scholarly journals Combating Global Antibiotic Resistance: Emerging One Health Concerns in Lower- and Middle-Income Countries

2018 ◽  
Vol 66 (6) ◽  
pp. 963-969 ◽  
Author(s):  
Maya Nadimpalli ◽  
Elisabeth Delarocque-Astagneau ◽  
David C Love ◽  
Lance B Price ◽  
Bich-Tram Huynh ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
One Health ◽  
Middle Income ◽  
Health Concerns ◽  
Middle Income Countries

scholarly journals Drivers of Antibiotic Resistance Transmission in Low- and Middle-Income Countries from a “One Health” Perspective—A Review

Antibiotics ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 372 ◽  
Author(s):  
Katia Iskandar ◽  
Laurent Molinier ◽  
Souheil Hallit ◽  
Massimo Sartelli ◽  
Fausto Catena ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
One Health ◽  
Geographical Area ◽  
Resistant Bacteria ◽  
Surveillance Systems ◽  
Market Failures ◽  
Middle Income ◽  
Safety Issues ◽  
Middle Income Countries ◽  
The One

Antibiotic resistance is an ecosystem problem threatening the interrelated human-animal-environment health under the “One Health” framework. Resistant bacteria arising in one geographical area can spread via cross-reservoir transmission to other areas worldwide either by direct exposure or through the food chain and the environment. Drivers of antibiotic resistance are complex and multi-sectoral particularly in Lower- and Middle-income countries. These include inappropriate socio-ecological behaviors; poverty; overcrowding; lack of surveillance systems; food supply chain safety issues; highly contaminated waste effluents; and loose rules and regulations. In order to examine the drivers of antibiotic resistance from a “one health” perspective, a literature review was conducted on three databases including PubMed, Medline and Google Scholar. A total of 485 studies of potential relevance were selected, out of which 182 were included in this review. Results have shown that the aforementioned market failures are the leading cause for the negative externality of antibiotic resistance that extends in scope from the individual to the global ecosystem. Incremental and sustainable global actions can make the change, however, the problem will continue to prevail if governments do not prioritize the “One health” approach and if individual’s accountability is still denied in a world struggling with profound socio-economic problems.

scholarly journals One Health contributions towards more effective and equitable approaches to health in low- and middle-income countries

2017 ◽  
Vol 372 (1725) ◽  
pp. 20160168 ◽  
Author(s):  
S. Cleaveland ◽  
J. Sharp ◽  
B. Abela-Ridder ◽  
K. J. Allan ◽  
J. Buza ◽  
...  
Keyword(s):  
Global Health ◽  
Human Health ◽  
One Health ◽  
Health Interventions ◽  
Global Health Security ◽  
Health Security ◽  
Middle Income ◽  
Emerging Zoonoses ◽  
Middle Income Countries ◽  
Global Health Security Agenda

Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive ‘One Health’ interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.

scholarly journals Characteristics of a Nationwide Voluntary Antibiotic Resistance Awareness Campaign in India; Future Paths and Pointers for Resource Limited Settings/Low and Middle Income Countries

2019 ◽  
Vol 16 (24) ◽  
pp. 5141
Author(s):  
Ashok J. Tamhankar ◽  
Ramesh Nachimuthu ◽  
Ravikant Singh ◽  
Jyoti Harindran ◽  
Gautam Kumar Meghwanshi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
World Health ◽  
Awareness Campaign ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Awareness Campaigns ◽  
Resource Limited ◽  
Low And Middle Income

