Implementation of an antibiotic resistance surveillance tool in Madagascar, the TSARA project: a prospective, observational, multicentre, hospital-based study protocol

Antimicrobial resistance (AMR) is a significant public health threat, with an estimated 10 million deaths annually by 2050, mainly in low/middle-income countries. The WHO has urged countries to implement antimicrobial stewardship programmes (ASPs) in hospitals to reduce AMR. A new tool, Technique de Surveillance Actualisée de la Résistance aux Antimicrobiens (TSARA), was developed with the Mérieux Foundation to provide a better understanding of AMR’s scope and effects in Madagascar. The study involved 10 hospitals in Madagascar, analyzing local ecology, resistance rates, and antibiotic prescription patterns.