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What the Future Holds for Resistance in Developing Countries

  • Michael L. Bennish
  • Wasif Ali Khan
Chapter

Abstract

The challenge to controlling antimicrobial resistance in coming years is to put into practice recent policy and programmatic advances. Increasing attention to the problem of antimicrobial resistance, and how resistance in developing countries can affect industrialized countries, has led to increased attention to the problem of resistance in developing countries.

Efforts, however, have lagged behind good intentions. Inappropriate use of antimicrobials, thought to be the major driver of resistance, remains the norm rather than the exception in most of the developing world, as well as in many industrialized countries. Enhanced educational outreach to both consumers and health-care providers to change the pattern of antimicrobial use is crucial and methods to do this effectively have been developed. There is an urgent need for greater regulation of antimicrobial distribution and sale so that private shops staffed by untrained owners and employees are no longer a common source of antimicrobials. Greater management capacity is required to ensure adherence to regulations, to audit prescribing in both the public and the private sectors, and to control corrupt practices and the proliferation of counterfeit or sub-standard drugs. Implementing and sustaining resistance surveillance systems that will alert the medical and public health communities to changes in resistance is also crucial. Development and introduction of rapid techniques to determine infecting pathogens and their susceptibility should enhance both surveillance and care.

The substantial funding that is now flowing to targeted diseases – HIV and AIDS, tuberculosis, and malaria, all three of which have substantial problems with antimicrobial resistance – can in the coming years be both a boon (if funds are used to enhance infrastructure to manage all diseases of public health concern) and a detriment (if efforts remain narrowly focused on these diseases) to controlling resistance. Efforts to reduce disease burden – through health interventions such as immunizations and improved socioeconomic conditions – have the potential to have profound effects on the burden of resistance. Ultimately, control of resistance will depend on an integrated, multidimensional effort, the components of which can be implemented if the commitment, political will, and resources are made available.

