scholarly journals Understanding antimicrobial resistance from the perspective of public policy: a multinational knowledge, attitude, and practice survey to determine global awareness

2021 ◽  
Author(s):  
Clara Balleste-Delpierre ◽  
Soe Yu Naing ◽  
Max van Wijk ◽  
Jordi Vila
Keyword(s):  
Antimicrobial Resistance ◽  
Good Governance ◽  
Global Awareness ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Level Of Knowledge ◽  
Survey Responses ◽  
Self Reporting Questionnaire

Abstract Background Minimizing the effect of antimicrobial resistance (AMR) requires an adequate policy response that relies on good governance and coordination. We have previously demonstrated a knowledge gap on infectious diseases within the general public, but equivalent data from a policy context are still lacking. The aim of this study is to have a better comprehension of how AMR is understood and perceived among policy makers and stakeholders in tackling AMR on a global level. Methods A digital survey was designed to capture the knowledge, attitude, and practices (KAP) towards AMR. A self-reporting questionnaire was distributed to politicians, policy advisors and relevant stakeholders, and survey responses were collected between November 2020 and March 2021. Results A total of 351 individuals participated in this study with 80% from high-income countries (HIC) and 20% from low- and middle-income countries (LMIC). Fifteen different countries were represented, and the majority of participants were from the Netherlands, Spain and Myanmar. Overall, participants had sufficient knowledge regarding AMR and reported the importance of political willingness in tackling AMR. More than half (65%) of participants from LMIC reported antibiotics misuse, and almost half (48%) claimed to be unaware of this health problem. Politicians and stakeholders from LMIC demonstrated a higher knowledge on AMR but showed poor perception and attitude toward antimicrobial use compared to those from HIC regions. HIC participants emphasized the role of the veterinary sector in particular, as well as the environmental dissemination of antibiotics and drug residues. The lack of funding resources was especially reported by participants from LMIC. Conclusion Inter-regional differences in KAP regarding AMR exist among politicians, policy advisors and relevant stakeholders. Overall, participants demonstrated to have a sufficient level of knowledge and awareness of AMR. This study characterizes a multi-national policymaker and stakeholder mapping that can be used to propose further policy implementation on various governance levels.

scholarly journals Understanding Antimicrobial Resistance from the Perspective of Public Policy: A Multinational Knowledge, Attitude, and Perception Survey to Determine Global Awareness

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1486
Author(s):  
SoeYu Naing ◽  
Max van Wijk ◽  
Jordi Vila ◽  
Clara Ballesté-Delpierre
Keyword(s):  
Antimicrobial Resistance ◽  
Regional Differences ◽  
Good Governance ◽  
Global Awareness ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Addition Level ◽  
Perception Survey ◽  
Digital Survey

Minimizing the effect of antimicrobial resistance (AMR) requires an adequate policy response that relies on good governance and coordination. This study aims to have a better comprehension of how AMR is understood and perceived by policy-makers and stakeholders in a multinational context. A digital survey was designed to capture the knowledge, attitudes, and perceptions (KAP) towards AMR, and it was distributed to politicians, policy advisors, and stakeholders. A total of 351 individuals from 15 different countries participated, 80% from high-income countries (HICs) and 20% from low- and middle-income countries (LMICs). The Netherlands, Spain, and Myanmar were the top 3 represented countries. Participants had sufficient knowledge regarding AMR and reported the importance of political willingness to tackle AMR. Overall, LMIC participants demonstrated better knowledge of AMR but showed poor perception and attitude towards antimicrobial use compared to HIC participants. In addition, level of education and field of expertise were significantly associated with knowledge, perception, and practices regardless of demographic characteristics. Inter-regional differences in KAP regarding AMR exist among politicians, policy advisors, and relevant stakeholders. This study captures multinational policy-maker and stakeholder mapping that can be used to propose further policy implementation on various governance levels.

scholarly journals The Contribution of Wastewater to the Transmission of Antimicrobial Resistance in the Environment: Implications of Mass Gathering Settings

2020 ◽  
Vol 5 (1) ◽  
pp. 33 ◽  
Author(s):  
Nour Fouz ◽  
Krisna N. A. Pangesti ◽  
Muhammad Yasir ◽  
Abdulrahman L. Al-Malki ◽  
Esam I. Azhar ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Mechanism ◽  
Animal Husbandry ◽  
Gram Negative Bacteria ◽  
Mass Gathering ◽  
Middle Income ◽  
Middle Income Countries ◽  
Complex Interactions ◽  
Environmental Reservoir

