scholarly journals Drivers of antimicrobial resistance amongst intestinalEscherichia coliisolated from children in South Asia and sub-Saharan Africa

2017 ◽  
Author(s):  
Danielle J. Ingle ◽  
Myron M. Levine ◽  
Karen L. Kotloff ◽  
Kathryn E. Holt ◽  
Roy M. Robins-Browne
Keyword(s):  
Developing Countries ◽  
Antimicrobial Resistance ◽  
South Asia ◽  
Enteric Bacteria ◽  
Sub Saharan Africa ◽  
Fluoroquinolone Resistance ◽  
E Coli ◽  
Antimicrobial Usage ◽  
Sub Saharan ◽  
Usage Data

AbstractAntimicrobial resistance (AMR) dynamics are poorly understood in developing countries, where data on the prevalence of AMR in enteric bacteria are sparse, particularly among children and in the community setting. Here we use a combination of phenotyping, genomics and antimicrobial usage data to investigate patterns of AMR amongst atypical enteropathogenicE. coli(aEPEC) strains isolated from children <5 years old in seven countries (four in sub-Saharan Africa and three in South Asia) over a three-year period. We detected very high rates of AMR, with 65% of isolates displaying resistance to ≥3 drug classes; the rates of AMR were the same amongst strains associated with diarrhea and strains that were carried asymptomatically. Whole genome sequencing identified a diversity of genetic mechanisms for AMR, which could explain >95% of observed phenotypic resistance. Analysis of AMR gene co-occurrence revealed clusters of acquired AMR genes that were frequently co-located on small plasmids and transposons, providing opportunities for acquisition of multidrug resistance in a single step. We used discriminant analysis to investigate potential drivers of AMR within the bacterial population, and found that genetic determinants of AMR were associated with geographical location of isolation but not with phylogenetic lineage of theE. colistrain or disease status of the human host. Comparison with antimicrobial usage data showed that the prevalence of resistance to newer drugs (fluoroquinolones and third-generation cephalosporins) was correlated with usage, which was generally higher in South Asia than Africa. In particular, fluoroquinolone resistance-associated mutations ingyrAwere significantly associated with use of these drugs for treatment of diarrheic children. Notably resistance to older drugs such as trimethoprim, chloramphenicol and ampicillin, which are conferred by acquired AMR genes that were frequently clustered together in mobile genetic elements, were common in all locations despite differences in usage; this suggests that reversion to sensitivity is unlikely to occur even if these drugs are removed from circulation. This study provides much-needed insights into the frequencies of AMR in intestinalE. coliin community-based children in developing countries and to antimicrobial usage for diarrhea where the burden of infections is greatest.

scholarly journals Prevalence and antibiotic resistance of bacterial pathogens isolated from childhood diarrhoea in four provinces of Kenya

2012 ◽  
Vol 6 (07) ◽  
pp. 572-578 ◽  
Author(s):  
Willie Kipkemboi Sang ◽  
Valerie Oundo ◽  
David Schnabel
Keyword(s):  
Antimicrobial Resistance ◽  
Rural Areas ◽  
Hospital Admissions ◽  
Sub Saharan Africa ◽  
Vibrio Cholera ◽  
Antimicrobial Drug Resistance ◽  
E Coli ◽  
Shigella Isolate ◽  
Stool Samples ◽  
Sub Saharan

Introduction: Diarrhoea is one of the main causes of morbidity and mortality among children in sub-Saharan Africa, and one of the main causes of hospital admissions in rural areas of Kenya. In Kenya, antimicrobial resistance surveillance has been conducted only at the institutional levels, with limited sharing of information and analysis of data. As a result, the actual scale of regional or national antimicrobial drug resistance is not well defined. Methodology: Stool samples were collected between 1 October 2007 and 30 September 2008 from a total of 651 outpatients with diarrhoea who were under five years of age in four provinces of Kenya.  Conventional, biochemical methods, multiplex PCR and antimicrobial susceptibility were conducted to identify the bacterial causes and virulence factors in the isolates, respectively.  Results: Of the 651 patients screened, we identified the causes of 115 cases (17.7%) as follows: Pathogenic E. coli (11.2%) [enteroaggregative (8.9%), enterotoxigenic (1.2%), enteroinvasive (0.6%), shigatoxigenic (0.5%)], Salmonella (3.5%), Shigella (2%) and Vibrio cholera O1 (0.7%). The highest levels of resistance among the E. coli isolates were observed in ampicillin and trimethoprim/sulphamethoxazole each at 95% followed by tetracycline at 81%. Shigella isolate levels of resistance ranged from 80% to 100% for ampicillin, tetracycline and trimethoprim/sulphamethoxazole. Conclusion: The highest prevalence of antimicrobial resistance was to ampicillin followed by trimethoprim/sulphamethoxazole and tetracycline. Though still at low levels, the major concern from our findings is the emerging resistance of enteric pathogens that was observed to quinolones (ciprofloxacin, nalidixic acid, norfloxacin) and gentamycin.

