Antimicrobial resistance preparedness in sub-Saharan African countries

Elton, Linzy; Thomason, Margaret J.; Tembo, John; Velavan, Thirumalaisamy P.; Pallerla, Srinivas Reddy; Arruda, Liã Bárbara; Vairo, Francesco; Montaldo, Chiara; Ntoumi, Francine; Hamid, Muzamil Mahdi Abdel; Haider, Najmul; Kock, Richard; Ippolito, Giuseppe; Zumla, Alimuddin; McHugh, Timothy D.

doi:10.1186/s13756-020-00800-y

Cited by 93 publications

(86 citation statements)

References 17 publications

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“…Elsewhere, despite the repetitive calls for better antimicrobial stewardship, the adoption of ASPs is still lagging behind, particularly in regions with a high burden of antimicrobial resistance, such as the Middle East [ 6 , 20 ]. Latin America [ 21 ], and Sub-Saharan Africa [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Stewardship Programmes in Saudi Hospitals: Evidence from a National Survey

et al. 2021

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Saudi hospitals and healthcare facilities are facing increasing rates of antimicrobial resistance and the emergence of new multi-drug resistant strains. This is placing an unprecedented threat to successful treatments and outcomes of patients accessing those facilities. The inappropriate use of antimicrobials is fueling this crisis, warranting urgent implementation of interventions to preserve antimicrobials and reduce resistance rates. Antimicrobial stewardship programmes (ASPs) can improve antimicrobial use, treatment success rates and reduce the levels of antimicrobial resistance. The Saudi Ministry of Health (MOH) devised a national antimicrobial stewardship plan to implement ASPs in hospitals, but little is known about the progress of implementation and the factors affecting it. This study aims to assess the level and the factors affecting the adoption and implementation of ASPs in Saudi hospitals at a national level. A nationwide cross-sectional survey was conducted in 2017 using an online questionnaire sent to all MOH hospitals. Overall, 147 out 247 MOH hospitals responded to the survey (54%). Only 26% of the hospitals reported the implementation of ASPs. Hospitals lack the knowledge, technological and staff resources to adopt and implement ASPs. Alternative models of ASP adoption could be explored to improve the rates of implementation of ASPs.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Stewardship Programmes in Saudi Hospitals: Evidence from a National Survey

et al. 2021

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Section: Methodsmentioning

confidence: 99%

“…The completed JEE reports from 44 SSA countries (as described by the WHO regions), were accessed between 6th November 2019 and 22nd March 2020 and analysed [25] and the sub-areas scores were compared [24]. The analysis of these data is described in Elton et al [24]. The 'Zoonotic disease' sub-area was compared to the other sub-areas (such as immunization and antimicrobial resistance preparedness) and a ranking table was compiled [24].…”

Section: Methodsmentioning

confidence: 99%

“…The zoonotic disease preparedness for countries is measured by the presence of a 'functional multisectoral, multidisciplinary mechanisms, policies, systems and practices to minimize the transmission of zoonotic diseases from animals to human populations' [23]. In March 2020, 86% (44/50) of the SSA countries (according to WHO definition), had completed a JEE [23,24]. JEE reports cover prevention, detection, response and IHR related hazards and points of entry areas, which are classified into 19 sub-areas.…”

Section: Introductionmentioning

confidence: 99%

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Zoonotic disease preparedness in sub-Saharan African countries

