Team:VIT Vellore/Public Engagement
Our outreach and public engagement measures
Workshop at Ambassador School, Dubai
Introducing students to the world of synthetic biology
As a part of our outreach program, we visited Ambassador School in Dubai and gave a short talk, and conducted a workshop on synthetic biology for middle and high school students. For the middle schoolers we started from the very basic by having a small presentation on the recent advances in biotechnology and genetic engineering, and conducted a few lab activities such as isolation of DNA from fruits & vegetable, observation of specimens under the microscope, in order to engage the students & ignite a curiosity about biology in them. Along with the lab experiments we also conducted a fun experiment/game to teach how diseases spread using the kits received from EduBioSkills. For the high schoolers we had more advanced level experiments which included isolation of bacteria from soil samples, preparation of media and streaking. Instead of using conventional media we decided to add a little more excitement by making the media with regular fruit juices. This was followed by a session on plating and streaking. We also showed them the procedure of counter staining & made them visualize the bacteria under a microscope. The students were taught about the codon chart and then were engaged in a fun activity which involved identifying the codons in given sequences. Finally, we had a short Q&A session. The students were extremely inquisitive & we had a great discussion with their questions.
Workshop at Vani Vidyalaya School, Vellore
Giving back to our own community
We visited Vani Vidyalaya School in Vellore, Tamil Nadu as a part of our outreach program. We started off with holding a short seminar for the 11th & 12th graders, giving them a crash course on genetic engineering & followed it up by educating them about a few recent miraculous discoveries in biotechnology. We asked them to fill out a small questionnaire about their knowledge of bacteria and antibiotic resistance, then proceeded to educate them about AMR & how it spreads. We then showed them some prepared slides for Gram staining, followed by a demo for the same with bacteria isolated from their own school’s soil with the help of kits we received from EduBioSkills. We also explained to them the principle behind Gram staining. The students were very inquisitive & the Q&A session that followed led to a great discussion.
Symposium - Phaging out Antibiotics
A conference on Antibiotic Resistance and Phage Therapy
We conducted a symposium in our college in collaboration with SABEST (Students’ Association of Bio-Engineering, Science & Technology), a club related to biotechnology. We invited multiple experts at the symposium to talk about the prevalent problem of Antibiotic Resistance, its causes & environmental impacts as well as avenues like Phage Therapy which offers a new & efficient curative approach to tackle it. The audience included students from the biotechnology as well as non-biotechnology background, professors, research scholars and many other curious attendees.
Mr. Pranav Johri & Mrs. Apurva Johri from Vitalis Phage Therapy spoke about Phage Therapy. Mr. Johri walked us through his experience of suffering from an antibiotic resistant infection & how treatment with Phage Therapy helped him recover. They gave us insights into the pros and cons of phage therapy. They told us about their organization, Vitalis Phage Therapy and how it makes phage therapy easier for common people in India. The curious freshers were very enthusiastic and overwhelmed the speakers with questions regarding phage therapy, which they were enthusiastically willing to answer.
Dr. Abi Manesh, an expert in infectious diseases at Christian Medical College (CMC), Vellore spoke about his experience in AMR research. He gave us an insight into the different approaches undertaken by the pharmaceutical industry to tackle AMR, such as bringing old generation antibiotics back into use.
Dr. Priscilla Rupali, HoD of infectious diseases at CMC explained about issues faced by doctors while diagnosing infections & prescribing medicines and also gave us an insight to tackle AMR in Indian context.
Dr. Sujith Chandy, professor of clinical pharmacology at CMC gave us an insight on how doctors deal with AMR in hospitals, implement Antibiotic Stewardship & made us aware of the menace of the problem.
Dr. Ponnari Gottipati, co-lead & program facilitator of Superheroes Against Superbugs told us about her organization’s efforts to raise awareness about AMR by engaging with school students and getting the students to make short comics about the causes and effects of antibiotic resistance.
Lastly, we also presented our project to an audience of professors, research scholars & undergraduate students. Towards the end of the symposium, was an interactive Q&A session where undergraduate and overgraduate students as well as research scholars asked a few doubts and questions to the speakers about the mechanism of antibiotic resistance, the policies implemented and about immune response to conventional phage therapies. The symposium provided a good platform for researchers-academia interaction.
