November 28, 2022
Assessment of Kenya’s antimicrobial resistance control plan
One Health Trust researchers collaborated with the World Health Organization to assess progress in implementing national antimicrobial resistance (AMR) strategies in Kenya. Kenya has laid a solid foundation for combating AMR with the establishment of a national surveillance network for AMR in human health representing a critical development. However, additional financial and human resources are needed to accelerate this progress and alleviate heavy reliance on foreign donor assistance, which is not sustainable in the long term. [WHO]
Antibiotic-resistant genes are abundant in agricultural soil.
Despite being a severe threat to human health, the occurrence of antibiotic resistance genes or ARGs in soil and their interactions with ecological factors, such as climate and land use, are poorly understood globally. An OHT-affiliated researcher and collaborators analyzed 1,088 metagenomic soil samples globally and generated a map of the 558 ARGs identified from these samples. The abundance of ARGs in agricultural habitats was higher than that in non-agricultural habitats. Clinical pathogens and gut microorganisms, which mediated the control of climatic and anthropogenic factors for ARGs, carried most of the soil ARGs. [ScienceAdvances]
Advocacy and access to care are needed to support refugees and asylum seekers.
The number of people forcibly displaced from their country of origin is rising, and so is the need to support these vulnerable populations. Support should extend beyond acute situations and consider socioeconomic and political factors’ impact on health, not only signs and symptoms of illness. This support not only reduces the burden of health inequalities but also lays the foundations for future generations. In this context, healthcare providers and policymakers can access the Handbook of Refugee Health as a reference in promoting the well-being of this growing social group. [PLOS Global Public Health Blog]
Some scientists cite safety concerns over the roll-out of a new dengue vaccine.
A new dengue vaccine called Qdenga is set to roll out in Indonesia in 2023. It is the first vaccine developed for those who have not been exposed to dengue. Some scientists argue against its roll-out, citing concerns that the vaccine may induce antibody-dependent enhancement (ADE) in people who have not been previously infected. In other words, vaccination could induce antibody responses which make a subsequent dengue infection worse. Research shows that an older vaccine, Dengvaxia, almost doubled the risk of hospitalization from dengue among children with ADE suspected to contribute to the disease severity. [Nature]
Preliminary findings indicate that phage therapy could effectively treat bacterial infections.
A meta-analysis of 32 studies assessing the efficacy of phage therapy in treating bacterial infections in animal models, demonstrated a significantly lower risk of mortality for mice or rats treated for systemic infections with phages. In seven studies that evaluated the effectiveness of phage therapy for the treatment of skin or burn infections caused by Staphylococcus aureus, phage therapy was associated with a significantly lower bacterial load in the skin compared with the placebo. While these findings indicate that phage therapy is highly effective at reducing mortality and tissue bacterial burdens in animal models, the authors emphasize caution regarding the interpretation due to the small number of studies eligible for inclusion in the meta-analysis. [The Lancet Microbe]
Childhood vaccination coverage in Italy is inversely correlated with AMR proportions.
The added value of vaccines in addressing AMR is known; however, few studies have quantified this impact. Using data on AMR proportions and vaccination coverage in children from 2000 to 2020, researchers in Italy demonstrated that vaccination coverage for pertussis, polio, diphtheria, and tetanus vaccines was inversely correlated with the proportions of resistant bacterial strains. Hib, MMR, and Varicella vaccinations had less significant correlations with AMR proportions. While the study falls short of establishing a causal relationship between vaccination and AMR, the findings suggest that the proportion of resistant pathogens can be reduced by increasing childhood vaccination coverage. [Antimicrobial Resistance & Infection Control]
The majority of Japanese patients would accept a placebo over an antibiotic prescription.
Researchers conducted a questionnaire-based study with 1,000 Japanese residents on January 15-17, 2019, to assess Japanese patients’ acceptance of a placebo substitute for unnecessary antibiotics, as it has been previously shown that patients in Japan frequently demand antibiotic prescriptions for treatments that do not require such medications. Overall, nearly 90 percent of the participants were willing to accept ethical placebos over antibiotics. While placebos may work to reduce the number of unnecessary antibiotic prescriptions, additional ethical investigations are needed before implementing this approach in clinical practice. [Journal of Pharmaceutical Policy and Practice]
Infection prevention and control measures for tuberculosis in South Africa are not effectively implemented.
An ethnographic study was conducted to analyze compromised tuberculosis (TB)-related infection prevention and control (IPC) in six primary care clinics in KwaZulu-Natal, South Africa, and describe environments that enable TB-IPC. Clinic employees reported mismatches between TB-IPC goals set by district governments and their implementation in clinics, often due to human resource or organizational constraints. In some cases, clinic spaces that were designated for one function but were used for another increased the risk of TB transmission. Mask-wearing by clinic staff working with TB patients was reported to be an individual decision rather than a normalized group behavior. The researchers emphasized the importance of empowering clinic staff and developing a shared set of beliefs around IPC to effectively implement practices to reduce TB transmission in South African health clinics. [PLOS Global Public Health]
Water, sanitation, and hygiene interventions had mixed results in schools in the Philippines.
Scientists conducted a cluster-randomized controlled trial to assess the impacts of school water, sanitation, and hygiene (WaSH) interventions on children’s health — including malnutrition, dehydration, health literacy (HL), and handwashing (HW) — in Metro Manila, Philippines, where WaSH-related diseases are endemic. Following interventions such as providing health education and hygiene supplies, the researchers performed surveys to compare with baseline survey results. The interventions had no effect on the children’s mean knowledge about HL, HW, or germs. High-intensity health education reduced severe dehydration; however, malnutrition status did not change from baseline. The researchers hypothesize that disparate communication skills among research assistants responsible for implementing the intervention across the schools may have contributed to the mixed results of the study. [BMC Public Health]
Researchers explore practices in the wild meat trade chain that may risk zoonotic spillover.
More than half of the households in Yangambi, in the Democratic Republic of the Congo (DRC) consume wild meat more than once a week. Researchers conducted an ethnographic study to examine the practices at all levels of the trade chain that may allow for zoonotic spillover in the area using observational and interview data collected between February 2018 and October 2021. The frequency of contact with wild meat and bodily fluids was highest at the level of hunters and market traders, with hunters being more exposed to fresh meat. Exposure to fresh meat decreased along the trade chain, and consumers in urban areas were rarely exposed to body fluids from wild animals. Access to electricity and running water were the main limiting factors to reducing food contamination. [Human Ecology]
Image from Canva.