scholarly journals Surveillance of antimicrobial resistance in low- and middle-income countries: a scattered picture

Author(s):  
Katia Iskandar ◽  
Laurent Molinier ◽  
Souheil Hallit ◽  
Massimo Sartelli ◽  
Timothy Craig Hardcastle ◽  
...  

AbstractData on comprehensive population-based surveillance of antimicrobial resistance is lacking. In low- and middle-income countries, the challenges are high due to weak laboratory capacity, poor health systems governance, lack of health information systems, and limited resources. Developing countries struggle with political and social dilemma, and bear a high health and economic burden of communicable diseases. Available data are fragmented and lack representativeness which limits their use to advice health policy makers and orientate the efficient allocation of funding and financial resources on programs to mitigate resistance. Low-quality data means soaring rates of antimicrobial resistance and the inability to track and map the spread of resistance, detect early outbreaks, and set national health policy to tackle resistance. Here, we review the barriers and limitations of conducting effective antimicrobial resistance surveillance, and we highlight multiple incremental approaches that may offer opportunities to strengthen population-based surveillance if tailored to the context of each country.

2017 ◽  
Vol 2 ◽  
pp. 91 ◽  
Author(s):  
Anna C. Seale ◽  
Coll Hutchison ◽  
Silke Fernandes ◽  
Nicole Stoesser ◽  
Helen Kelly ◽  
...  

Development of antimicrobial resistance (AMR) threatens our ability to treat common and life threatening infections. Identifying the emergence of AMR requires strengthening of surveillance for AMR, particularly in low and middle-income countries (LMICs) where the burden of infection is highest and health systems are least able to respond. This work aimed, through a combination of desk-based investigation, discussion with colleagues worldwide, and visits to three contrasting countries (Ethiopia, Malawi and Vietnam), to map and compare existing models and surveillance systems for AMR, to examine what worked and what did not work. Current capacity for AMR surveillance varies in LMICs, but and systems in development are focussed on laboratory surveillance. This approach limits understanding of AMR and the extent to which laboratory results can inform local, national and international public health policy. An integrated model, combining clinical, laboratory and demographic surveillance in sentinel sites is more informative and costs for clinical and demographic surveillance are proportionally much lower. The speed and extent to which AMR surveillance can be strengthened depends on the functioning of the health system, and the resources available. Where there is existing laboratory capacity, it may be possible to develop 5-20 sentinel sites with a long term view of establishing comprehensive surveillance; but where health systems are weaker and laboratory infrastructure less developed, available expertise and resources may limit this to 1-2 sentinel sites. Prioritising core functions, such as automated blood cultures, reduces investment at each site. Expertise to support AMR surveillance in LMICs may come from a variety of international, or national, institutions. It is important that these organisations collaborate to support the health systems on which AMR surveillance is built, as well as improving technical capacity specifically relating to AMR surveillance. Strong collaborations, and leadership, drive successful AMR surveillance systems across countries and contexts.


2010 ◽  
Vol 89 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Sarah E Rosenbaum ◽  
Claire Glenton ◽  
Charles Shey Wiysonge ◽  
Edgardo Abalos ◽  
Luciano Mignini ◽  
...  

2017 ◽  
Vol 211 (5) ◽  
pp. 264-265 ◽  
Author(s):  
K. S. Jacob

SummarySuicide, a common cause of death in many low- and middle-income countries, has often been viewed through a medical/psychiatric lens. Such perspectives medicalise social and personal distress and suggest individual and medication-based treatments. This editorial argues for the need to examine suicide from a public health perspective and suggests the need for population-based social and economic interventions.


2020 ◽  
Author(s):  
Gibran Cruz-Martinez ◽  
Gokce Cerev

Global AgeWatch Index and Insights by HelpAge International aim to contribute to achievement of long-term transformative change in respect to ageing and the lives of older people by advocating for better production of timely and good quality data to inform policy and program response.The Global AgeWatch Index is a composite index that measures quality of life of older people, and ranks countries based on four domains – income security, health status, enabling environment and capability. The index was developed in partnership with Professor Asghar Zaidi. The index was published during 2013-2015.The Global AgeWatch Insights is a research-based advocacy tool that examines situation of older people in low- and middle-income countries, assesses availability of relevant data and evidence to support the analysis, and identification of policy actions. The Insights are produced in partnership with AARP. The reports were launched in 2018 are planned to be released every three years with a different thematic focus. The first report focuses on the inequities of the health systems in twelve low- and middle-income countries.


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