scholarly journals Antimicrobial Resistance of Sterile Site Infections in Sub-Saharan Africa: A Systematic Review

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Meklit Workneh ◽  
Morgan J Katz ◽  
Mohammed Lamorde ◽  
Sara E Cosgrove ◽  
Yukari C Manabe
Keyword(s):  
Antimicrobial Resistance ◽  
Sub Saharan Africa ◽  
Eastern Africa ◽  
World Health ◽  
Fluoroquinolone Resistance ◽  
Mechanisms Of Resistance ◽  
Salmonella Spp ◽  
Sterile Site ◽  
Sub Saharan ◽  
Tract Infections

Abstract Sparse data exist from sub-Saharan Africa (SSA) on the prevalence of antimicrobial resistance (AMR). A prior review of antimicrobial resistance in SSA from 1990 to 2013 showed a high prevalence of AMR to commonly used antibiotics in this setting. We reviewed the literature published since 2013. Four databases (PubMed, EMBASE, Cochrane, and African Journals Online) were searched for articles between February 2013 and March 2016 with a focus on sterile site infections (bacteremia, urinary tract infections [UTIs], and meningitis). We focused on the original World Health Organization–identified priority pathogens and antibiotics, prior to the release of the most recently updated and expanded list in 2017. There were 19 eligible studies: bacteremia (12), UTI (6), and meningitis (1). Eight studies were from Western and Central Africa, 8 from Eastern Africa, and 4 from Southern Africa. Prevalence of Escherichia coli resistance to third-generation cephalosporins ranged from 0% to 75%. No studies reported resistance to carbapenems among Klebsiella spp. Prevalence of fluoroquinolone resistance ranged from 8.3% to 100% among E. coli and 0% to 15% among Salmonella spp. Prevalence of resistance to penicillin among Streptococcus pneumoniae isolates ranged from 25% to 100%. Testing for extended-spectrum beta-lactamase was reported in 7 studies (range, 1.3–60% among tested isolates). Methods for evaluating AMR varied across studies; standardized approaches are needed in the region. Testing for mechanisms of resistance is low even in research settings, but important mechanisms of resistance such as ESBL production are present.

scholarly journals Milk Hygiene in Rural Southwestern Uganda: Prevalence of Mastitis and Antimicrobial Resistance Profiles of Bacterial Contaminants of Milk and Milk Products

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Paul Ssajjakambwe ◽  
Gloria Bahizi ◽  
Christopher Setumba ◽  
Stevens M. B. Kisaka ◽  
Patrick Vudriko ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Production Efficiency ◽  
Sub Saharan Africa ◽  
Milk Products ◽  
E Coli ◽  
Antimicrobial Sensitivity ◽  
Causative Agents ◽  
Sub Saharan ◽  
The Government ◽  
Milk Hygiene

Mastitis and antimicrobial resistance are a big challenge to the dairy industry in sub-Saharan Africa. A study was conducted in Kashongi and Keshunga subcounties of Kiruhura District (in Uganda) where the government and private sector have deliberate programs to improve production efficiency, quality, and safety of milk and its products. The study aimed to determine the prevalence of mastitis, its common causative agents, antimicrobial sensitivity of mastitis causing organisms, and contaminants of processed milk products: yoghurt and ghee. Seventy-one milk, fourteen yoghurt, and three ghee samples were collected from nine farms. Of the 71 cows tested, 54 (76.1%) had mastitis. The mastitis cases from Keshunga were 32 (59.3%) and Kashongi contributed 22 (40.7%) of the cases. The common mastitis causative agents wereStaphylococcusspp. (30.8%),Streptococcusspp. (12.3%),Corynebacteriumspp.(15.4%), andE. coli(7.7%). Some of the isolates were resistant to tetracycline and penicillin. Prevalent contaminants of yoghurt wereStaphylococcusspp. (8.3%),Streptococcusspp. (8.3%),Corynebacteriumspp. (8.3%), andE. coli(8.3%), whereas all ghee containedStreptococcusspp. (100%). Prevalence of mastitis, antimicrobial resistance, and contamination of milk products are high in the study area. Targeted programs to prevent and control mastitis as well as antibiotic resistance are recommended.

