scholarly journals Supporting surveillance capacity for antimicrobial resistance: Laboratory capacity strengthening for drug resistant infections in low and middle income countries

2017 ◽  
Vol 2 ◽  
pp. 91 ◽  
Author(s):  
Anna C. Seale ◽  
Coll Hutchison ◽  
Silke Fernandes ◽  
Nicole Stoesser ◽  
Helen Kelly ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Health Systems ◽  
Clinical Laboratory ◽  
Surveillance Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Laboratory Capacity ◽  
Model Combining ◽  
Laboratory Surveillance ◽  
Low And Middle Income

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.

scholarly journals Antimicrobial resistance in the Pacific Island countries and territories

2020 ◽  
Vol 5 (4) ◽  
pp. e002418
Author(s):  
Michael Loftus ◽  
Andrew Stewardson ◽  
Ravi Naidu ◽  
Ben Coghlan ◽  
Adam Jenney ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Surveillance Systems ◽  
Pacific Island ◽  
Middle Income ◽  
Middle Income Countries ◽  
Adequate Funding ◽  
The Pacific ◽  
Laboratory Surveillance ◽  
Pacific Island Countries

Antimicrobial resistance (AMR) is a critical global health threat with a disproportionate impact on low-income and middle-income countries (LMICs) due to their higher burden of infections, reduced laboratory surveillance infrastructure and fewer regulations governing antimicrobial use among humans or animals. While there have been increasing descriptions of AMR within many LMICs in WHO’s Western Pacific and South East Asian regions, there remains a paucity of data from Pacific Island countries and territories (PICTs). The PICTs represent 22 predominantly middle-income countries and territories with a combined population of 12 million people and 20 official languages, spread over hundreds of separate islands spanning an area corresponding to more than 15% of the earth’s surface. Our paper outlines the present state of the evidence regarding AMR in PICTs—discussing the present estimates of AMR and their accompanying limitations, important drivers of AMR, as well as outlining key priorities and potential solutions for tackling AMR in this region. Significant areas for action include developing National Action Plans, strengthening laboratory surveillance systems and educational activities targeted at both healthcare workers and the wider community. Ensuring adequate funding for AMR activities in PICTs is challenging given competing health and environmental priorities, in this context global or regional funding initiatives such as the Fleming Fund can play a key role.

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

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Katia Iskandar ◽  
Laurent Molinier ◽  
Souheil Hallit ◽  
Massimo Sartelli ◽  
Timothy Craig Hardcastle ◽  
...  
Keyword(s):  
Health Policy ◽  
Antimicrobial Resistance ◽  
Social Dilemma ◽  
Population Based ◽  
Quality Data ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Laboratory Capacity ◽  
Low And Middle Income

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.

scholarly journals Integrated Interventions Delivered in Health Systems, Home, and Community Have the Highest Impact on Breastfeeding Outcomes in Low- and Middle-Income Countries

2017 ◽  
pp. jn242321 ◽  
Author(s):  
Bireshwar Sinha ◽  
Ranadip Chowdhury ◽  
Ravi Prakash Upadhyay ◽  
Sunita Taneja ◽  
Jose Martines ◽  
...  
Keyword(s):  
Health Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Antibiotic Use in Low and Middle-Income Countries and the Challenges of Antimicrobial Resistance in Surgery

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 497
Author(s):  
Massimo Sartelli ◽  
Timothy C. Hardcastle ◽  
Fausto Catena ◽  
Alain Chichom-Mefire ◽  
Federico Coccolini ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
And Control ◽  
Low And Middle Income

Antimicrobial resistance (AMR) is a phenomenon resulting from the natural evolution of microbes. Nonetheless, human activities accelerate the pace at which microorganisms develop and spread resistance. AMR is a complex and multidimensional problem, threatening not only human and animal health, but also regional, national, and global security, and the economy. Inappropriate use of antibiotics, and poor infection prevention and control strategies are contributing to the emergence and dissemination of AMR. All healthcare providers play an important role in preventing the occurrence and spread of AMR. The organization of healthcare systems, availability of diagnostic testing and appropriate antibiotics, infection prevention and control practices, along with prescribing practices (such as over-the-counter availability of antibiotics) differs markedly between high-income countries and low and middle-income countries (LMICs). These differences may affect the implementation of antibiotic prescribing practices in these settings. The strategy to reduce the global burden of AMR includes, among other aspects, an in-depth modification of the use of existing and future antibiotics in all aspects of medical practice. The Global Alliance for Infections in Surgery has instituted an interdisciplinary working group including healthcare professionals from different countries with different backgrounds to assess the need for implementing education and increasing awareness about correct antibiotic prescribing practices across the surgical pathways. This article discusses aspects specific to LMICs, where pre-existing factors make surgeons’ compliance with best practices even more important.

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