Distribution of paper bags for pharmacies
Raising awareness at the grassroots level
Some of our team members participated in the environmental initiative held at Ambassador School, Dubai. We helped the students of their primary school in making paper bags out of waste paper in order to promote eco-friendly products. We collected around 50-70 bags and brought them with us. On these paper bags we stuck a dosage chart on one side, to help patients keep track of their medication, and a comic made by Superheroes Against Superbugs on the other side which helps in explaining the consequences of antibiotic resistance. These bags were distributed to local pharmacies in order to spread awareness of antibiotic resistance as well as to stress the importance of following the given dosage.
Antimicrobial Stewardship
‘Antibiotic Stewardship’ was a term that we had not come across until we met with Dr Abdul Ghafur. During our meeting he mentioned that each and every hospital should follow certain guidelines to effectively regulate the use of antibiotics in the hospital. These guidelines are known as ‘Antibiotic Stewardship’, and aim to increase the frequency of correct prescription of antibiotics specific for an infection and prevent excessive usage of antibiotics. Ideally, the doses for a patient who has been prescribed antibiotics for an infection should be constantly monitored and altered according to their responses to treatment.After our discussions with Dr Ghafur, we realized how significant antibiotic stewardship could be a driving force to control antibiotic resistance. We felt there was a need to educate and raise awareness to pharmacies to stop the sale of antibiotics without proper prescription.
In India and many parts of the world, antibiotic stewardship guidelines are overlooked due to lack of awareness and lack of resources. We decided to come up with an easy to use solution to promote antibiotic stewardship. Our team member Abhinav designed an application to make it easier for doctors to follow antibiotic stewardship guidelines.
The application serves two functions
(i) Monitor the symptom history of a patient and to provide a list of possible causative pathogens responsible for infection and
(ii) provide recommended dosages for different types of antibiotics depending on the type of infection. Doctors first have to enter the basic details of the patient followed by their symptoms. Following that, they can select from a list of antibiotics to prescribe to the patient. Every antibiotic prescribed will automatically be updated on an existing database that can be accessed by an official in the clinic to ensure that doctors do not prescribe excess or insufficient antibiotics.This saves time for the clinic to manually register the antibiotics prescribed every time.This was a new approach to the antibiotic stewardship that we have tried to design and we also further gained feedback from doctors from the Chettinad Hospital,Vellore and made necessary changes to the software according to the doctors preference.
Antibiotic Resistance Awareness Survey
Taking a peek into the general public’s mind
We conducted a survey to gauge the information about the awareness of antibiotic resistance among the people involved in scientific backgrounds like biotech students, and people involved in the healthcare sector like doctors, pharmacists and related fields. We designed the survey drawing inspiration from WHO's Public Awareness Survey on Antibiotic Resistance[1]. The survey aimed at gathering information on various aspects like the respondents’ association with the healthcare sector, the dose pattern of antibiotic consumption by the respondents, how and where from the respondents purchase antibiotics, how often do the respondents discontinue the dose prescribed by doctors and some other questions on similar tracks to gain an insight into the pattern of misuse of antibiotics, the reasons common in terms of misuse, and also to gain a basic understanding on the extent to which people are aware on what exactly is antibiotic resistance, its causes and effects. The survey also included some scale-based questions for respondents to rate their agreement on some of the improvements we think are needed to overcome the issue.
We found that about 1 in every 6 respondents felt it was okay to stop taking antibiotics when they started feeling well, and hence end up not completing their prescribed courses.
Further, about 1 in 3 thought that antibiotics can cure viral infections as well, confirming our initial thoughts, and showing that this is a common misconception among school children, as well as adults.
While only 25% had heard of AMR from a trusted source like doctors, more than 40% thought that AMR is only a problem for those who take antibiotics regularly. It showed that many of them don't have information about the other ways how AMr spreads, like effluent downflow from industries, antibiotics fed to poultry farms, etc.
Almost the same fraction felt it was okay to themselves take antibiotics prescribed to another family member if they too had exhibited the same symptoms, which shows that a substantial amount of people self diagnose themselves and take medicines without consulting Medical professionals.
