February 21, 2022
Burkina Faso faces challenges in combating AMR. Researchers from CDDEP and the World Health Organization (WHO) synthesized a policy brief analyzing Burkina Faso’s multisectoral national strategic plan to fight antimicrobial resistance. Burkina Faso has taken major strides in developing a multisectoral and One Health-based approach to reduce the AMR burden, including the development of national surveillance guides in healthcare settings and collection of AMR data in sentinel surveillance sites. However, the government’s appropriation of the National Action Plan (NAP) on AMR remains weak and this represents a significant barrier for its implementation. [WHO]
The Drug Resistance Index (DRI) can help track antibiotic effectiveness over time. In an observational study, researchers from CDDEP and other international institutions explored the antibiotic susceptibility of Gram-negative bacteria and their antibiotic prescribing rates at a tertiary care facility in Jeddah, Saudi Arabia. The impact of new antibiotic restrictions on antibiotic effectiveness in the ICU was determined by calculating the DRI (a measure efficacy through assessment of the ability of antibiotics to treat infections with the extent of their use in clinical practice) for the four most common Gram-negative pathogens and eight commonly used antibiotic classes. Acinetobacter baumannii and Klebsiella pneumoniae had the highest DRIs (conveying poorer efficacy) across the hospital, with notably higher DRIs for carbapenems and antipseudomonal penicillins + beta-lactamase inhibitors. Pre-restrictions, the ICU’s DRI was higher than the rest of the hospital, but post-restrictions, the DRI for carbapenems dropped significantly. [Cureus]
The global adoption of a One Health approach cannot wait. Researchers analyzed documents published by the WHO, before and after the start of the COVID-19 pandemic, to dissect the close relationship between emerging lifestyles and increased health threats. While the One Health approach has been recognized as vital for more than 30 years, inadequate local and world health policies haven’t translated into concrete actions for its application, exacerbating global health threats such as the COVID-19 pandemic. One Health should become the mainstream approach in public health, supported by interdisciplinary research, intersectoral policies, and effective health and development governance at all levels of decision-making. [IOS]
People treated with CAR-T-cell cancer therapies remain in remission after 12 years. CAR-T-cell therapies require removing immune cells from a person with cancer and genetically altering them so that they produce proteins that recognize cancer cells. The cells are reinfused into the person, anticipating that they will find and destroy tumors. Because the therapy is expensive, risky, technically demanding, and often unsuccessful, it remains a last resort, utilized when all other treatments fail. However, the long-term success of the treatment in many cases gives researchers hope, and projects applying CAR-T-cell approaches to treat solid tumors and destroy scar tissue in the heart are underway. [Nature News]
COVID-19 causes fewer complications than Influenza except among specific demographics. In a retrospective cohort study, researchers used claims data to identify patients who are more vulnerable to complications from COVID-19 and the number and types of complications experienced. When compared to similar data from influenza patients, fewer COVID-19 patients had one or more complications after their diagnosis (19.1% vs. 28.5%). However, COVID-19 patients were at higher risk of hair loss, heart failure, mood disorder, and dementia than influenza patients. Although the complication rate of COVID-19 is relatively low, its high fatality rate is concerning. However, with vaccinations, COVID-19 management strategies can resemble those of influenza. [CDC]
Researchers developed an app to predict viral diarrhea in children. Diarrheal illness is a leading cause of antibiotic use for children in low- and middle-income countries. Determining diarrhea etiology without reliance on laboratory testing could reduce inappropriate antibiotic use. Researchers developed a mobile software application (app) to predict viral-only etiology of acute diarrhea in children in Bangladesh and Mali. The app was developed using a model consisting of patient-specific clinical variables (like age, blood in stool, and other factors); location-specific viral diarrhea seasonality curves; and other external data sources (like location-specific climate and recent patient data). The app was proven to accurately identify children with a high likelihood of viral-only diarrhea etiology. [eLife]
About half of 18-30-year-olds intentionally exposed to low doses of SARS-CoV-2 were infected. In a study assessing COVID-19 transmission, 34 individuals volunteered to receive low viral doses, comparable to a single droplet of nasal fluid. Participants who developed COVID-19 reported mild-to-moderate symptoms including sore throats, runny noses, and anosmia/parosmia, with symptoms appearing two days post-exposure, though some were asymptomatic. Around 70% lost senses of smell or taste to varying degrees, persisting for 6-9 months in 18%. Rapid viral replication persisted for an average of nine days, with comparable amounts of virus in both asymptomatic and symptomatic individuals and infections of the same duration. [Nature News]
Gut microbial populations may be related to cognitive aging in midlife. A cross-sectional study sequenced stool samples from 597 individuals (aged 48-66), exploring taxonomy, β-diversity (between-person), and α-diversity defined by genera count, richness, and evenness. 107 genera were identified post-filtering, with nine (including six from the Clostridia class), associated with more than one cognitive test. Microbial composition was associated with domain-specific and global measures of cognition, with Barnesiella, Lachnospiraceae, and Akkermansia positively associated with cognitive function, and Sutterella associated negatively. Once longitudinal data confirms that gut microbial changes precede cognitive aging, gut microbiota can be modified, potentially reducing future risks of cognitive decline. [JAMA]
A multidisciplinary, holistic approach is essential for treatment of long covid. As multiple symptoms are very common, it is unlikely that addressing a single organ or using a single treatment will help resolve long covid. This condition, which occurs in both adults and children following SARS-CoV-2 infection, involves at least one persisting physical symptom for at least 12 weeks. Fatigue, breathlessness, and headache are among the most common symptoms. These and other issues, including cognitive fog, dizziness, anxiety, and depression, may continue or develop even after testing negative for COVID-19, fluctuate or relapse over time, and impact everyday functioning. [BMJ]
Despite facing COVID-19 vaccine inequity, Bangladesh has administered at least one vaccine dose to 50% of its population. The country has procured vaccines from various manufacturers, and COVAX vaccine roll-out is notably, the second highest among Southeast Asian countries. Bangladesh is also working to become self-reliant, developing its own mRNA-based vaccine, producing the Chinese Sinopharm vaccine in-country, and participating in the nasal COVID-19 vaccine clinical trial. Bangladesh’s local vaccine research and production capacity, alongside a focus on hosting clinical trials, including heterologous booster trials, can help give long-term protection to the country’s population and prevent future variants of concern. [The Lancet Infectious Diseases]
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