Prevention of antimicrobial resistance in sub-Saharan Africa: What has worked? What still needs to be done?

Moyo, Perseverance; Moyo, Enos; Mangoya, Derek; Mhango, Malizgani; Mashe, Tapfumanei; Imran, Mohd; Dzinamarira, Tafadzwa

doi:10.1016/j.jiph.2023.02.020

Cited by 35 publications

(26 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The following variables reported at T1 were used as covariates: sex (male, female, others)[54,55], age group (20–29, 30–39, 40–49, 50–59, ≥ 60)[54,55], income level (< Japanese yen [JPY] 3,000,000, < JPY 10,000,000, ≥ JPY 10,000,000, unknown or refuse to respond)[56,57], the presence of psychiatric history (yes, no)[24,54,55], hospitalized (yes, no)[54,58], and the presence of acute symptoms (yes, no)[55,58]. We also adjusted for BMI[48,54,59] and pre-existing comorbidities, including respiratory diseases (COPD, asthma, bronchitis, and pneumonia)[54,55,60], hypertension[55,61,62], diabetes[48,59,63], and cardiac diseases (angina and myocardial infarction)[48,64]. These pre-existing comorbidities were identified as those who selected options other than “Nothing before” or “Never,” “Yes, in the past,” “Yes, currently (in hospitals),” and “Yes, currently (not in hospitals)” to the question about above comorbidities.…”

Section: Methodsmentioning

confidence: 99%

Psychological distress after COVID-19 recovery and subsequent prolonged post-acute sequelae of COVID-19: A longitudinal study with 1-year follow-up in Japan

Hazumi,

Kataoka,

Narita

et al. 2024

Preprint

View full text Add to dashboard Cite

BackgroundThis study investigated the longitudinal association between psychological distress in the post-acute phase and the subsequent prolonged post-acute sequelae of COVID-19 (PASC) among individuals with PASC.MethodsAn online longitudinal survey with 1-year interval was conducted from July to September 2021 (T1) and July to September 2022 (T2). Individuals who were 20-years-old or older, had a positive Polymerase Chain Reaction test, were one month post-infection, and did not select “Nothing” to a question regarding PASC presence were included. The primary outcome was the presence of PASC at T2. The presence of general, respiratory, muscular, neurological, gastrointestinal, dermatological, and cardiac symptoms at T2 was also used as an outcome among patients with relevant symptoms at time 1 (T1). Exposure was measured using the Kessler distress scale (K6) at T1, and those whose K6 was 13 or higher were identified as having psychological distress. Marginal structure models with robust standard errors were used to examine the association between psychological distress at T1 and any PASC symptoms at T2, and the associations between psychological distress and each symptom at T2 among participants with relevant symptoms at T1.ResultsA total of 1674 patients were analyzed; 17%had psychological distress. ; In total, 818 (48.9%), 523 (31.2%), and 672 (40.1%) patients reported general, respiratory, and neurological symptoms at T1, respectively. Individuals with psychological distress had higher odds of any symptoms at T2 (Odds Ratio [OR] =1.81, 95% Confidence Interval [CI]= 1.08 – 3.03) and general and respiratory symptoms at T2 among participants with relevant symptoms at T1 (OR = 1.95, 95% CI = 1.02 – 3.76; OR = 2.44, 95% CI = 1.03 – 5.80).ConclusionPsychological distress in the post-acute phase may lead to prolonged PASC symptoms, mainly general and respiratory symptoms, at the 1-year follow-up in individuals with PASC.Key MessagesPsychological distress before infection and during the acute phase predicts prolonged Post-Acute Sequelae of COVID-19 (PASC); however, in individuals with PASC, it is unclear whether psychological distress during the post-acute phase predicts prolonged PASC. This longitudinal survey indicated that psychological distress in the post-acute phase led to prolonged any levels of PASC, especially general and respiratory symptoms, at the 1-year follow-up. Therefore, mental health care for individuals with PASC may help to improve or mitigate prolonged PASC.

show abstract

Section: Methodsmentioning

confidence: 99%

Psychological distress after COVID-19 recovery and subsequent prolonged post-acute sequelae of COVID-19: A longitudinal study with 1-year follow-up in Japan

Hazumi,

Kataoka,

Narita

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Disease severity and admission to the intensive care unit during acute COVID-19, for example, were found to be associated with long COVID in Nigeria and South Africa [35, 36]. Scoping studies on long COVID in Africa found comorbidities and age >40 years to be associated factors [33, 37]. In Zambia, 17% of persons with acute COVID-19 in July 2020 were found to be experiencing symptoms ∼2 months later [38].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Factors Associated with Long COVID in Zambia, August 2020 to January 2023: A Mixed Methods Design

