November 11, 2024
Increases in age of marriage among women in India during the COVID-19 pandemic
One Health Trust researchers led a modeling study that found that the age of marriage among women in India during the COVID-19 pandemic increased by 1.1-1.2 years compared to those who got married before the pandemic. Using district- and household-level fixed effects models of data from India’s National Family and Health Survey, the study found that the increase in the age of marriage applied to women across all education levels, income backgrounds, and socioeconomic groups, suggesting important post-pandemic implications for Indian women’s health, education, and fertility outcomes. [Population and Development Review]
Routine immunization against Streptococcus pneumoniae and Haemophilus influenzae type B can heavily reduce antibiotic consumption.
Childhood vaccinations against Streptococcus pneumoniae and Haemophilus influenzae type B (Hib) can significantly reduce antibiotic use, thereby mitigating the risk of antimicrobial resistance (AMR). One Health Trust researchers used IndiaSim, a dynamic microsimulation model, to analyze the impact of these vaccines on antibiotic consumption in India from their inclusion in the national immunization program in 2004 through 2016. Pneumococcal and Hib vaccination with coverage similar to the DPT3 vaccine could decrease antibiotic use by 61.4 percent. Increased vaccination coverage since 2004 has likely reduced antibiotic demand by up to 93.4 percent among the poorest quintile of the country. Further enhancing vaccination rates may diminish health inequities and reduce outbreak-related antibiotic use. [Lancet Regional Health – Southeast Asia]
One Health Trust during the 79th United Nations General Assembly week
This September, the One Health Trust co-hosted an event to kick off the week of the 79th UN General Assembly High-Level meeting on antimicrobial resistance. The evening included a Fireside Chat with the Honorable Mia Amor Mottley, Prime Minister of Barbados and chair of the Global Leaders Group on AMR, to discuss the next steps towards mitigating AMR. The OHT team also attended other UNGA side events that covered a wide range of issues intersecting with global AMR control. During one of the sessions of the High-level Meeting on AMR, Dr. Ramanan Laxminarayan highlighted the findings and recommendations published in the May 2024 The Lancet Series on AMR and stressed the importance of promoting access to antibiotics when people need them. [One Health Trust]
An urgent call for expanded antibiotic access in high-burden countries
OHT’s Dr. Ramanan Laxminarayan authored an opinion piece emphasizing the urgent need for improved access to antibiotics in countries where most of the global deaths related to bacterial infections occur. Prevention strategies including safe water and proper sanitation, vaccinations, and improved handwashing in hospitals could avert at least 750,000 deaths from bacterial infections, but the largest reduction in deaths would come from expanding access to effective antibiotics. International funders, such as the Global Fund, must invest to take the necessary steps to meet global targets on AMR. [Nature]
One Health must integrate historical Indigenous knowledge of human, animal, and environmental health.
While Indigenous Peoples and communities have embodied the idea that human, animal, and environmental health are intertwined, One Health initiatives do not sufficiently recognize and respect Indigenous knowledge systems. The Western-centric approach to One Health often uses English terms in non-English-speaking settings and ignores the longstanding work of Indigenous Peoples to integrate the three spheres of health. Future work should emphasize existing Indigenous knowledge of planetary health and collaborate with Indigenous Peoples to incorporate their work into One Health. [Research Directions: One Health]
WHO AWaRe antibiotic prescribing patterns vary worldwide.
A retrospective study found that 74.8 percent of antibiotics prescribed to children under 10 years of age hospitalized in Nampula, Mozambique, belonged to the Access group (antibiotics used in the first- and second-line treatment of infections in the WHO AWaRe classification of antibiotics) and 23.7 percent belonged to the Watch group (broad-spectrum antibiotics with a higher potential of developing resistance). None of the antibiotics prescribed belonged to the Reserve group. These and findings from other countries paint a picture of highly variable global adherence to the WHO AWaRe guidance and warrant reinforced recommendations to adopt the framework and its associated indicators. [Nature Scientific Reports]
High global burden of rabies warrants a focused One Health approach.
Rabies claims an estimated 59,000 lives annually. The high burden of deaths can be attributed to low animal vaccination coverage, poor public awareness, and inadequate resources for post-exposure prophylaxis. Implementation of a One Health approach to rabies control has been challenged by logistical, financial, and structural barriers. A multifaceted model that prioritizes practicality and sustainability and includes digital health interventions, enhances rabies surveillance, and deploys mobile vaccination units would help operationalize a One Health approach to eliminate rabies. [The Lancet]
Neural networks and Bayesian models are suitable to predict antimicrobial susceptibility.
A comparative analysis of machine learning and probabilistic methods on hospital data revealed that multilayer dense neural networks and Bayesian models are appropriate for early prediction of antimicrobial susceptibility. These two models performed best in the early, intermediate, and late stages of the bacteriological process. These results, when appropriate, can be used to refine empiric antimicrobial therapy at the patient’s bedside, in electronic medical record platforms, and on laboratory information management systems to flag antimicrobial prescriptions with low susceptibility probability or ineffective broad-spectrum activity. [Nature Scientific Reports]
Identifying and prioritizing research gaps in environmental hygiene and cleaning
The CLEAN Group, a multidisciplinary stakeholder group convened by the UK Public Health Support Team, utilized a systematic prioritization process to define 12 priority research questions related to environmental cleaning standards, system strengthening, behavior change, and innovation in healthcare facilities. Answering these questions would help achieve progress on universal quality of healthcare; increased coverage of safely managed drinking water, sanitation, and hygiene; and AMR. [Antimicrobial Resistance & Infection Control]
Exploring the role of wild birds as bioindicators of AMR
Researchers in Italy assessed the role of wild birds as bioindicators of AMR by analyzing the antimicrobial susceptibility profiles of bacterial commensal isolates collected from 73 wild birds. Among the Gram-negative isolates, Escherichia was the most frequently isolated bacterial genus, reflecting existing findings that E. coli is a model bacteria for detecting AMR in wildlife. More than half of the isolates in this study were resistant to at least one antimicrobial agent and 10.3 percent were multidrug-resistant. The highest resistance was observed toward tetracycline at 12.2 percent. [Research in Veterinary Science]
Assessing vaccination strategies to prevent mpox epidemics in New York City
An age-structure model simulating the first wave of mpox transmission from May to November 2022 found that prophylactic vaccination would be most effective at preventing new infections among high-risk individuals aged 35-45 years old. Two vaccination strategies were assessed in the model: 1) complete vaccination before the epidemic according to an age-based allocation strategy and 2) complete vaccination before the beginning of the epidemic according to the results of a sensitivity analysis. Compared to the city’s current vaccination program, these strategies would reduce the number of new mpox infections in New York City by 94.2 and 96 percent, respectively. [BMC Infectious Diseases]
Image from Shutterstock