et al. 2021

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Background The emergence of high consequence pathogens such as Ebola and SARS-CoV-2, along with the continued burden of neglected diseases such as rabies, has highlighted the need for preparedness for emerging and endemic infectious diseases of zoonotic origin in sub-Saharan Africa (SSA) using a One Health approach. To identify trends in SSA preparedness, the World Health Organization (WHO) Joint External Evaluation (JEE) reports were analysed. JEEs are voluntary, collaborative processes to assess country’s capacities to prevent, detect and rapidly respond to public health risks. This report aimed to analyse the JEE zoonotic disease preparedness data as a whole and identify strengths and weaknesses. Methods JEE zoonotic disease preparedness scores for 44 SSA countries who had completed JEEs were analysed. An overall zoonotic disease preparedness score was calculated as an average of the sum of all the SSA country zoonotic disease preparedness scores and compared to the overall mean JEE score. Zoonotic disease preparedness indicators were analysed and data were collated into regions to identify key areas of strength. Results The mean ‘Zoonotic disease’ preparedness score (2.35, range 1.00–4.00) was 7% higher compared to the mean overall JEE preparedness score (2.19, range 1.55–3.30), putting ‘Zoonotic Diseases’ 5th out of 19 JEE sub-areas for preparedness. The average scores for each ‘Zoonotic Disease’ category were 2.45 for ‘Surveillance Systems’, 2.76 for ‘Veterinary Workforce’ and 1.84 for ‘Response Mechanisms’. The Southern African region scored highest across the ‘Zoonotic disease’ categories (2.87). A multisectoral priority zoonotic pathogens list is in place for 43% of SSA countries and 70% reported undertaking national surveillance on 1–5 zoonotic diseases. 70% of SSA countries reported having public health training courses in place for veterinarians and 30% had veterinarians in all districts (reported as sufficient staffing). A multisectoral action plan for zoonotic outbreaks was in place for 14% countries and 32% reported having an established inter-agency response team for zoonotic outbreaks. The zoonotic diseases that appeared most in reported country priority lists were rabies and Highly Pathogenic Avian Influenza (HPAI) (both 89%), anthrax (83%), and brucellosis (78%). Conclusions With ‘Zoonotic Diseases’ ranking 5th in the JEE sub-areas and a mean SSA score 7% greater than the overall mean JEE score, zoonotic disease preparedness appears to have the attention of most SSA countries. However, the considerable range suggests that some countries have more measures in place than others, which may perhaps reflect the geography and types of pathogens that commonly occur. The category ‘Response Mechanisms’ had the lowest mean score across SSA, suggesting that implementing a multisectoral action plan and response team could provide the greatest gains.

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“…Bangladesh developed a National Action Plan to contain AMR in 2018, however, the country still faces challenges for practical implementation due to poor awareness about AMR, inadequate resources, and absence of national surveillance [ 44 ]. AMR preparedness is lacking in sub-Saharan African countries when compared to intervention strategies of developed countries due to a lack of real-time monitoring, surveillance, and regulatory guidelines [ 45 ]. Irrational use of antimicrobials is a complex and multifactorial problem in developing countries, and a proper understanding of the problem is necessary for effective implementation strategies to combat AMR.…”

Section: Global Undertakings For Threat Of Antimicrobial Resistancmentioning

confidence: 99%

Antibiotics Use in Food Animal Production: Escalation of Antimicrobial Resistance: Where Are We Now in Combating AMR?

Kasimanickam

2021

Medical Sciences

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The use of antibiotics has been very beneficial to human health, animal wellbeing, and food production, however, there are no alternatives to antimicrobials in treating infectious diseases. Their use can contribute to the development of antimicrobial resistance, but the world has realized the need to combat antimicrobial resistance in recent decades due to the continued escalation of the problem jeopardizing human and veterinary medicine and food and environmental safety. Understanding the AMR and judicious use of antimicrobials are critical, and one health approach involving several sectors and multiple disciplines is important to tackle the problem. National, regional, and global action plans have been instigated to tackle the escalation of AMR. Antimicrobials are frequently used in food animal production. Therefore, food animal producers are important participants to prevent overuse and misuse of antimicrobials. Recent regulations to address the challenges have not been perceived well in animal farming communities. More awareness regarding these action plans and understanding the impact of AMR are needed. A nationwide survey of perceptions of food animal producers regarding AMR mitigation approaches should be conducted to evaluate the effectiveness of the current policies regarding antibiotics use and AMR. These outcomes should be incorporated in future policies and awareness campaigns targeting food animal producers.

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Antimicrobial resistance preparedness in sub-Saharan African countries

Cited by 93 publications

References 17 publications

Antimicrobial Stewardship Programmes in Saudi Hospitals: Evidence from a National Survey

Antimicrobial Stewardship Programmes in Saudi Hospitals: Evidence from a National Survey

Zoonotic disease preparedness in sub-Saharan African countries

Antibiotics Use in Food Animal Production: Escalation of Antimicrobial Resistance: Where Are We Now in Combating AMR?

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