scholarly journals Child Marriage: A Discussion Paper

2015 ◽  
Vol 6 (2) ◽  
pp. 8-14 ◽  
Author(s):  
Tahera Ahmed
Keyword(s):  
Developing Countries ◽  
Literature Review ◽  
South Asia ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Discussion Paper ◽  
Life Threatening ◽  
Sub Saharan ◽  
Set Up

Child marriage is still a massive problem in many developing countries. The issue is more concentrated in countries of Sub Saharan Africa and South Asia. This paper, through literature review attempts to assess the situation, the consequences, various programmes and recommendations on the reduction of child marriage. In this article it is reinforced that, consequences of child marriage put the girls at risk of early pregnancies with life-threatening conditions. This paper suggests that each country should set up its own mid-term and long-term goals to bring about significant reduction in child marriages.

scholarly journals Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and sub-Saharan Africa

2018 ◽  
Vol 3 (9) ◽  
pp. 1063-1073 ◽  
Author(s):  
Danielle J. Ingle ◽  
Myron M. Levine ◽  
Karen L. Kotloff ◽  
Kathryn E. Holt ◽  
Roy M. Robins-Browne
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
South Asia ◽  
Sub Saharan Africa ◽  
Community Settings ◽  
Sub Saharan

scholarly journals Genomic diversity of Escherichia coli isolates from backyard chickens and guinea fowl in the Gambia

2020 ◽  
Author(s):  
Ebenezer Foster-Nyarko ◽  
Nabil-Fareed Alikhan ◽  
Anuradha Ravi ◽  
Nicholas M. Thomson ◽  
Sheikh Jarju ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Guinea Fowl ◽  
Genomic Diversity ◽  
Sub Saharan Africa ◽  
Human Society ◽  
E Coli ◽  
Backyard Poultry ◽  
Link Type ◽  
Sub Saharan

AbstractChickens and guinea fowl are commonly reared in Gambian homes as affordable sources of protein. Using standard microbiological techniques, we obtained 68 caecal isolates of Escherichia coli from ten chickens and nine guinea fowl in rural Gambia. After Illumina whole-genome sequencing, 28 sequence types were detected in the isolates (four of them novel), of which ST155 was the most common (22/68, 32%). These strains span four of the eight main phylogroups of E. coli, with phylogroups B1 and A being most prevalent. Nearly a third of the isolates harboured at least one antimicrobial resistance gene, while most of the ST155 isolates (14/22, 64%) encoded resistance to ≥3 classes of clinically relevant antibiotics, as well as putative virulence factors, suggesting pathogenic potential in humans. Furthermore, hierarchical clustering revealed that several Gambian poultry strains were closely related to isolates from humans. Although the ST155 lineage is common in poultry from Africa and South America, the Gambian ST155 isolates belong to a unique cgMLST cluster comprised of closely related (38-39 alleles differences) isolates from poultry and livestock from sub-Saharan Africa—suggesting that strains can be exchanged between poultry and livestock in this setting. Continued surveillance of E. coli and other potential pathogens in rural backyard poultry from sub-Saharan Africa is warranted.Author notesAll supporting data and protocols have been provided within the article or as supplementary data files. Eleven supplementary figures and eight supplementary files are available with the online version of this article.Data summaryThe genomic assemblies for the isolates reported here are available for download from EnteroBase (http://enterobase.warwick.ac.uk/species/index/ecoli) and the EnteroBase assembly barcodes are provided in File S2.Sequences have been deposited in the NCBI SRA, under the BioProject ID: PRJNA616250 and accession numbers SAMN14485281 to SAMN14485348 (File S2). Assemblies have been deposited in GenBank under the BioProject ID: PRJNA616250 and accession numbers CP053258 and CP053259.Impact statementDomestic birds play a crucial role in human society, in particular contributing to food security in low-income countries. Many households in Sub-Saharan Africa rear free-range chickens and guinea fowl, which are often left to scavenge for feed in and around the family compound, where they are frequently exposed to humans, other animals and the environment. Such proximity between backyard poultry and humans is likely to facilitate transmission of pathogens such as Escherichia coli or antimicrobial resistance between the two host species. Little is known about the population structure of E. coli in rural chickens and guinea fowl, although this information is needed to contextualise the potential risks of transmission of bacterial strains between humans and rural backyard poultry. Thus, we sought to investigate the genomic diversity of E. coli in backyard poultry from rural Gambia.

