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Africa most affected by growing TB, malaria drug resistance, says WHO


Life Cycle of Malaria parasite

Life Cycle of Malaria parasite

AFRICAN countries are the most affected by the growing global drug resistance to malaria and tuberculosis (TB), a situation, which is compounded by incomplete data due to lack of information and poor quality medicines.

This is the verdict of a new World Health Organisation (WHO) survey published over the weekend.

The new report is titled: “Worldwide country situation analysis: Response to antimicrobial resistance.”

The survey also found that most countries do not yet have a comprehensive national plan to tackle drug resistance – a year after the organisation warned that the world is heading toward a “post-antibiotic era.”

The WHO revealed that only 34 of 133 countries that participated in the survey have composed a plan to address the increasing problem of bacterial resistance to antibiotics and other drugs.

Highlight on the WHO African region reads: “Eight out of 47 Member States in the region participated in the survey. The data in this region are incomplete due to lack of information, however, the results suggest that antimicrobial resistance is a growing problem.

“All eight countries in the region that responded state that resistance to treatments for malaria and TB are their greatest challenges. Poor-quality medicines are a general problem, further contributing to the challenge.”

The eight African countries that participated in the survey include: Burkina Faso, Central African Republic, Gambia, Ghana, South Sudan, United Republic of Tanzania, Uganda, and Zambia.

Drug resistance, also referred to as antimicrobial resistance, is when microorganisms – such as bacteria and viruses – evolve and develop the ability to prevent antimicrobial medications, such as antibiotics and antivirals, from killing them.

Other key findings of the report include:
* Monitoring is key for controlling antibiotic resistance, but it is infrequent. In many countries, poor laboratory capacity, infrastructure and data management are preventing effective surveillance, which can reveal patterns of resistance and identify trends and outbreaks.

* Sales of antibiotics and other antimicrobial medicines without prescription remain widespread, with many countries lacking standard treatment guidelines, increasing the potential for overuse of antimicrobial medicines by the public and medical professionals.

* Public awareness of the issue is low in all regions, with many people still believing that antibiotics are effective against viral infections.

* Lack of programmes to prevent and control hospital-acquired infections remains a major problem.

Issued a year after WHO’s first report on the extent of antimicrobial resistance globally, which warned of a ‘post-antibiotic era’, this survey—which was completed by 133 countries in 2013 and 2014—is the first to capture governments’ own assessments of their response to resistance to antimicrobial medicines used to treat conditions such as bloodstream infections, pneumonia, TB, malaria and Human Immuno-deficiency Virus (HIV). It summarises current practices and structures aimed to address the issue, and shows there are significant areas for improvement.

Assistant director-general for health security at WHO, Dr. Keiji Fukuda, said: “This is the single greatest challenge in infectious diseases today. All types of microbes – including many viruses and parasites – are becoming resistant to medicines. Of particularly urgent concern is the development of bacteria that are progressively less treatable by available antibiotics.”

Meanwhile, children born to mothers experiencing economic hardship, who were also exposed during pregnancy to high levels of PAH (polycyclic aromatic hydrocarbons), scored significantly lower on IQ tests at age five compared with children born to mothers with greater economic security and less exposure to the pollutants.

The findings by researchers at the Columbia Center for Children’s Environmental Health (CCCEH) at the Mailman School of Public Health appear in the journal Neurotoxicology and Teratology.

PAH are ubiquitous in the environment from emissions from motor vehicles, oil, and coal-burning for home heating and power generation, tobacco smoke, and other combustion sources.

The researchers followed 276 mother-child pairs, a subset of CCCEH’s ongoing urban birth cohort study in New York City, from pregnancy through early childhood. Mothers self-reported maternal material hardship during pregnancy and at multiple time points through early childhood. Material hardship is a measure used to assess an individual’s unmet basic needs with regard to food, clothing, and housing. The Columbia researchers, led by Frederica Perera, PhD, DrPH, director of CCCEH, previously reported that that prenatal exposure to airborne PAH during gestation was associated with development delay at age three, reduced verbal and full scale IQ at age five, and symptoms of anxiety and depression at age seven.

At child age seven years, researchers used the Wechsler Intelligence Scale for Children to assess IQ. PAH-DNA adducts in cord blood provided an individual measure of prenatal exposure to the pollutants. The researchers observed that, among children whose mothers reported greater material hardship, the group with high levels of PAH-DNA cord adducts significantly scored lower on tests of full scale IQ, perceptual reasoning, and working memory compared to those children with lower levels of adducts.

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