Antibiotic resistance has reached alarming proportions globally, prompting the World Health Organization to advise nations to take up antibiotic awareness campaigns. Several campaigns have been taken up worldwide, mostly by governments. The government of India asked manufacturers to append a ‘redline’ to packages of antibiotics as identification marks and conducted a campaign to inform the general public about it and appropriate antibiotic use. We investigated whether an antibiotic resistance awareness campaign could be organized voluntarily in India and determined the characteristics of the voluntarily organized campaign by administering a questionnaire to the coordinators, who participated in organizing the voluntary campaign India. The campaign characteristics were: multiple electro–physical pedagogical and participatory techniques were used, 49 physical events were organized in various parts of India that included lectures, posters, booklet/pamphlet distribution, audio and video messages, competitions, and mass contact rallies along with broadcast of messages in 11 local languages using community radio stations (CRS) spread all over India. The median values for campaign events were: expenditure—3000 Indian Rupees/day (US$~47), time for planning—1 day, program spread—4 days, program time—4 h, direct and indirect reach of the message—respectively 250 and 500 persons/event. A 2 min play entitled ‘Take antibiotics as prescribed by the doctor’ was broadcast 10 times/day for 5 days on CRS with listener reach of ~5 million persons. More than 85%ofcoordinators thought that the campaign created adequate awareness about appropriate antibiotic use and antibiotic resistance. The voluntary campaign has implications for resource limited settings/low and middle income countries.

scholarly journals Strategic Approach for Prioritising Local and Regional Sanitation Interventions for Reducing Global Antibiotic Resistance

Water ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 27 ◽  
Author(s):  
David Graham ◽  
Myra Giesen ◽  
Joshua Bunce
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Priority ◽  
Strategic Approach ◽  
Starting Point ◽  
Improved Sanitation ◽  
Intervention Costs

Globally increasing antibiotic resistance (AR) will only be reversed through a suite of multidisciplinary actions (One Health), including more prudent antibiotic use and improved sanitation on international scales. Relative to sanitation, advanced technologies exist that reduce AR in waste releases, but such technologies are expensive, and a strategic approach is needed to prioritize more affordable mitigation options, especially for Low- and Middle-Income Countries (LMICs). Such an approach is proposed here, which overlays the incremental cost of different sanitation options and their relative benefit in reducing AR, ultimately suggesting the “next-most-economic” options for different locations. When considering AR gene fate versus intervention costs, reducing open defecation (OD) and increasing decentralized secondary wastewater treatment, with condominial sewers, will probably have the greatest impact on reducing AR, for the least expense. However, the best option for a given country depends on the existing sewerage infrastructure. Using Southeast Asia as a case study and World Bank/WHO/UNICEF data, the approach suggests that Cambodia and East Timor should target reducing OD as a national priority. In contrast, increasing decentralized secondary treatment is well suited to Thailand, Vietnam and rural Malaysia. Our approach provides a science-informed starting point for decision-makers, for prioritising AR mitigation interventions; an approach that will evolve and refine as more data become available.

scholarly journals Improving Mental Health on College Campuses: Perspectives of Indian College Students

2021 ◽  
Author(s):  
Akash R Wasil ◽  
Tanvi Malhotra ◽  
Nivedita Nandakumar ◽  
Nandita Tuteja ◽  
Robert DeRubeis ◽  
...  
Keyword(s):  
Mental Health ◽  
College Students ◽  
Health Promotion ◽  
Mental Health Problems ◽  
College Campuses ◽  
Health And Wellness ◽  
Middle Income ◽  
Health Concerns ◽  
Middle Income Countries ◽  
Promotion Strategies

The mental health of college students is increasingly viewed as an important public health priority. However, there has been little attention paid specifically to college students’ perspectives on factors that contribute to mental health challenges or on potential initiatives that could address them. Even less research has focused on students in low-and middle-income countries. In an effort to better understand how to improve mental health and wellness on college campuses, we administered an open-ended survey to 141 Indian college students (Mage=19.47, 65% female). We asked the students to identify: a) issues that contribute to mental health problems among college students, b) potential initiatives or strategies that could be used to improve mental health and wellness, and c) topics that students would like to learn about in a course about mental health and wellness. Applying thematic analysis, we identified academic stressors (e.g., pressure to succeed, competitiveness) and social stressors (e.g., lack of community, party culture and substance abuse) that students reported as contributors to mental health problems. Students also described mental health promotion strategies that could be implemented by faculty members (e.g., providing academic accommodations for students with mental health concerns), the student body (e.g., establishing peer counseling groups), and individual students (e.g., checking-in with others). Finally, they identified topics that they would like to learn about in mental health and wellness courses (e.g., how to identify mental health concerns, how to support friends). By raising several potential targets for mental health and wellness interventions for Indian college students, our study illustrates how open-ended surveys can be a useful and feasible way to solicit input from stakeholders in low- and middle-income countries. Future research will be needed to assess the effectiveness and feasibility of mental health promotion strategies, including those proposed by students.

