The unique and truly multidisciplinary research methodology employed by the Dust Bunny research team has been published in the Design Journal. The paper is entitled ‘Combining design research with microbiology to tackle drug-resistant infections in different home environments in Ghana: Challenging the boundaries of design thinking‘ and can be freely accesses from here.
It posits that the approach adopted has the opportunity to provide a platform for understanding complex issues regarding microbiology (microbial resistance) and public health through engaging the community of practice. Doing this from various perspectives (design, social science, epidemiology/public health and microbiological perspectives) presents the best opportunity to adequately address emerging public health concerns, such as antimicrobial resistance in the home setting.
We envisage that the experiences and insights outlined in this paper, will help other researchers to embark on transdisciplinary research that challenges the boundaries of design in new specialist medical areas.
Following the collection of dust data samples from the 12 households participating in the study, the team has been analysing them used different microbiology analyses.
This will help determine if the bacterial strains being identified are of public health importance i.e. known to cause any disease and if these are resistant to one or more antibiotics.
Then the team will assess the implications in the household (i.e. babies and toddlers, food safety, treatment/control options, etc…) and whether, in terms of cleaning, there are any particular cleaning processes (i.e. detergents) that can kill these?
The Dust Bunny project was presented at the 13th International Conference of the European Academy of Design (EAD), in Dundee, UK. The conference, was found to promote the publication and dissemination of research in design through by different educational institutions in Europe and the publication of proceedings, newsletters and a journal.
The paper and discussions that followed after its presentation raised awareness on the project. It presented its unique research approach of combining design-led research with microbiology profiling methods. It highlighted some of the lessons learned in applying design research within this context and the benefits of such a transdispilinary research for both microbiology and design.
It is envisaged that the paper presented, which is also published and can be accessed at the Design Journal, will encourage further transdiciplinary research collaborations for tackling global health challenges, such as antimicrobial resistance.
Lancaster University in collaboration with Lancaster University Ghana and with funding from the UKRI and the Global Challenges Research Fund, has organised the International Forum on Health and Wellbeing, with the main objective of creating impact on existing research among academics in the areas of social health, medicine, environment, sustainability, water and food availability. The Forum took place in the Lancaster University Ghana between the 21-22 March 2019.
Following the Forum the Dust Bunny team explored how to achieve maximum impact and genuine, embedded change for the better across Ghana and wider Africa.
The project team along with several experts from Ghana and Africa discussed how the outputs of the project research can be applied, disseminated, adapted and further developed in order to achieve maximum benefit in African countries. The team also discussed some of barriers to change in this area as well as some of the opportunities that might arise from combining the results of multiple, related work to tackle key issues.
Lastly everyone engaged in a discussion on local, national and continental issues in the area of health and wellbeing more broadly and how research can be applied in the right way to meet these challenges in the most effective way.
Apart from achieving wider dissemination of the Dust Bunny through the Forum, This also led to new collaborations and the development of a revised Impact strategy and pathway for the Dust Bunny project.
The design ethnography was intended to give researchers a closer understanding of the cleaning practices and the perceptions of cleanliness and hygiene, in relation to dust, of householders and the people who regularly clean homes as part of, and for, households in the Greater Accra Region of Ghana. In addition, it sought to gain insights into the physical actions undertaken and the range of cleaning agents and cleaning tools used as part of those actions. During the review of the data fifteen recurrent themes emerged.
1. Religion, superstition and traditional practice
2. Individual creed over religious practice
3. Social judgement
4. Taught knowledge and situated practice
5. Negotiated practice
6. Cleaning styles are often tacit practices
8. Different brooms for different rooms
9. Walking dirt in and sweeping dirt out
10. New and old or new for old
11. Chemical storage and safety practices, strong smells and mitigations
12. Dusting, sweeping, scrubbing and mopping
14. Waste disposal
15. Seasonal Variation
Additional work is currently undertaken to develop these initial findings along with the microbiology sampling analysis and the development and testing of interventions.
In a co-design workshop run in February in Accra, representatives of the communities participating in the Dust Bunny project and experts (public health, epidemiology, behavioural psychology, etc) came together to co-develop an interdisciplinary research project addressing infectious disease in the home environment in Ghana.
Through a series of creative and interactive activities, workshop co-designers identified the key health challenges faced by communities as well as the barriers to conducting research with communities in Ghana. These included the role of cleaning and hygiene practices in the transmission of infectious disease in the home and the impact of cultural and religious beliefs on them. Furthermore, attention was paid to antimicrobial resistance (AMR) in Ghana in light of the national action plan on AMR.
In terms of the challenges of conducting research with local communities, these included access to communities and establishing trust, use of technology for recording data (i.e. cameras, audio recorders) and sampling of microbiological material, such as dust. Again the role of culture and religion featured on these discussions.
