Community Mapping and Engagement to co-create a One Health under-5 (U5) infection in urban slums conceptual diagram: Childhood Infection and Pollution (CHIP) Consortium

Abstract

Infections are a leading cause of mortality in children Under-5 (U5s) and morbidity due to these infections are exacerbated by increasing antimicrobial resistance (AMR) from poor antibiotic governance. The Childhood Infection and Pollution (CHIP) Consortium aims to utilise novel approaches to use; a One Health framework to identify infection determinants and technology-enabled citizen science to work with slum-dwelling communities to change their environments sustainably and employing novel public health surveillance.Between September-December 2019, we undertook transect walks, social mapping and 1:1 interview with mothers and key informants in Jaipur, Jakarta and Antofagasta. We utilised a geo-tagged action camera in transect walks to extensively observe potential infection pathways. Social mapping with slum-dwellers then produced detailed slum level drawings of households, general resource access and One Health infection determinants. Lastly, 1:1 interview explored the community’s understanding of infections and pathways, whilst assessing mobile phone penetrance, and the feasibility of collecting biological and non-biological samples. In consenting slum dwellers, pictures and geographical data were noted and preserved into Cloud Storage to be developed as a platform of citizen science software.With safeguards, high acceptability of invasive procedures was observed across the 3 countries. The detailed conceptual map of potential One Health factors associated with infections and AMR in U5s living in urban slums were created from the collected data.The infection pathways involve a complex network of multiple One Health, including environmental, factors and AMR. Therefore, co-designing interventions addressing this are critical; research involving policy and the private sector is necessary to address the upstream factors needed for meaningful changes of slum-dwellers’ health. The slum-dwellers will participate throughout the complex intervention design of CHIP via a novel opportunity that continuously enables communities to record data. This includes participatory Geographic Information Systems using mobiles/sensors to detect and/or track diseases, pollution, mould and temperature.