Designing for Scale: Strengthening Surveillance of Antimicrobial Resistance in Low Resource Settings

Author(s):  
Sundeep Sahay ◽  
Gitika Arora ◽  
Yogita Thakral ◽  
Ernst Kristian Rødland ◽  
Arunima Sehgal Mukherjee
2020 ◽  
Vol 5 (5) ◽  
pp. e002396 ◽  
Author(s):  
Camille Escadafal ◽  
Sandra Incardona ◽  
B Leticia Fernandez-Carballo ◽  
Sabine Dittrich

C reactive protein (CRP), a marker for the presence of an inflammatory process, is the most extensively studied marker for distinguishing bacterial from non-bacterial infections in febrile patients. A point-of-care test for bacterial infections would be of particular use in low-resource settings where other laboratory diagnostics are not always available, antimicrobial resistance rates are high and bacterial infections such as pneumonia are a leading cause of death. This document summarises evidence on CRP testing for bacterial infections in low-income and middle-income countries (LMICs). With a push for universal health coverage and prevention of antimicrobial resistance, it is important to understand if CRP might be able to do the job. The use of CRP polarised the global health community and the aim of this document is to summarise the ‘good and the bad’ of CRP in multiple settings in LMICs. In brief, the literature that was reviewed suggests that CRP testing may be beneficial in low-resource settings to improve rational antibiotic use for febrile patients, but the positive predictive value is insufficient to allow it to be used alone as a single tool. CRP testing may be best used as part of a panel of diagnostic tests and algorithms. Further studies in low-resource settings, particularly with regard to impact on antibiotic prescribing and cost-effectiveness of CRP testing, are warranted.


2018 ◽  
Vol 74 (3) ◽  
pp. 541-546 ◽  
Author(s):  
Elizabeth A Ashley ◽  
Nandini Shetty ◽  
Jean Patel ◽  
Rogier van Doorn ◽  
Direk Limmathurotsakul ◽  
...  

Animals ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1264 ◽  
Author(s):  
Hayden D. Hedman ◽  
Karla A. Vasco ◽  
Lixin Zhang

The emergence, spread, and persistence of antimicrobial resistance (AMR) remain a pressing global health issue. Animal husbandry, in particular poultry, makes up a substantial portion of the global antimicrobial use. Despite the growing body of research evaluating the AMR within industrial farming systems, there is a gap in understanding the emergence of bacterial resistance originating from poultry within resource-limited environments. As countries continue to transition from low- to middle income countries (LMICs), there will be an increased demand for quality sources of animal protein. Further promotion of intensive poultry farming could address issues of food security, but it may also increase risks of AMR exposure to poultry, other domestic animals, wildlife, and human populations. Given that intensively raised poultry can function as animal reservoirs for AMR, surveillance is needed to evaluate the impacts on humans, other animals, and the environment. Here, we provide a comprehensive review of poultry production within low-resource settings in order to inform future small-scale poultry farming development. Future research is needed in order to understand the full extent of the epidemiology and ecology of AMR in poultry within low-resource settings.


2016 ◽  
Vol 03 (02) ◽  
pp. 079-083
Author(s):  
Lawrence Mbuagbaw ◽  
Francisca Monebenimp ◽  
Bolaji Obadeyi ◽  
Grace Bissohong ◽  
Marie-Thérèse Obama ◽  
...  

2020 ◽  
Author(s):  
Afework Kassu ◽  
Getnet Yimer ◽  
Solomon Benor ◽  
Kassahun Tesfaye ◽  
Yifokre Tefera ◽  
...  

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