Malnutrition and Drug-Resistant Infections

Malnutrition is a global health emergency that exacerbates other global health crises like antimicrobial resistance, especially in low-income countries. Antimicrobial resistance, or AMR, happens when bacteria, viruses, fungi, and parasites become resistant to the drugs we use to treat the infections they cause. This means that illnesses last longer, treatment costs more, and more people die as a result. As a nutrition and dietetics major at Jomo Kenyatta University of Agriculture and Technology in Kenya, I am passionate about showing the connection between drug-resistant infections and malnutrition to communities in Kenya and across the world. Last year, I was fortunate enough to be selected for the Students Against Superbugs Africa: AMR Ambassadors Program for Young People in Africa, which gave me the opportunity to learn more about AMR and how it relates to our diets and access to safe, enough, and nutrient-rich food.

Before joining the program, my understanding of AMR was limited to resistance to tuberculosis and human immuno-deficiency virus medication which I came across in my clinical and community work. However, through personal research and the program, I learned that AMR is a complex issue connected to every aspect of health. I discovered that diet; nutritional status; livestock and agriculture practices; and food production, preparation, and storage could contribute to the emergence and spread of AMR.

Nutrition is crucial for promoting immune function and preventing infections, which can help reduce the need to use medicine in the first place. People need nutrient-rich food to fight infections; when malnourished, they are more likely to have frequent, severe, and longer bouts of infections. Infections aggravated by malnutrition augment the need for antimicrobial use, potentially contributing to AMR.

As a clinical nutrition intern, I had the opportunity to work in the pediatric inpatient unit, where I met an infant named AJ*. AJ, at just one and a half years old, was admitted with a challenging combination of gastroenteritis, severe pneumonia, and severe acute malnutrition. It became apparent that AJ had a history of poor nutrition, having been introduced to solid foods at only four months and weaned off breastfeeding at five months. AJ’s weight-for-age had steadily declined well below the normal range, indicative of severe acute malnutrition. Unfortunately, AJ’s parents had stopped regular appointments for growth monitoring when AJ reached nine months, delaying early identification and intervention until AJ was battling many conditions at once.

Despite the efforts of the medical team, the initial antibiotics used to treat AJ’s pneumonia proved ineffective. By the third day of admission, AJ’s condition deteriorated rapidly. Tragically, the rural public hospital where AJ was being treated did not have the required antibiotics in stock, and the family lacked the means to transfer AJ to a private or city hospital for immediate treatment. This dire situation resulted in the devastating loss of AJ’s life.

AJ’s heartbreaking story is a poignant reminder of the escalating global crisis of resistant infections and the profound impact of malnutrition and a lack of access to enough nutrient-rich food on people’s health. In a crisis situation, there is no time to wait, and access to the right antibiotics can save lives.

(*Names changed to maintain anonymity.)

Image from Shutterstock

Edited by Samantha Serrano