Keywords

Antimicrobial Agent Antimicrobial Therapy Antimicrobial Resistance Resistance Pattern Private Practitioner 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Adeyi O., Chellaraj G., Goldstein E., Preker A. and Ringold D. 1997. Health status during the transition in Central and Eastern Europe: development in reverse? Health Policy Plan 12:132–145CrossRefPubMedGoogle Scholar
  2. Andre F. E., Booy R., Bock H. L., Clemens J., Datta S. K., John T. J., Lee B. W., Lolekha S., Peltola H., Ruff T. A., Santosham M. and Schmitt H. J. 2008. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ 86:140–146CrossRefPubMedGoogle Scholar
  3. Bennett D. E., Bertagnolio S., Sutherland D. and Gilks C. F. 2008. The World Health Organization’s global strategy for prevention and assessment of HIV drug resistance. Antivir Ther 13 Suppl 2:1–13PubMedGoogle Scholar
  4. Carter G. M., Newhouse J. P. and Relles D. A. 1990. How much change in the case mix index is DRG creep? J Health Econ 9:411–428CrossRefPubMedGoogle Scholar
  5. Cherian T. 2007. WHO expert consultation on serotype composition of pneumococcal conjugate vaccines for use in resource-poor developing countries, 26–27 October 2006, Geneva. Vaccine 25:6557–6564CrossRefPubMedGoogle Scholar
  6. Chetley A., Hardon A., Hodgkin C. and Haaland A. 2007 How to improve the use of medicines by consumers World Health Organization Geneva http://www.who.int/medicines/publications/WHO_PSM_PAR_2007.2.pdf Accessed August 22 2008
  7. Chowdhury E. K., El Arifeen S., Rahman M., Hoque D. E., Hossain M. A., Begum K., Siddik A., Begum N., Rahman Q. S., Akter T., Haque T. M., Al-Helal Z. M., Baqui A. H., Bryce J. and Black R. E. 2008. Care at first-level facilities for children with severe pneumonia in Bangladesh: a cohort study. Lancet 372:822–830Google Scholar
  8. Coenen S., Michiels B., Renard D., Denekens J. and Van Royen P. 2006. Antibiotic prescribing for acute cough: the effect of perceived patient demand. Br J Gen Pract 56:183–190PubMedGoogle Scholar
  9. Dong L., Yan H. and Wang D. 2008. Antibiotic prescribing patterns in village health clinics across 10 provinces of Western China. J Antimicrob Chemother 62:410–415CrossRefPubMedGoogle Scholar
  10. Drechsler D. and Jutting J. 2007. Different countries, different needs: the role of private health insurance in developing countries. J Health Polit Policy Law 32:497–534CrossRefPubMedGoogle Scholar
  11. El-Sadr W. M. and Hoos D. 2008. The president’s emergency plan for AIDS relief – is the emergency over? N Engl J Med 359:553–555CrossRefPubMedGoogle Scholar
  12. Finch R. G., Metlay J. P., Davey P. G. and Baker L. J. 2004. Educational interventions to improve antibiotic use in the community: report from the International Forum on Antibiotic Resistance (IFAR) colloquium, 2002. Lancet Infect Dis 4:44–53CrossRefPubMedGoogle Scholar
  13. Geissbuhler A., Bagayoko C. O. and Ly O. 2007. The RAFT network: 5 years of distance continuing medical education and tele-consultations over the Internet in French-speaking Africa. Int J Med Inform 76:351–356CrossRefPubMedGoogle Scholar
  14. Girosi F., Olmsted S. S., Keeler E., Hay Burgess D. C., Lim Y. W., Aledort J. E., Rafael M. E., Ricci K. A., Boer R., Hilborne L., Derose K. P., Shea M. V., Beighley C. M., Dahl C. A. and Wasserman J. 2006. Developing and interpreting models to improve diagnostics in developing countries. Nature 444 Suppl 1:3–8CrossRefPubMedGoogle Scholar
  15. Greene J. M., Plunkett G., 3rd, Burland V., Glasner J., Cabot E., Anderson B., Neeno-Eckwall E., Qiu Y., Mau B., Rusch M., Liss P., Hampton T., Pot D., Shaker M., Shaull L., Shetty P., Shi C., Whitmore J., Wong M., Zaremba S., Blattner F. R. and Perna N. T. 2007. A new asset for pathogen informatics – the Enteropathogen Resource Integration Center (ERIC), an NIAID Bioinformatics Resource Center for Biodefense and Emerging/Re-emerging Infectious Disease. Adv Exp Med Biol 603:28–42CrossRefPubMedGoogle Scholar
  16. Greenwood B. M., Fidock D. A., Kyle D. E., Kappe S. H., Alonso P. L., Collins F. H. and Duffy P. E. 2008. Malaria: progress, perils, and prospects for eradication. J Clin Invest 118:1266–1276CrossRefPubMedGoogle Scholar
  17. Gul H., Omurtag G., Clark P. M., Tozan A. and Ozel S. 2007. Nonprescription medication purchases and the role of pharmacists as healthcare workers in self-medication in Istanbul. Med Sci Monit 13:PH9–PH14Google Scholar
