Tackling Antimicrobial Resistance in Prevention of Surgical Site Infections – “TARSI”

The Ifakara Health Institute (IHI), in collaboration with St. Francis Regional Referral Hospital (SFRRH), the University Hospital Basel, and Swiss TPH, has launched a new study aimed at addressing one of the most persistent challenges in rural healthcare: surgical site infections (SSIs) in the era of antimicrobial resistance (AMR).

The project, known as TARSI (Tackling Antimicrobial Resistance in Prevention of Surgical Site Infections in patients undergoing abdominal surgery in rural Tanzania), officially kicked off with the goal of generating evidence that will strengthen infection prevention practices and improve surgical outcomes for patients in rural Tanzania.

A growing threat in rural hospitals

SSIs remain the most common healthcare-associated infections in low-income settings, with rates ranging from 7% to 41%. In rural regions, the threat is intensified by the rising burden of AMR, which limits treatment options and drives up the cost and complexity of care.

Challenges such as poor environmental hygiene, limited infrastructure, shortages of essential antibiotics, understaffing, and incomplete implementation of infection prevention and control (IPC) guidelines all contribute to the problem.

At the same time, key questions remain unanswered. How does colonization with multidrug-resistant Gram-negative bacteria (MDR-GNB) influence the likelihood of infection? Which perioperative strategies—screening, targeted prophylaxis, or broader antibiotic use—are most effective in high-AMR settings?

The TARSI project is designed to fill these gaps.

What TARSI will do?

Running from November 2025 to November 2026, the study will track adult patients undergoing major abdominal surgery at SFRRH. By generating real-world data from a rural surgical setting, the project aims to guide safer, more effective surgical care across Tanzania and beyond.

Supporting National and Global AMR Efforts

TARSI aligns with Tanzania’s National Action Plan on AMR (2023–2028), which emphasizes surveillance, improved diagnostics, and stronger IPC programs. Rural areas—where diagnostic testing is limited or unaffordable and antibiotic options are scarce—stand to benefit most from evidence-driven interventions.

The project also contributes to two key goals of the WHO Global AMR Action Plan:

1. Strengthening the evidence base through surveillance 
2. Understanding how resistance affects clinical outcomes

Its focus on IPC aligns with the WHO IPC Strategy (2023), promoting better hospital practices and antimicrobial stewardship.

Led by experts, backed by strong partnerships

TARSI is implemented under the leadership of Dr. Franzisca Mmbando (PI) and Prof. Maja Weisser (PL), with funding support from the University Hospital Basel, the Von Tobel Foundation, and additional in-kind contributions.

>> Photo courtesy of ITN Business