Malambo,

Chanda,

Besa

et al. 2024

Preprint

View full text Add to dashboard Cite

BackgroundSeveral seroprevalence studies in Africa documented the extent of spread of SARS-CoV-2, yet there is limited data on signs, symptoms and conditions that continue or develop after acute COVID-19 infection (long COVID). We sought to examine patient characteristics at post-acute COVID-19 (PAC-19) clinics in Zambia and assess factors associated with long COVID at first visit to a PAC-19 clinic and longitudinally among a cohort of patients.MethodsLong COVID was defined, initially in the Zambia PAC-19 clinical guidelines, as new, relapsing or persistent symptoms lasting >4 weeks after an initial SARS-CoV-2 infection. Severe illness was defined as COVID-19 episode that required supplemental oxygen therapy, intensive care unit stay or treatment with steroids/remdesivir. We fitted logistic regression models with cross-sectional and longitudinal data and considered statistical significance at p<0.05.ResultsIn total, 1,359 patients attended PAC-19 clinics and had data abstracted from Aug-2020 to Jan-2023; 548 (40.3%) patients with ≥2 visits were included in the longitudinal analysis. Patients’ median age was 53 (interquartile range [IQR]: 41-63) years, 919 (67.6%) were hospitalized for acute COVID-19, and of whom 686 (74.6%) had severe illness. Patients with hospital length of stay ≥15 days (adjusted odds ratio [aOR]: 5.50; 95% confidence interval [95% CI]: 3.06-10.3), severe illness (aOR: 3.23; 95% CI: 1.68-6.75), and comorbidities (aOR:1.51; 95% CI: 1.04-2.22) had significantly higher odds of long COVID. Longitudinally, long COVID prevalence significantly (p<0.001) declined from 75.4% at the first PAC-19 visit to 26.0% by the fifth visit. The median follow-up time was 7 (IQR: 4-12) weeks.ConclusionLong COVID symptoms were common among patient presenting for care in PAC-19 clinics in Zambia, but most recovered within ∼2 months. Despite potentially substantial morbidity due to long COVID, few patients overall with COVID-19 attended a PAC-19 clinic. Scaling up PAC-19 services and integrating into routine clinical care could improve access by patients.

show abstract

“…Notwithstanding the importance of antimicrobial resistance particularly in paediatric samples, there is scarce published scholarly information on this topic. Moyo (2023) points out that the available data in the African continent indicates a significant antimicrobial resistance. Therefore, the proposed study aims to gain more knowledge of the antimicrobial resistance patterns of paediatric samples at King Edward VII Hospital.…”

Section: The Rationale For the Studymentioning

confidence: 99%

“…Studies have linked prolonged hospital stays with the development of antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae, and Extended Beta-Lactamase-Producing (ESBL) Escherichia coli and Klebsiella spp (WHO, 2020; Saini et al, 2021). Limited diagnostic capacity and antimicrobial resistance surveillance in Sub-Saharan Africa contribute to the problem (Moyo et al, 2023). Monitoring prevalence and antimicrobial susceptibility patterns is crucial for modifying treatments and hospital policies, especially in paediatrics (Habyarimana et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Factors contributing to antimicrobial resistance include over-prescription of antibi-otics, non-compliance, poor hygiene, inadequate surveillance, and limited research (WHO, 2021). The cost implications of antibiotic resistance are high, particularly in developing countries, necessitating effective prevention strategies and increased research (Achi et al, 2023;Moyo et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antimicrobial Resistance Patterns in Paediatric Patients: A Retrospective Analysis of Microbial Isolates and Antibiotic Susceptibility

Nsele,

Thembane

View full text Add to dashboard Cite

This study aimed to determine the frequency and antibiotic resistance patterns of various organisms isolated from paediatric samples in a South African hospital. Antibiotic resistance is a growing concern in healthcare, particularly in paediatric patients who are more vulnerable to infections. It was conducted in an attempt to address the lack of data on the prevalence of antibiotic-resistant organisms in South African paediatric patients. Methodology:A retrospective study was conducted on microbiological results of paediatric samples obtained between 2017 and 2018 at a tertiary hospital in South Africa. Organisms were identified using standard microbiological techniques, and their antibiotic susceptibility patterns were determined using the Kirby-Bauer disc diffusion and Vitek method. Results:Of the 165 organisms isolated, the most common were Acinetobacter baumannii (20.6%), Klebsiella pneumoniae (16.3%), and Enterobacter cloacae (10.9%). High rates of resistance were observed to commonly used antibiotics, including amikacin, ciprofloxacin, and augmentin. Candida albicans and Candida spp. showed high resistance rates to fluconazole. Conclusion:This study underscores the importance of continued surveillance of antibiotic resistance patterns in paediatric patients in South Africa. The high prevalence of antibiotic-resistant organisms and limited treatment options emphasize the need for implementing antibiotic stewardship programs, strengthening infection control measures, and conducting ongoing surveillance. Additionally, investment in research and development, along with promoting education and awareness, is crucial for effectively managing antimicrobial resistance in this population.Recommendation: These recommendations will guide the selection of empiric therapy and aid in the development of antibiotic stewardship programs in South African hospitals.

show abstract

Prevention of antimicrobial resistance in sub-Saharan Africa: What has worked? What still needs to be done?

Cited by 35 publications

References 29 publications

Psychological distress after COVID-19 recovery and subsequent prolonged post-acute sequelae of COVID-19: A longitudinal study with 1-year follow-up in Japan

Psychological distress after COVID-19 recovery and subsequent prolonged post-acute sequelae of COVID-19: A longitudinal study with 1-year follow-up in Japan

Clinical Characteristics and Factors Associated with Long COVID in Zambia, August 2020 to January 2023: A Mixed Methods Design

Antimicrobial Resistance Patterns in Paediatric Patients: A Retrospective Analysis of Microbial Isolates and Antibiotic Susceptibility

Contact Info

Product

Resources

About