scholarly journals Antibiotic Resistance: A Complete Trouble Maker for Healthcare System Especially among Lower and Middle-Income Countries

2020 ◽  
Vol 2 (4) ◽  
pp. 42-43
Author(s):  
Mainul Haque
Keyword(s):  
Antibiotic Resistance ◽  
Healthcare System ◽  
Middle Income ◽  
Middle Income Countries

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 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 Realist Synthesis of the International Theory and Evidence on Strategies to Improve Childhood Vaccination in Low- and Middle-Income Countries: Developing Strategies for the Nigerian Healthcare System

2019 ◽  
Author(s):  
Oluwadamilola Solabi Omoniyi ◽  
Iestyn Williams
Keyword(s):  
Healthcare System ◽  
Vaccination Coverage ◽  
Realist Synthesis ◽  
Childhood Vaccination ◽  
Routine Immunisation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Published Evidence ◽  
Social Mobilisation ◽  
Low And Middle Income

Background: Childhood vaccination coverage rates in low- and middle-income countries (LMICs) vary significantly, with some countries achieving higher rates than others. Several attempts have been made in Nigeria to achieve universal vaccination coverage but with limited success. This study aimed to analyse strategies used to improve childhood vaccine access and uptake in LMICs in order to inform strategy development for the Nigerian healthcare system. Methods: A realist synthesis approach was adopted in order to elucidate the contexts and mechanisms wherewith these strategies achieved their aim (or not). Nine databases were searched for relevant articles and 27 articles were included in the study. Programme theories were generated from the included articles, and data extraction was carried out paying particular attention to context, mechanism and outcomes configurations. Results: Interventions used in LMICs to improve vaccination coverage were categorised as follows: communication/ educational, reminder-type, incentives, social mobilisation, provider-directed strategies, health service integration and multi-pronged strategies. The strategies that appeared most likely to be effective in the health contexts of contemporary Nigeria include communication and educational interventions; employing informal change agents, and; monitoring and evaluation to strengthen communication. The programme theories for the use of reminders, social mobilisation, staff training and supportive supervision were observed in practice, and these strategies were generally successful within some contexts. By contrast, the use of monetary incentives in Nigeria is not supported by the evidence, although further research and evaluation is required. The integration of other interventions with routine immunisation (RI) to improve uptake was more effective when the perceived value of the other program was high. Adoption of multipronged interventions for hard to reach communities was beneficial. However, caution should be exercised because of varying levels of published evidence in respect of each intervention type and a relative lack of the rich description required to conduct a full realist analysis. Conclusion: This paper adds to the evidence base on the adaption of strategies to improve vaccine access and uptake to the context of LMICs.

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.

Improving equity

2020 ◽  
pp. 476-487
Author(s):  
Sharon Friel ◽  
David Melzer
Keyword(s):  
Social Determinants Of Health ◽  
Healthcare System ◽  
Health Equity ◽  
Social Determinants ◽  
Health Inequities ◽  
Health Inequity ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Social ◽  
Improve Health

After reading this chapter you will: be familiar with the concept and extent of health inequity in high- and middle- income countries; understand how the healthcare system can be both a cause of health inequities and a mechanism by which to improve health equity; recognize how to address the social determinants of health inequity; begin to systematically apply an equity lens to your daily professional practice.

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.

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