{"id":25496,"date":"2024-05-16T04:15:00","date_gmt":"2024-05-15T20:15:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25496"},"modified":"2024-05-16T05:58:33","modified_gmt":"2024-05-15T21:58:33","slug":"lancet-glob-health%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9awho%e9%9d%9e%e6%b4%b2%e5%8c%ba%e5%9f%9f2019%e5%b9%b4%e7%bb%86%e8%8f%8c%e8%80%90%e8%8d%af%e8%b4%9f%e6%8b%85","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25496","title":{"rendered":"[Lancet Glob Health\u53d1\u8868\u8bba\u6587]\uff1aWHO\u975e\u6d32\u533a\u57df2019\u5e74\u7ec6\u83cc\u8010\u836f\u8d1f\u62c5"},"content":{"rendered":"\n

ARTICLES|\u00a0VOLUME 12, ISSUE 2<\/a>,\u00a0E201-E216,\u00a0FEBRUARY 2024<\/p>\n\n\n\n

The burden of bacterial antimicrobial resistance in the WHO African region in 2019: a cross-country systematic analysis<\/h1>\n\n\n\n

Antimicrobial Resistance Collaborators<\/h3>\n\n\n\n

Lancet Glob Health 2024; 12: E201-E216 Published: December 19, 2023 DOI:https:\/\/doi.org\/10.1016\/S2214-109X(23)00539-9<\/a><\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

A critical and persistent challenge to global health and modern health care is the threat of antimicrobial resistance (AMR). Previous studies have reported a disproportionate burden of AMR in low-income and middle-income countries, but there remains an urgent need for more in-depth analyses across Africa. This study presents one of the most comprehensive sets of regional and country-level estimates of bacterial AMR burden in the WHO African region to date.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen\u2013drug combinations for countries in the WHO African region in 2019. Our methodological approach consisted of five broad components: the number of deaths in which infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antimicrobial drug of interest, and the excess risk of mortality (or duration of an infection) associated with this resistance. These components were then used to estimate the disease burden by using two counterfactual scenarios: deaths attributable to AMR (considering an alternative scenario where infections with resistant pathogens are replaced with susceptible ones) and deaths associated with AMR (considering an alternative scenario where drug-resistant infections would not occur at all). We obtained data from research hospitals, surveillance networks, and infection databases maintained by private laboratories and medical technology companies. We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

In the WHO African region in 2019, there were an estimated 1\u00b705 million deaths (95% UI 829\u2009000\u20131\u2009316\u2009000) associated with bacterial AMR and 250\u2009000 deaths (192\u2009000\u2013325\u2009000) attributable to bacterial AMR. The largest fatal AMR burden was attributed to lower respiratory and thorax infections (119\u2009000 deaths [92\u2009000\u2013151\u2009000], or 48% of all estimated bacterial pathogen AMR deaths), bloodstream infections (56\u2009000 deaths [37\u2009000\u201382\u2009000], or 22%), intra-abdominal infections (26\u2009000 deaths [17\u2009000\u201339\u2009000], or 10%), and tuberculosis (18\u2009000 deaths [3850\u201339\u2009000], or 7%). Seven leading pathogens were collectively responsible for 821\u2009000 deaths (636\u2009000\u20131\u2009051\u2009000) associated with resistance in this region, with four pathogens exceeding 100\u2009000 deaths each:\u00a0Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli<\/em>, and\u00a0Staphylococcus aureus<\/em>. Third-generation cephalosporin-resistant\u00a0K pneumoniae<\/em>\u00a0and meticillin-resistant\u00a0S aureus<\/em>\u00a0were shown to be the leading pathogen\u2013drug combinations in 25 and 16 countries, respectively (53% and 34% of the whole region, comprising 47 countries) for deaths attributable to AMR.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

This study reveals a high level of AMR burden for several bacterial pathogens and pathogen\u2013drug combinations in the WHO African region. The high mortality rates associated with these pathogens demonstrate an urgent need to address the burden of AMR in Africa. These estimates also show that quality and access to health care and safe water and sanitation are correlated with AMR mortality, with a higher fatal burden found in lower resource settings. Our cross-country analyses within this region can help local governments to leverage domestic and global funding to create stewardship policies that target the leading pathogen\u2013drug combinations.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.<\/p>\n","protected":false},"excerpt":{"rendered":"

ARTICLES|\u00a0VOLUME 12, ISSUE 2,\u00a0E201-E216,\u00a0FEBRUARY 2024 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25496"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25496"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25496\/revisions"}],"predecessor-version":[{"id":26008,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25496\/revisions\/26008"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25496"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25496"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}