Understanding the home as a source of infection of AMR bacteria carried by dust by exploring hygiene practices in different home environments in Ghana

The Dust Bunny project will apply design methods coupled with microbiological analyses to address issues of home-based infections in Ghana, particularly those carrying antimicrobial resistance, resulting in a reduction of infection and in positive increase of health outcomes. Bacteria found in the natural and built environment (e.g. homes, schools, hospitals, etc.) are building up a resistance to drugs -changing to protect themselves against antibiotics. What this means is that in the not-too-distant future, something as simple as a minor cut infection could become life-threatening. This is such a concern that antimicrobial resistance (AMR) is now considered a global health crisis, far surpassing outbreaks of diseases such as Ebola and as real as climate change. This is even more evident and critical in developing countries in Africa, such as in Ghana, where there are a great number of deaths from infectious diseases. Bacteria are made up of pathogens (bad germs) and non-pathogens (good germs) and are generally scattered across the home. Most surfaces in the home are covered to a certain degree with bacteria, but unlike fixed surfaces such as kitchen work surfaces and furniture, dust can move more easily around different parts of the home and therefore presents a major route for human exposure to bacterial infections. Despite being clear evidence for microbial exposure and infection transmission within the home, there has been less research effort invested in understanding the home environment, due to difficulty of conducting detailed studies. Although the transmission routes by dust in the home environment are well known, what has not been studied is how to prevent bacterial infection at home and thereby reduce resistance. Particularly in developing countries, such as Ghana, social inequalities mean a range of different quality and types of homes; this combined with often poor levels of domestic hygiene that is influenced by a number of economic, educational and religion factors, contributes to the spread of infectious diseases. Although there are hygiene guidelines available for preventing infection in the home environment, these are targeted at hygiene professionals and do not reach the everyday household in Ghana. There is therefore a much-required and unmet need to identify, understand and develop domestic hygiene practices that are relevant to different home environments, educational and cultural backgrounds in developing countries, such as in Ghana, in order to reduce exposure to bacteria pathogens and thereby exposure to resistance forms. Within this context, the Dust Bunny project aims at developing an understanding of the home as a source of infection of bacteria, resistant to antibiotics, found and carried by dust. This will be done by exploring hygiene practices across different home environments in Ghana, with the ultimate aim to reduce bacterial infection in the home environment thereby reducing AMR. Understanding the hygiene practices in the household and interactions with airborne AMR bacteria will serve as a first step to designing appropriate education/information dissemination materials for various sections of the Ghanaian population as well as other low- and middle-income countries in Africa. Dust Bunny, uniquely combines design research and microbiology to provide an informed assessment of societal practices in domestic cleanliness and novel solution to reduce infections in the home. The project team includes Imagination@Lancaster -an internationally leading research institution in design research- and the Noguchi Memorial Institute for Medical Research -a research centre of excellence and the prime biomedical research institution in Ghana, involved with the Ghana Health Service and Ministry of Health in providing the evidence to effect policy changes.