This made us wonder about the knowledge of this issue among the common public, who are not in sync with the biology behind AMR. We went out to conduct verbal interviews with the citizens around our college, of various educational backgrounds and professions, to ask them the same questions in the survey.
We figured that only 1 in 10 had heard about the term AMR, but not even half of them could actually give a gist of what it actually means. 1 in 5 still saved antibiotics from the times they fell ill previously, and the same amount felt it was okay to stop using antibiotics once they started feeling better and didn’t find any utility in completing the course.
More worryingly, almost half the people didn't know if the medicines their doctor prescribed were antibiotics, or antibacterial or antifungal. It was all 'medicine' for them.
An underlying cause for this sort of behaviour on the patients’ end could be attributed to inaccessibility of knowledge about how these antibiotics actually work, and how resistance develops. Since this can lead to actual AMR development, it was imperative for us to go out and educate these people as to why they need to follow their doctors’ instructions properly. We also tackled grassroots education through medicinal paper bags(refer to Public Engagement).
Superheroes Against Superbugs
Comics translated to regional Indian languages to increase reach among the masses
Superheroes Against Superbugs (SaS) is a public engagement project, started in 2018, that aims to raise public awareness and improve public understanding of antibiotic resistant-infections in India, and to build a society of smart antibiotic users.
Based out of Hyderabad, India, they go to various schools and play interactive games and creative activities around various concepts related to microbes, infections, antibiotics and resistance aimed at improving scientific understanding of AMR for children. They also conduct interactive sessions between children and different stakeholders such as scientists, doctors, pharmacists and parents;development of skits, posters and comics by children to initiate and sustain a dialogue on AMR.
The children are instructed to make ‘Grassroot Comics’ over 2-3 days after being taught the basic biology behind AMR, which they use to further engage with their peers, teachers, parents and communities. By its very nature, comics appeal to children and adults alike and make the audience more receptive to the message than a regular awareness campaign. We collaborated with them to translate some of their comics into regional Indian languages like Hindi and Tamil, aside from their default language, English, so that these comics are much more accessible among the people who are the least informed about AMR, but also affected the most.
Video on Traditional Indian Medicine
Traditional Siddha medicine, which is prevalent mostly in Tamil Nadu is found to be mentioned in various ancient scriptures in Tamil which happens to be one of the oldest languages in the world. The name Siddha medicine owes its origin to medicinal ideas and practices of a class of Tamil sages called the Siddhas (“holy immortals”). A belief system at its core, Siddha medicine has immense faith in the “miracles” of mercurial drugs and in the prolongation of life through rejuvenating treatments and intense yogic practices which connects the body, mind and the soul. Their drugs are prepared from mercury, sulphur, mica, arsenic compounds, gems, several other minerals, and many indigenous herbs. The range of Siddha medicine is not extensive, however Siddha practitioners believe that the same drug with dietary regimen, can cure several diseases by varying its adjuvants. The drugs are potentiated by the efficacy of the adjuvant used, as the drug is administered in extremely small quantities.
To validate this we spoke to a Siddha practitioner named T Ramesh Kuamr from Krishnagiri (district in Tamil Nadu, India), who has been practicing Siddha medication for over 15 years. He informed us that a particular person could get susceptible to a particular bacteria upon subsequent infection, this is said to occur if the course of medication is not completed to its entirety. This is a major cause for the development of antibiotic resistance as well. But he happened to mention that, if the same Siddha medication if repeated again for a specified amount of time with the right composition and dosage of the plant-derived medicine, can still cure the disease. This possibly directs to the fact that the bacteria does not seem to gain resistance to the active component. This is an inference that can surely be understood better with further research. The conversation we had with him has been recorded and documented as a video given below.
As such, no systematic attempt has yet been made to convert these scriptures to its appropriate scientific understanding to validate these medicines with critical evaluation of their effects as the enigmatic nature of these texts make it difficult to interpret them. Nevertheless the concept of Siddha medicine has its own nuance.
Reference
[1] World Health Organization. (2015). Antibiotic resistance: multi-country public awareness survey. World Health Organization
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