  18. Hadi U., Duerink D. O., Lestari E. S., Nagelkerke N. J., Keuter M., Huis In’t Veld D., Suwandojo E., Rahardjo E., van den Broek P. and Gyssens I. C. 2008a. Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia. Clin Microbiol Infect 14:698–707Google Scholar
  19. Hadi U., Keuter M., van Asten H. and van den Broek P. 2008b. Optimizing antibiotic usage in adults admitted with fever by a multifaceted intervention in an Indonesian governmental hospital. Trop Med Int Health 13:888–899Google Scholar
  20. Hanif M., Mobarak M. R., Ronan A., Rahman D., Donovan J. J., Jr. and Bennish M. L. 1995. Fatal renal failure caused by diethylene glycol in paracetamol elixir: the Bangladesh epidemic. BMJ 311:88–91PubMedGoogle Scholar
  21. Hartwig K., Pashman J., Cherlin E., Dale M., Callaway M., Czaplinski C., Wood W. E., Abebe Y., Dentry T. and Bradley E. H. 2008. Hospital management in the context of health sector reform: a planning model in Ethiopia. Int J Health Plann Manage 23:203–218CrossRefPubMedGoogle Scholar
  22. Holmström K., Gräslund S., Wahlström A., Poungshompo S., Bengtsson B.-E. and Kautsky N. 2003. Antibiotic use in shrimp farming and implications for environmental impacts and human health. Int J Food Sci Technol 38:255–266CrossRefGoogle Scholar
  23. Hsia D. C., Krushat W. M., Fagan A. B., Tebbutt J. A. and Kusserow R. P. 1988. Accuracy of diagnostic coding for Medicare patients under the prospective-payment system. N Engl J Med 318:352–355CrossRefPubMedGoogle Scholar
  24. Jacobs M. R. 2003. Worldwide trends in antimicrobial resistance among common respiratory tract pathogens in children. Pediatr Infect Dis J 22:S109–S119CrossRefPubMedGoogle Scholar
  25. Koplan J. 2001. CDC’s strategic plan for bioterrorism preparedness and response. Public Health Rep 116 Suppl 2:9–16CrossRefPubMedGoogle Scholar
  26. Lim Y. W., Steinhoff M., Girosi F., Holtzman D., Campbell H., Boer R., Black R. and Mulholland K. 2006. Reducing the global burden of acute lower respiratory infections in children: the contribution of new diagnostics. Nature 444 Suppl 1:9–18CrossRefPubMedGoogle Scholar
  27. Lord Soulsby of Swaffham Prior 2008. The 2008 Garrod Lecture: antimicrobial resistance – animals and the environment. J Antimicrob Chemother 62:229–233CrossRefGoogle Scholar
  28. MDG Africa Steering Group 2008 Achieving the Millennium Development Goals in Africa. Recommendations of the MDG Africa Steering Group June 2008 United Nations New York City http://www.mdgafrica.org/pdf/MDG%20Africa%20Steering%20Group%20Recommendations%20-%20English%20-%20HighRes.pdf Accessed August 25 2008
  29. Morris S. K., Moss W. J. and Halsey N. 2008. Haemophilus influenzae type b conjugate vaccine use and effectiveness. Lancet Infect Dis 8:435–443CrossRefPubMedGoogle Scholar
  30. Moszynski P. 2008. Alliance aims to help health workers in poor countries challenge corruption, excessive pricing, and waste of drugs. Bmj 336:1155CrossRefPubMedGoogle Scholar
  31. Okeke I. N., Klugman K. P., Bhutta Z. A., Duse A. G., Jenkins P., O’Brien T. F., Pablos-Mendez A. and Laxminarayan R. 2005b. Antimicrobial resistance in developing countries. Part II: strategies for containment. Lancet Infect Dis 5:568–580Google Scholar
  32. Okeke I. N., Laxminarayan R., Bhutta Z. A., Duse A. G., Jenkins P., O’Brien T. F., Pablos-Mendez A. and Klugman K. P. 2005a. Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect Dis 5:481–493Google Scholar
  33. Ooms G., Van Damme W., Baker B. K., Zeitz P. and Schrecker T. 2008. The ‘diagonal’ approach to Global Fund financing: a cure for the broader malaise of health systems? Global Health 4:6CrossRefPubMedGoogle Scholar
  34. Paphassarang C., Philavong K., Boupha B. and Blas E. 2002. Equity, privatization and cost recovery in urban health care: the case of Lao PDR. Health Policy Plan 17:72–84CrossRefPubMedGoogle Scholar
  35. Planta M. B. 2007. The role of poverty in antimicrobial resistance. J Am Board Fam Med 20:533–539CrossRefPubMedGoogle Scholar
  36. Reddy S. G. 2008. Death in China: market reforms and health. Int J Health Serv 38:125–141CrossRefPubMedGoogle Scholar
  37. Richet H. M., Mohammed J., McDonald L. C. and Jarvis W. R. 2001. Building communication networks: international network for the study and prevention of emerging antimicrobial resistance. Emerg Infect Dis 7:319–322CrossRefPubMedGoogle Scholar
  38. Ritchie M. R. 2007. Use of herbal supplements and nutritional supplements in the UK: what do we know about their pattern of usage? Proc Nutr Soc 66:479–482CrossRefPubMedGoogle Scholar