Antimicrobial resistance (AMR) is the major issue posing a serious global health threat. Low- and middle-income countries are likely to be the most affected, both in terms of impact on public health and economic burden. Recent studies highlighted the role of resistance networks on the transmission of AMR organisms, with this network being driven by complex interactions between clinical (e.g., human health, animal husbandry and veterinary medicine) and other components, including environmental factors (e.g., persistence of AMR in wastewater). Many studies have highlighted the role of wastewater as a significant environmental reservoir of AMR as it represents an ideal environment for AMR bacteria (ARB) and antimicrobial resistant genes (ARGs) to persist. Although the treatment process can help in removing or reducing the ARB load, it has limited impact on ARGs. ARGs are not degradable; therefore, they can be spread among microbial communities in the environment through horizontal gene transfer, which is the main resistance mechanism in most Gram-negative bacteria. Here we analysed the recent literature to highlight the contribution of wastewater to the emergence, persistence and transmission of AMR under different settings, particularly those associated with mass gathering events (e.g., Hajj and Kumbh Mela).

scholarly journals What is ‘antimicrobial resistance’ and why should anyone make films about it? Using ‘participatory video’ to advocate for community-led change in public health

2020 ◽  
Vol 17 (1) ◽  
pp. 85-107 ◽  
Author(s):  
Paul Cooke ◽  
Ashim Shrestha ◽  
Abriti Arjyal ◽  
Romi Giri ◽  
Nichola Jones ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
World View ◽  
Power Relationships ◽  
Health Issues ◽  
Middle Income ◽  
Participatory Video ◽  
Mainstream Media ◽  
Middle Income Countries

In this article, we discuss the role of participatory video (PV) as a tool for developing community-level solutions to ‘Antimicrobial Resistance’ (AMR) in Nepal. In recent years, PV has become an ever more popular tool in development contexts for supporting communities in low and middle income countries to raise awareness of issues that they do not feel are adequately represented in mainstream media. One area of growing interest in this regard is public health. However, PV has not, to date, been used to address AMR, currently considered to be one of the biggest public health issues we face globally. Placing our project within the wider context of ‘participatory documentary’ practice, we examine the world-view presented in the films this project generated, a dimension of such projects that is, somewhat curiously perhaps, often overlooked, with commentators tending to focus on the process of delivering PV, rather than the final products made. Here we are particularly interested in questions of power and how a close reading of the texts produced highlights the complexity of the power relationships at work in these films, which, in turn, can allow us to reflect in new ways on the processes at work in the project.

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.

Depression in the Developing World

2017 ◽  
Author(s):  
Harry Minas
Keyword(s):  
Mental Health ◽  
International Development ◽  
Social Services ◽  
Development Programs ◽  
Middle Income ◽  
Health And Social Services ◽  
Middle Income Countries ◽  
Culturally Informed ◽  
Global Understanding

This chapter provides an overview of what is known about prevalence, social determinants, treatment, and course and impact of depression in developing, or low- and middle-income, countries. The importance of culture in depression and in the construction and application of diagnostic classifications and in health and social services is highlighted, with a particular focus on the applicability of ‘Western’ diagnostic constructs and service systems in developing country settings. The role of international organizations, such as WHO, and international development programs, such as the SDGs, in improving our understanding of depression and in developing effective and culturally appropriate responses is briefly examined. There is both a need and increasing opportunities in developing countries for greater commitment to mental health of populations, increased investment in mental health and social services, and culturally informed research that will contribute to improved global understanding of mental disorders in general and depression in particular.

Health research capacity in Nepal: Analysis of the trend and the role of local researchers

2021 ◽  
pp. 004947552098277
Author(s):  
Madhu Kharel ◽  
Alpha Pokharel ◽  
Krishna P Sapkota ◽  
Prasant V Shahi ◽  
Pratisha Shakya ◽  
...  
Keyword(s):  
Health Research ◽  
Fold Increase ◽  
Research Capacity ◽  
Rapid Review ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Evidence Based Decision Making

Evidence-based decision-making is less common in low- and middle-income countries where the research capacity remains low. Nepal, a lower-middle-income country in Asia, is not an exception. We conducted a rapid review to identify the trend of health research in Nepal and found more than seven-fold increase in the number of published health-related articles between 2000 and 2018. The proportion of articles with Nepalese researchers as the first authors has also risen over the years, though they are still only in two-thirds of the articles in 2018.

scholarly journals Peripheral Inotropes in Critically Ill Children: Is It Safe?

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110222
Author(s):  
Ravi K. Mooli ◽  
Kalaimaran Sadasivam
Keyword(s):  
Central Venous Access ◽  
Pediatric Intensive Care ◽  
Venous Access ◽  
Critically Ill Children ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications

Many children needing pediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries (LMIC) may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access. Aim: The aim of our study was to describe the role of peripheral vasoactive inotropes in children. Methods: Children requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at 2 time points on use and complications of peripheral vasoactive medications. Results: Eighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely. Conclusions: Results from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it may be safely administered in children at a diluted concentration.

scholarly journals A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sanjeev Singh ◽  
Esmita Charani ◽  
Sarada Devi ◽  
Anuj Sharma ◽  
Fabia Edathadathil ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
The State ◽  
Action Plans ◽  
Public And Private ◽  
Middle Income ◽  
Middle Income Countries ◽  
Public Health Threat

Abstract Background The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. Strategies Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. Conclusion Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

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