May 05, 2019
Antimicrobial resistance threatens human, animal, and planetary health. CDDEP researchers Jyoti Joshi and Isabel Frost, writing in the Quint Fit, note that 5.7 million people die every year due to antibiotic-treatable diseases and barriers to access to essential antibiotics persist in low- and middle- income countries. However, the global threat of antimicrobial resistance will also impede access in the long term if it is not addressed. The impact of increasing antimicrobial resistance is not limited to human health – antimicrobials are needed to protect the systems that feed the planet, in the raising of livestock and in agriculture. To conserve access to essential antibiotics, leaders from multiple sectors including human health, agriculture, and environmental health must come together to identify country-specific strategies to address this global crisis. [The Quint Fit, CDDEP]
Mass drug administration successfully controls scabies and impetigo in the Solomon Islands. To assess the safety and feasibility of a mass drug administration of oral ivermectin and azithromycin for the control of scabies and impetigo, researchers conducted a community intervention trial in Choiseul Province, Solomon Islands. Ivermectin and azithromycin were offered to the entire population of Choiseul Province, and prevalence rates of scabies and impetigo were compared between baseline and 12 months post-drug administration. There was an 88 percent relative reduction in scabies and a 74 percent relative reduction in impetigo. Findings indicate that mass drug administrations could have high efficacy in certain populations over 25,000. [The Lancet Infectious Diseases]
Long-term antibiotic exposure in older women associated with increased CVD risk. Previous studies have suggested that long-term alterations to the gut microbiome may be associated with cardiovascular disease (CVD) risk. To determine the association between duration of antibiotic use at various stages in adulthood and CVD risk in women, researchers analyzed questionnaire responses from the Women’s Health Study between 2004-2012. Results found that women with at least 2 months of antibiotic exposure in late adulthood (age 60 and older) had a significantly increased risk of cardiovascular disease compared to those who did not take antibiotics (HR:1.32). [European Heart Journal]
Patient privacy curtains a potential source of transmission for MDROs. Research presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) last month notes patient privacy curtains as a potential source of transmission for multidrug-resistant organisms (MDROs). Researchers sampled patients and high-touch surfaces in six nursing facilities in southeast Michigan. Results found 22 percent of privacy curtains were contaminated with MDROs, and 15.7 percent of samples identified the same MDRO colonized on the patient as well as their respective privacy curtain. Findings highlight the need for improved cleaning procedures of high-touch hospital surfaces. [ECCMID, Healio]
US sees highest number of measles cases since elimination in 2000. The Centers for Disease Control and Prevention (CDC) reported last week a total of 695 measles cases, which is the largest number of cases the United States has seen since measles was eliminated from the country in 2000. The CDC notes decreased vaccination rates are a significant driver in the ongoing measles outbreaks. [CDC]
Point-of-care tests to reduce the burden of STIs in resource-limited settings. The women’s improvement of sexual and reproductive health (WISH) study compared the diagnostic accuracy of sexually transmitted infections (STIs) using WISH point-of-care tests and WHO-recommended syndromic algorithms to gold-standard STI testing in Kigali, Rwanda. Researchers found that compared to gold-standard testing, WISH algorithms identified similar prevalence rates of Chlamydia trachomatis, Neisseria gonorrhea, and Trichomonas vaginalis infections, but higher rates of bacterial vaginosis and vulvovaginal candidiasis infections. The WISH algorithm had high sensitivity and specificity for a majority of STIs compared to gold-standard testing, while the WHO-recommended algorithm had moderate sensitivity and poor specificity for all of the infections. Targeted point-of-care testing could eventually be a feasible option for diagnosing and managing STIs in resource-poor settings. [The Lancet Infectious Diseases]
Cost-effectiveness of immunization programs in LMICs. As low- and middle-income countries grow economically, they lose international support for public health programs and must decide to either self-finance the program or discontinue it. Researchers modeled the health and economic impacts of continuing use of the pneumococcal conjugate vaccine (PCV) at full cost in Kenya, compared to discontinuing the vaccine program entirely following the transition from Gavi support in 2022. Although PCV continuation is estimated to cost Kenya $15.8 million USD more than discontinuation, the vaccine program is necessary to prevent 4,329 deaths and 101,513 diseases from pneumococcal infections per year in 2032. Continuation of the PCV immunization program is cost-effective and necessary to produce continued health gains in Kenya. [The Lancet Global Health]
Factors associated with childhood vaccination coverage in rural India. A cross-sectional household survey of 643 children in Vellore, southern India on the factors associated with childhood vaccination uptake found no sociodemographic differences associated with childhood vaccine status. However, parents’ familiarity with the vaccination schedule and pregnant women’s access to vaccine recommendation information during antenatal visits were both significantly associated with the vaccination status of their children (aPOR= 2.06 and 2.16, respectively). [Vaccine]
Zika transmission in India. An observational study of Zika virus in Thailand suggests that the disease has been circulating throughout the country since 2002 with the potential for epidemic transmission to neighboring countries. These findings raise concerns in India, where 2018 Zika outbreaks resulted in 159 cases in Rajasthan and 127 in Madhya Pradesh. India’s climate, distribution of mosquito species, large population, and high poverty levels mirror those of Thailand and Zika infected countries in South America, creating an optimal environment for uncontrolled Zika transmission. Research is needed to address the potential risk of a Zika outbreak in India. [The Lancet Infectious Diseases]
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