June 10, 2016
A weekly roundup of news on drug resistance and other topics in global health.
Incentives to stimulate antibiotic innovation: DRIVE-AB (Driving reinvestment in research and development and responsible antibiotic use) held a conference on June 2 to release its preliminary findings. The coalition reported that in addition to promoting sustainable antibiotic use and ensuring access to drugs for those who need them, a variety of new incentives are needed to stimulate each step of the antibiotic innovation process. Possible incentives included rewards for market entry of newly approved drugs, a model that charges lower prices for drugs in the case of appropriate de-escalation of antibiotic therapy, a nonprofit antibiotic development organization and grants for early steps of research and development. The event was attended by more than 180 high-level policymakers, decision-makers, researchers, economists and public health experts, including CDDEP staff. A summary of the event, “Stimulating innovation: sustainable use and global access to antibiotics” and a report of preliminary findings are available on the DRIVE-AB website. [DRIVE-AB, DRIVE-AB]
As Brazil enters winter months, the risk of a Zika outbreak at the Rio Olympic Games is “near zero,” according to a news article in BMJ. The chief medical officer for the Olympic Games, João Grangeiro, said “Zika numbers started declining rapidly in April. The cooler and drier weather will reduce mosquito populations, lowering the risk of mosquito-borne infections.” A model created by Cambridge University press estimated that only one or two tourists would likely become infected with Zika during the Games. Several Olympic athletes have expressed concerns about Zika, and a few have elected to not participate for fear of contracting the virus. [BMJ, BBC]
More than 75 percent of antibiotic prescriptions for sexually-transmitted infections in the emergency department may be unnecessary, according to researchers at St. John Hospital and Medical Center in Detroit. The researchers examined records of more than 1100 individuals who were tested for an STI in the emergency department, and found that 40 percent of those tested were given an antibiotic for either chlamydia or gonorrhea. Of the patients given an antibiotic, 77 percent did not have either infection, according to test results. That doesn’t mean bad practice in all cases, as patients with serious symptoms are often treated before the test results are available. But it does suggest that better ways are needed to identify the right patients before the results are in. “There is a tricky balance between not furthering antibiotic resistance by over-prescribing, but also still getting people treatment for STDs they might have,”
according to Karen Jones, MPH, BSN, RN, infection preventionist at the study site. The findings will be presented this weekend at the annual conference of the Association of Professionals in Infection Control and Epidemiology (APIC). [CIDRAP, APIC]
One-third of children in low- and middle-income countries fail to reach mental development milestones. Researchers at the Harvard T. H. Chan School of Public Health used data from USAID and UNICEF on over 99,000 three- and four-year-olds in 35 LMICs to calculate the proportion of children with low cognitive and/or socioemotional development. The study is unusual in using direct evidence and not proxies, such as poverty or physical growth. Their findings, published in PLOS Medicine, estimate that nearly 81 million three- and four-year-olds worldwide did not meet established mental development milestones, such as following simiple directions, inhibiting aggressive behaviors, getting along with other children, and ability to maintain attention. [Reuters, PLOS Medicine]
WHO will consider recommending a plan to stretch yellow fever vaccine supplies by using just one-fifth of the standard dose. For the first time during the current outbreak, which began in Angola, local transmission of yellow fever was reported in the Democratic Republic of the Congo. Health officials are concerned that if local transmission reaches the capital, Kinshasa, the vaccine supply could run out before everyone can be vaccinated. Limited scientific evidence suggests that the lower dose does protect adults from the virus. [Reuters]
“Tackling Antimicrobial Resistance in Developing Countries: The Role of Aid and International Agencies.” Jim O’Neill, chair of the U.K. government-sponsored Review on AMR, and Lawrence Kerr, Director of Pandemics and Emerging Threats at the U.S. Department of Health and Human Services, told a gathering at the Center for Global Development in Washington, D.C. that in order to effectively fight the threat of antimicrobial resistance, countries across the world must come together in a global coalition to raise awareness of the issue, reduce antibiotic use, improve surveillance and develop new rapid diagnostics for resistant infections, amongst other strategies. Video of the event, which focused on findings from the final report, is available online. [Center for Global Development]
Vaccinating pregnant women against the flu can decrease an infant’s likelihood of contracting flu in the first four months of life by 70 percent, according to results of a randomized trial that included more than 4000 pregnant women in Bamako, Mali, published in The Lancet Infectious Diseases. Flu vaccine is not recommended for infants under six months old, so vaccinating the mother is an important prevention strategy. The researchers stated that the study was the largest to date to show that the influenza vaccine for pregnant women is feasible and effective for both mother and infant. [The Lancet Infectious Diseases, University of Maryland School of Medicine]
Just two confirmed cases of Guinea worm disease have been reported worldwide this year—down from 3 million in 1983. Guinea worm is a parasite that is contracted from contaminated drinking water and though nonfatal, has no cure and is painful to remove. Eradication of the disease has long been the goal of former U.S. President Jimmy Carter, whose nonprofit Carter Center has made Guinea worm elimination a goal since 1986. The progress made containing the disease is remarkable because much of it involved behavioral change through educating communities about how to avoid contaminated water, rather than a technological fix. [NPR, Carter Center]
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