scholarly journals Metagenome-Wide Analysis of Rural and Urban Surface Waters and Sediments in Bangladesh Identifies Human Waste as a Driver of Antibiotic Resistance

mSystems ◽  
2021 ◽  
Author(s):  
Ross Stuart McInnes ◽  
Md Hassan uz-Zaman ◽  
Imam Taskin Alam ◽  
Siu Fung Stanley Ho ◽  
Robert A. Moran ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Surface Waters ◽  
Antibiotic Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Middle Income ◽  
Antibiotic Resistant ◽  
Human Waste ◽  
Middle Income Countries ◽  
Rural And Urban

Low- and middle-income countries (LMICs) have higher burdens of multidrug-resistant infections than high-income countries, and there is thus an urgent need to elucidate the drivers of the spread of antibiotic-resistant bacteria in LMICs. Here, we study the diversity and abundance of antibiotic resistance genes in surface water and sediments from rural and urban settings in Bangladesh.

scholarly journals Optical maps of plasmids as a proxy for clonal spread of MDR bacteria: a case study of an outbreak in a rural Ethiopian hospital

2020 ◽  
Vol 75 (10) ◽  
pp. 2804-2811
Author(s):  
Yii-Lih Lin ◽  
Tsegaye Sewunet ◽  
Sriram KK ◽  
Christian G Giske ◽  
Fredrik Westerlund
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Large Fraction ◽  
Antibiotic Resistance Genes ◽  
Future Application ◽  
Resistant Bacteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Clonal Spread

Abstract Objectives MDR bacteria have become a prevailing health threat worldwide. We here aimed to use optical DNA mapping (ODM) as a rapid method to trace nosocomial spread of bacterial clones and gene elements. We believe that this method has the potential to be a tool of pivotal importance for MDR control. Methods Twenty-four Escherichia coli samples of ST410 from three different wards were collected at an Ethiopian hospital and their plasmids were analysed by ODM. Plasmids were specifically digested with Cas9 targeting the antibiotic resistance genes, stained by competitive binding and confined in nanochannels for imaging. The resulting intensity profiles (barcodes) for each plasmid were compared to identify potential clonal spread of resistant bacteria. Results ODM demonstrated that a large fraction of the patients carried bacteria with a plasmid of the same origin, carrying the ESBL gene blaCTX-M-15, suggesting clonal spread. The results correlate perfectly with core genome (cg)MLST data, where bacteria with the same plasmid also had very similar cgMLST profiles. Conclusions ODM is a rapid discriminatory method for identifying plasmids and antibiotic resistance genes. Long-range deletions/insertions, which are challenging for short-read next-generation sequencing, can be easily identified and used to trace bacterial clonal spread. We propose that plasmid typing can be a useful tool to identify clonal spread of MDR bacteria. Furthermore, the simplicity of the method enables possible future application in low- and middle-income countries.

scholarly journals A One Health Approach to Child Stunting: Evidence and Research Agenda

2021 ◽  
Author(s):  
Radhika Gharpure ◽  
Siobhan Mor ◽  
Mark Viney ◽  
Tinashe Hodobo ◽  
Joanne Lello ◽  
...  
Keyword(s):  
Synergistic Effect ◽  
Research Agenda ◽  
One Health ◽  
Evidence Based ◽  
Middle Income ◽  
Limited Impact ◽  
Child Stunting ◽  
Middle Income Countries ◽  
Health Strategy ◽  
Height For Age

Stunting (low height for age) affects approximately one-quarter of children aged < 5 years worldwide. Given the limited impact of current interventions for stunting, new multisectoral evidence-based approaches are needed to decrease the burden of stunting in low- and middle-income countries (LMICs). Recognizing that the health of people, animals, and the environment are connected, we present the rationale and research agenda for considering a One Health approach to child stunting. We contend that a One Health strategy may uncover new approaches to tackling child stunting by addressing several interdependent factors that prevent children from thriving in LMICs, and that coordinated interventions among humans, animals, and environmental health sectors may have a synergistic effect in stunting reduction.

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