  39. Rupp R. E., Stanberry L. R. and Rosenthal S. L. 2005. Vaccines for sexually transmitted infections. Pediatr Ann 34:818–820, 822–814PubMedGoogle Scholar
  40. Ryan M., Griffin S., Chitah B., Walker A. S., Mulenga V., Kalolo D., Hawkins N., Merry C., Barry M. G., Chintu C., Sculpher M. J. and Gibb D. M. 2008. The cost-effectiveness of cotrimoxazole prophylaxis in HIV-infected children in Zambia. AIDS 22:749–757CrossRefPubMedGoogle Scholar
  41. Shekelle P., Maglione M., Geotz M. B., Wagner G., Wang Z., Hilton L., Carter J., Chen S., Tringle C., Mojica W. and Newberry S. 2007. Antiretroviral (ARV) drug resistance in the developing world. Evid Rep Technol Assess (Full Rep) 156:1–74Google Scholar
  42. Simonsen G. S., Tapsall J. W., Allegranzi B., Talbot E. A. and Lazzari S. 2004. The antimicrobial resistance containment and surveillance approach – a public health tool. Bull World Health Organ 82:928–934PubMedGoogle Scholar
  43. Sinha T., Ranson M. K., Chatterjee M. and Mills A. 2007. Management initiatives in a community-based health insurance scheme. Int J Health Plann Manage 22:289–300CrossRefPubMedGoogle Scholar
  44. Smith R. D. and Coast J. 2002. Antimicrobial resistance: a global response. Bull World Health Organ 80:126–133PubMedGoogle Scholar
  45. Stelling J. M. and O’Brien T. F. 1997. Surveillance of antimicrobial resistance: the WHONET program. Clin Infect Dis 24 Suppl 1:S157–168PubMedGoogle Scholar
  46. Stenson B., Syhakhang L., Eriksson B. and Tomson G. 2001a. Real world pharmacy: assessing the quality of private pharmacy practice in the Lao People’s Democratic Republic. Soc Sci Med 52:393–404Google Scholar
  47. Stenson B., Syhakhang L., Lundborg C. S., Eriksson B. and Tomson G. 2001b. Private pharmacy practice and regulation. A randomized trial in Lao P.D.R. Int J Technol Assess Health Care 17:579–589Google Scholar
  48. Tenover F. C., Mohammed M. J., Stelling J., O’Brien T. and Williams R. 2001. Ability of laboratories to detect emerging antimicrobial resistance: proficiency testing and quality control results from the World Health Organization’s external quality assurance system for antimicrobial susceptibility testing. J Clin Microbiol 39:241–250CrossRefPubMedGoogle Scholar
  49. Thiam S., LeFevre A. M., Hane F., Ndiaye A., Ba F., Fielding K. L., Ndir M. and Lienhardt C. 2007. Effectiveness of a strategy to improve adherence to tuberculosis treatment in a resource-poor setting: a cluster randomized controlled trial. JAMA 297:380–386CrossRefPubMedGoogle Scholar
  50. UNICEF 2007 The State of the World’s Children 2008 http://www.unicef.org/publications/files/The_State_of_the_Worlds_Children_2008.pdf Dated Accessed August 18, 2008
  51. United Nations Statistics Division Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupings http://unstats.un.org/unsd/methods/m49/m49regin.htm#developed Dated Accessed August 18
  52. Victora C. G., Huicho L., Amaral J. J., Armstrong-Schellenberg J., Manzi F., Mason E. and Scherpbier R. 2006. Are health interventions implemented where they are most needed? District uptake of the integrated management of childhood illness strategy in Brazil, Peru and the United Republic of Tanzania. Bull World Health Organ 84:792–801CrossRefPubMedGoogle Scholar
  53. Volpato D. E., de Souza B. V., Dalla Rosa L. G., Melo L. H., Daudt C. A. and Deboni L. 2005. Use of antibiotics without medical prescription. Braz J Infect Dis 9:288–291CrossRefPubMedGoogle Scholar
  54. Wenzel R. P. 2004. The antibiotic pipeline – challenges, costs, and values. N Engl J Med 351:523–526CrossRefPubMedGoogle Scholar
  55. Wilkins K., Nsubuga P., Mendlein J., Mercer D. and Pappaioanou M. 2008. The Data for Decision Making project: assessment of surveillance systems in developing countries to improve access to public health information. Public Health 122:914–922Google Scholar
  56. Ybarra M. L. and Bull S. S. 2007. Current trends in Internet- and cell phone-based HIV prevention and intervention programs. Curr HIV/AIDS Rep 4:201–207CrossRefPubMedGoogle Scholar
  57. Zhang R., Eggleston K., Rotimi V. and Zeckhauser R. J. 2006. Antibiotic resistance as a global threat: evidence from China, Kuwait and the United States. Global Health 2:6CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.MpilonhleMtubatubaSouth Africa
  2. 2.Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.CSD, International Centre for Diarrheal Disease ResearchDhakaBangladesh

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