of UTI/AMR diagnostics, reducing unnecessary antibiotic use, preventing resistance, strengthening health systems and their response to epidemics, and increasing accessibility and quality of diagnostics through interdisciplinary and robust industrial collaboration.