Anti-Microbial Resistance Strategies Need Urgent Attention to Prevent Unnecessary Deaths in Africa — Global Issues
ACCRA, 3/11 (IPS) – African countries must find ways to combat drug resistance in the health care system to avoid unnecessary deaths.
A few months ago, the President of the Ghana Public Health Association, Amofah George, recounted how he witnessed a patient die after failing to respond to all currently used antibiotics. to control sepsis, blood poisoning, especially caused by bacteria or their toxins. . He attributes the situation to antibiotic resistance, also known as Antimicrobial Resistance (AMR), which he says has become a growing epidemic.
The problem is simple: Africa’s healthcare system does not routinely rely on laboratories to provide tests for treatment. African Association of Laboratory Medicine (ASLM) AMR program director, Edwin Shumba, told IPS, “Ghana, like other countries on the continent, relies on a number of medical laboratories to make progress. bacteriological testing as part of routine clinical services.”
“This means that doctors are blindly prescribing treatments for their patients, and public health professionals have no insight into what is going on in relation to the disease,” said Shumba. AMR, at the hospital and national level.
“The growing threat of AMR has implications for patient care: the antibiotics that once worked will no longer be able to cure infections caused by resistant bacteria. This means that infections can take longer to cure, can be more serious (death, illness) and will cost society more.”
Worried about the growing AMR cases, the African Society for Laboratory Medicine (ASLM) led a study, and data from 14 sub-Saharan countries showed that only 5 out of 15 pathogens are resistant to AMR. antibiotics – bacteria, viruses or others. microorganisms that can cause disease – designated as priority by the World Health Organization (WHO) are being tested consistently and all year show high resistance.
Across 14 countries, clinical and treatment data are not linked to test results, making it difficult to understand what is driving AMR. Of the nearly 187,000 samples tested for AMR, approximately 88% had no information on the patient’s clinical record, including diagnosis/source of infection, presence of in-house devices (such as urinary catheters, etc.) , feeding tubes, and wound drainage tubes) are often associated with the development of healthcare-associated infections, comorbidities, or antibiotic use. The remaining 12% have incomplete information.
The multi-year, multi-country study was carried out by the Antimicrobial Use and Resistance Mapping Partnership (MAAP), an association led by the African Association for Laboratory Medicine (ASLM), with partners including the Africa Centers for Disease Control and Prevention (Africa CDC), One Health Trust, West African Health Organization (WAHO), East, Central and South African Health Communities (ECSA- HC), Innovative Support for Emergencies, Illnesses and Disasters, and IQVIA. It provides insights into the unreported depths of the AMR crisis across Africa and makes urgent policy recommendations to address the emergency.
MAAP reviewed 819,584 AMR applications between 2016 and 2019 from 205 laboratories across Burkina Faso, Ghana, Nigeria, Senegal, Sierra Leone, Kenya, Tanzania, Uganda, Malawi, Eswatini, Zambia, Zimbabwe, Gabon and Cameroon. MAAP also looked at data from 327 hospital and community pharmacies and 16 country-level AMC datasets.
The researchers found that most laboratories in Africa were not ready for AMR testing. Only 1.3% of the 50,000 medical laboratories that make up the network of 14 countries participate in bacteriological testing. And of those, only a small fraction can handle the scientific procedures needed to evaluate AMR. The researchers also found that in eight of the 14 countries, more than half of the population did not have access to any bacteriology lab.
The study results provide insights into AMR burden and antibiotic consumption in 14 countries where most of the available AMR data are based on statistical modeling only. The MAAP effort is the first of its kind to systematically collect, process and evaluate data on AMR and antimicrobial drug consumption (AMC) in Africa.
WHO has repeatedly stated that AMR is a global health priority – and in fact, one of the leading public health threats of the 21st century. A recent study estimates that, in In 2019, nearly 1.3 million deaths globally were attributed to antibiotic-resistant bacterial infections. Africa was found to have the highest AMR mortality rate in the world, with 24 deaths per 100,000 people linked to AMR.
ASLM’s director of science and new initiatives, Pascale Ondoa, said, “Africa is struggling to fight drug-resistant pathogens, just like the rest of the world, but their struggles are. I’m also complicated by the fact that we don’t have an accurate picture of how antibiotic resistance is affecting our citizens and health systems. “
The study also showed that just four drugs accounted for more than two-thirds (67%) of all antibiotics used in healthcare settings. Stronger drugs to treat more resistant infections (such as severe pneumonia, sepsis, and complicated intra-abdominal infections) are not available, suggesting limited access for some groups antibiotics.
ASLM CEO Nqobile Ndlovu said, “Across Africa, even when resistance data is collected, it is not always accessible, is often recorded manually and rarely aggregated or shared with policy makers; As a result, health professionals are blind and unable to develop and implement policies that can limit or limit antibiotic resistance. “
Dr Yewande Alimi, Africa CDC AMR program coordinator, said: “The disconnect between patient data and resistance outcomes, coupled with the extremely high burden of antibiotic resistance, makes it difficult to recommend Precise guidance on patient care and broader public health policies, said. “Therefore, the collection and interconnection of laboratory, pharmaceutical and clinical data will be essential to provide baselines and references for public health actions.”
“Overall, the data highlight a dual problem of limited access to antibiotics and the inappropriate use of existing drugs,” said the head of the Department of Public Health (Africa and China). East) and IQVIA Real World (Middle East) Evidence, said Deepak Batra.
“As a result, people do not get appropriate treatment for severe infections, and the inappropriate use of antibiotics leads to resistance to existing treatment options. Regular monitoring of antibiotic consumption can help monitor limited access and inappropriate use,” he added.
Based on the findings, MAAP calls for a dramatic increase in the quality and quantity of AMR and AMC data being collected across the continent, along with revised AMR control strategies and research priorities.
For Shumba, Ghana, as well as the rest of Africa, can combat AMR by including key interventions in revised versions of the National AMR Action Plan, Essential Medicines List. , laboratory strategies and standard treatment guidelines.
He added: “This devastating damage to the health system poses a major threat to health progress and to achieving Universal Health Coverage, the United Nations Agenda 2063. Alliance Africa: The Africa We Want and the United Nations Sustainable Development Goals.
Shumba said Ghana’s AMR coordination committee can assist other policymakers in using the evidence gathered by the MAAP project to tailor their strategies to prevent AMR. In addition, they may plan to increase the number and capacity of medical laboratories to perform bacteriological testing in the country.
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