scholarly journals The Dynamics of Extreme Poverty in Developing Countries

2018 ◽  
Vol 28 (2) ◽  
pp. 18-35 ◽  
Author(s):  
Edmore Mahembe ◽  
Nicholas M. Odhiambo
Keyword(s):  
Developing Countries ◽  
South Asia ◽  
Sub Saharan Africa ◽  
Poor People ◽  
World Population ◽  
Absolute Poverty ◽  
Critical Question ◽  
Extreme Poverty ◽  
The World ◽  
Sub Saharan

Abstract This paper aims to analyses the trends and dynamics of extreme poverty in developing countries. The study attempts to answer one critical question: has the world achieved its number one Millennium Development Goal (MDG) target of reducing extreme poverty by half by 2015? The methodology used in this study mainly involves a descriptive data analysis during the period 1981-2015. The study used the World Bank’s US$1.90 a day line (popularly known as $1 a day line) in 2011 prices to measure the level of absolute poverty. In order to analyze the dynamics of poverty across different regions, the study grouped countries into five regions: i) sub-Saharan Africa; ii) East Asia and the Pacific; iii) South Asia; iv) Europe and Central Asia; and v) Latin America and the Caribbean. The study found that in 1990, there were around 1.9 billion people living below US$1.90 a day (constituting 36.9 percent of the world population) and this number is estimated to have reduced to around 700 million people in 2015, with an estimated global poverty rate of 9.6 percent. The world met the MDG target in 2010, which is five years ahead of schedule. However, extreme poverty is becoming increasingly concentrated in sub-Saharan Africa (SSA) and South Asia (SA), where its depth and breadth remain a challenge. SSA remains the poorest region, with more than 35 percent of its citizens living on less than US$1.90 a day. Half of the world’s extremely poor people now live in SSA, and it is the only region which has not met its MDG target.

scholarly journals FINANCIAL DEVELOPMENT IN DEVELOPING COUNTRIES

2020 ◽  
Vol 20 (03) ◽  
pp. 2050016
Author(s):  
OBINNA FRANKLIN EZEIBEKWE
Keyword(s):  
Developing Countries ◽  
South Asia ◽  
Financial Development ◽  
Trade Openness ◽  
National Income ◽  
Political Stability ◽  
Policy Implications ◽  
Sub Saharan Africa ◽  
Marginal Effect ◽  
Sub Saharan

What are the economic, political, institutional, socio-cultural, and geographical determinants of financial development in developing countries? This paper uses the two-way fixed effects (with clustered standard errors) and annual panel data from 1980 to 2018 for 69 developing countries in sub-Saharan Africa, Middle East and North Africa, East and South Asia, Latin America, and the Caribbean to address this question. The principal component analysis is employed to construct a financial development index based on three financial development indicators. This study builds on the previous studies by introducing new potential determinants of financial development such as the perception of corruption, and by exploring important quadratic and interaction effects. The results show that national income, trade openness, indices of political stability and Polity2 (a democracy score), perception of corruption, the predominant religion in the countries, and geographical factors such as territorial access to the sea explain the differences in the levels of financial development across countries and regions. A rise in national income leads to a higher level of financial development and countries with a high perceived level of corruption have a lower level of financial development. There is strong evidence of threshold effects as trade openness has a diminishing marginal effect on financial development while the auxiliary growth regressions show that financial development has an increasing marginal effect on national income. Of the five regions studied, East and South Asia and sub-Saharan Africa have the highest and lowest levels of financial development, respectively. Also, fuel-exporting countries, least developed countries, and landlocked countries tend to have lower levels of financial development. These results have relevant policy implications for developing countries in their continued efforts to achieve better financial development and ultimately, sustainable economic development.

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