October 31, 2022
OHT launches a blueprint for a national oxygen grid in India
The One Health Trust, with support from USAID, the Bill & Melinda Gates Foundation, and Swasth Alliance, launched a report exploring the concept of a national medical oxygen grid (NOG) to supply high-quality medical oxygen across the country and respond to public health needs as such as those experienced during the second wave of the COVID-19 pandemic in India. Beyond emergency preparedness, an NOG can provide vital help in the management of childhood illnesses such as pneumonia. While the evidence used in the report is primarily from India, the recommendations can apply to all low- and middle-income countries working to strengthen their health systems and increase access to medical oxygen. [The Hindu]
Staphylococcus aureus and MRSA are prevalent in fresh and processed fish in India.
Researchers analyzed fish collected from a fish market and a fish processing plant in the Indian state of Gujarat between 2012 and 2017 and screened them for the presence of S. aureus and MRSA (Methicillin-resistant Staphylococcus aureus). Out of the 498 fish samples, 14 and 3 percent tested positive for S. aureus and MRSA, respectively. Fresh and processed fish had a higher prevalence than chilled, frozen, water, and ice samples. Since marine water is devoid of S. aureus, the researchers theorize that the fish were contaminated by infected handlers, improper hygiene practices, or poor sanitary utensils. [BMC Microbiology]
Antibiotic resistance in Gram-negative bacteria in Iran has increased since the start of the COVID-19 pandemic.
Antibiotic resistance patterns in E. coli, P. aeruginosa, K. pneumoniae, and A. baumannii were determined through analysis of 1,672 clinical samples collected from patients hospitalized in northeast Iran between January 2020 and January 2022. E. coli isolated were highly resistant to ampicillin (89.6%), cefazolin (74.0%), and cefepime (71.4%). Overall, the findings suggested an increase in antibiotic resistance among these bacterial species since January 2020. [Antimicrobial Resistance & Infection Control]
Self-medication and antimalarial drug resistance is prevalent in the Democratic Republic of the Congo.
Researchers conducted a scoping review of 40 studies published between 2003 and 2022 evaluating self-medication with antimalarial agents and antimalarial drug resistance in the Democratic Republic of the Congo (DRC), a country that carries ten percent of the world’s malaria burden. Many of the studies demonstrated a relationship between self-medicating and accepting inappropriate treatments for malaria. One study in particular showed that a lack of pharmaceutical regulation in a town in eastern DRC resulted in a high incidence of self-medication with antimalarial drugs and emerging resistance in the Plasmodium falciparum parasite. The findings highlight the need for tighter regulations of the DRC’s pharmaceutical sector and establishment of a standardized antimalarial regimen in healthcare facilities and pharmacies. [Tropical Medicine and Health]
Routine adult vaccination is associated with older age but is inversely correlated with ethnicity and vaccine hesitancy.
A systematic review of 61 articles revealed that older age and insurance coverage were both positively correlated with greater vaccine uptake globally. While gender was heavily explored in these studies, its relationship with vaccination was varied and unclear. Generally, immigrant and ethnic minority groups had lower vaccination rates, but this association was mixed depending on the specific minority group studied. Hesitancy towards vaccines was negatively associated with influenza vaccine uptake. Attitudinal factors were most consistently associated with vaccination rates, indicating that educational campaigns should aim to change public attitudes to expand vaccination coverage in older adult populations. [Human Vaccines & Immunotherapeutics]
US residents generally favor wastewater surveillance for community health monitoring despite its lack of health privacy regulation.
In this pioneering study, researchers evaluated the public’s perception and awareness of wastewater surveillance as a public health tool using an online survey. Respondents mainly endorsed wastewater surveillance to screen for diseases, environmental toxins, and terrorist threats, more so than for health and lifestyle behaviors such as smoking, mental illness, and healthy eating. Respondents had limited awareness of the role wastewater surveillance has played in monitoring COVID-19 infections throughout the pandemic. Two-thirds of respondents supported a lack of prohibition on the exact location of the monitoring, favoring wastewater surveillance in both individual households and public facilities. [PLOS One]
Antibiotic overprescription increases AMR rates in Vietnam, especially among children under the age of five.
Researchers conducted a retrospective study to assess patterns of outpatient antibiotic prescribing for acute respiratory infections (ARIs) in rural primary care facilities in northern Vietnam. Out of 193,010 outpatient visits included in the study, almost all resulted in an antibiotic prescription, of which over 90% consisted of Access antibiotics (narrow spectrum) according to the WHO AWaRe classification. Children under the age of five received the greatest proportion of Watch antibiotic prescriptions, which is concerning given that these broad-spectrum agents have been previously found to be ineffective against ARIs in children. Further training of prescribers and tighter regulations of antibiotic use are urgently needed to curb the increasing rates of AMR in the country. [The Lancet Regional Health]
Relaxed COVID-19 restrictions predicted to result in a greater 2022-23 influenza season.
Researchers anticipate a heavier than pre-pandemic 2022-2023 influenza season, given the recent relaxation of public health and social measures (PHSMs) that had kept influenza infection rates relatively low throughout the first two years of the pandemic. Simulation studies using data from eleven countries estimate that PHSMs reduced influenza transmission rates as much as 41%, depending on the location. Assuming that COVID-19 PHSMs remain relaxed in October 2022, the model suggests a rise in peak magnitude of influenza by anywhere from one- to five-fold, and an increase in epidemic size between one- and four-fold. [The Lancet Global Health]
Over half of preterm neonates in India and Pakistan died of non-infectious conditions.
A prospective cohort study, Project to Understand and Research Preterm Pregnancy Outcomes and Stillbirths (PURPOSe) in south Asia, investigated preterm newborn deaths in Davangere, India and Karachi, Pakistan. Preterm newborns who died within 28 days after birth were weighed and measured, while placentas and umbilical cords were analyzed through minimally invasive tissue sampling (MITS) to determine the cause of death. More than half of the neonatal deaths were attributed to non-infectious conditions, including intrauterine hypoxia and congenital malformations. Maternal hypertensive disease was the primary cause of nearly one-third of the neonatal deaths. [The Lancet Global Health]
Ongoing political conflict fuels the rise of non-communicable diseases in Libya.
Following decades of worsening political conflict and instability, World Bank health specialists and Libyan policymakers have collaborated to understand the current state of Libya’s health infrastructure and determine ways to strengthen its response to non-communicable diseases (NCDs). It is estimated that one-third of Libyan primary health facilities have been destroyed amidst fighting, and the absence of a governmental body capable of passing policies and imposing regulations is the country’s largest barrier in the fight against NCDs. Furthermore, the public’s perception of governmental inadequacy fosters a sense of mistrust and disappointment, perpetuating a positive feedback loop of civil unrest and instability. [BMJ Global Health]
Detection of type 2 poliovirus in London since February 2022 demonstrates the importance of wastewater surveillance.
Environmental surveillance, particularly of wastewater, has been implemented to monitor emerging poliovirus cases since early 2022. Countries that distribute the inactivated poliovirus vaccine can often have poliovirus circulating undetected over long periods of time, as this vaccine is less effective than the live-attenuated vaccine at inducing intestinal immunity and disrupting poliovirus transmission. Type 2 poliovirus isolates were found in 21 of 52 samples collected in London between February and July 2022. Geographic mapping of the identified isolates and their high genetic diversity indicates significant viral transmission in north and east London, signifying the first detection of poliovirus transmission in the UK since 1984. [The Lancet]
Image from Canva.