Workshop participants, led by community members provided ways of mitigating these challenges and set aims and objective fo a new and impactful project that would tackle these. Examples included working with schools (primary and junior), religious groups (churches, mosques) and other social groups. This led to discussion and a set of research methods that would work well with the identified communities, including citizen science and research endorsed, carried and promoted by different communities.
Following this and working in groups, workshop participants were invited to think and discuss about what they would hope to learn knowledge from project such as this, what is important about that knowledge, how might it impact Ghana and the world. This led to the identification of several research outcomes as well as pathway to impact for the project.
What became clear from this co-design workshop was the value of engaging the community along with experts in the research planning process and in defining the wider contexts of infectious diseases , as well as the research methods, outcomes, stakeholders and pathways to impact.
The Dust Bunny team run engagement workshops in the second week of February in Accra, Ghana. The workshops engaged with members of the community who are participating in the project as well as Ghanian external to the project public health experts and researchers.
It presented the preliminary findings (from the design ethnography and first round of microbiology analysis) and provided a space for feedback and debate. It also presented some of the challenges faced by the research team in conducting design-led research in Ghana and invited workshop participate in brainstorming sessions aimed at generating solutions .
Themes that emerged from the workshop related to the influence of cultural, religious practices and beliefs of different communities in the cleaning and hygiene practices employed across a range of households. Furthermore, there was discussion around the importance of establishing trust and rapport with household research participant prior to the fieldwork, especially given the morally bound nature of the research. In addition to this, the tables were turned with workshop participants asking questions to the research team and making suggestions for maximising the dissemination of findings.
Lastly, community members and experts alike were provided with dissemination material to take back to their respective communities.
Dust Bunny is a 2-year UK funded research project that applies innovative design research 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.
In the first part of the workshop the Ghanaian (Noguchi Memorial Institute for Medical Research, University of Ghana) and UK (University of Lancaster) project team will be presenting the project, its initial findings as well as challenges and opportunities in this area.
In the second part of the workshop it will be inviting participants, through a number of creative and interactive activities, in sharing their feedback on the work thus far and help define future steps.
The workshop is scheduled for Wednesday 13th February 2019 at 09:30am – 14:30pm
Venue: Noguchi Memorial Institute for Medical Research, University of Ghana.
For more information on the event and to register contact Dr Dziedzom de Souza at email@example.com .
This project has a microbiological component which seeks to assess the extent of antimicrobial resistance (AMR) in bacteria attached to dust in Ghanaian homes. This is a problem as resistance, if found in infectious bacteria, may hinder treatment of infectious disease. However it may be lurking in non-infectious bacteria as well. No problem? Well there is… this resistance might be mobile and transfer from non-infectious to infections bacteria. So we are going to assess the extent of AMR in all the bacteria we can. No matter which environment we look at there are common microbiological problems: We can culture bacteria directly from dust and we can test them for their resistance or sensitivity to a range of antibiotics commonly used in the treatment of infectious disease.
The sting is the tail is we can only culture usually less than 1% of all the bacteria present. The remaining >99% cannot be cultured but are still active, they may contain infectious bacteria that are resistant to antibiotics. So how do were find these unculturable microbes?
Two strategies can be adopted in addition to culture: one for identifying bacteria and the other for identifying AMR. Both involve taking a dust sample and extracting all DNA from all the attached bacteria. For bacteria we will use next generation sequencing which generates signatures of bacterial species from which we can identify and quantify (within limits) species and this will tell us about bacterial diversity in a number of homes. For AMR, we will detect the signatures of different genes that will tell us which antibiotic resistances are present.
By combining the sequencing and culturing we will obtain a picture of AMR is different households.
*Photo Credit: Dr. Graham Beards, CC BY-SA
The team at Noguchi have been running for the past month a survey on the hygiene and cleaning practices across different domestic environments (i.e. urban vs rural, private vs communal dwellings) and a range of social scales (i.e. low, low-middle, middle, upper) within Accra, Ghana.
Recruited household complete with the help of researchers a survey of over 50 questions. These include questions on the household demographics, the household configuration, dwelling information, the cleaning methods, cleaning items, cleaning frequency, cleaning responsibilities within the household, cleanliness and hygiene perceptions and practices. So far over 200 surveys have been completed.
The team aims at collecting 250 surveys. From the 250 surveys 12 households (across urban and rural domestic environments, private and communal house environments, low, low-middle, middle and upper social scales) are currently being recruited to participate in the rapid ethnography phase of the project in order to collect more in-depth information on the cleaning and hygiene practices. Dust samples from each study household will also be collected to assess bacterial diversity, including the presence of infectious bacteria and to assess the degree of AMR in those bacteria.