Developed and developing countries
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Transcript of Developed and developing countries
Prevalence and Impacts on Developed
and Developing Countries
Methicillin-resistant S aureus Infection Rates
Produced by CDDEP, found at: http://www.cddep.org/tool/mrsa_infection_rates_country#sthash.4eSoOCcP.zR0cdm2A.dpbs
Much greater than a third world problem
Prevalence of certain antibiotic resistant strains (notably MRSA) a growing problem in many developed countries1 – not just in developing countries
USA and the UK were ranked among the countries with the highest prevalence of MRSA infection rates
Spread of resistance is facilitated by interspecies gene transmission, poor sanitation and hygiene in communities and hospitals, and the increasing frequency of global, travel, trade, and disease transmission1
Number of cases showing a resistance causing genetic
element by country
Produced by the IMF, found at: http://www.imf.org/external/pubs/ft/fandd/2014/12/jonas.htm
A Global ProblemIn high-income countries, continued high rates
of antibiotic use in hospitals, the community, and agriculture have contributed to sustained resistant strains, forcing a shift to more expensive and more broad-spectrum antibiotics1
In low-income and middle-income countries (LMICs), antibiotic use is increasing with rising incomes, high rates of hospitalization, and high prevalence of hospital infections1
MortalityAn estimated 25 000 people die every year in
Europe from antibiotic-resistant bacteria2
A report conservatively estimated that at least 2 million illnesses and 23 000 deaths a year in the USA were caused by antibiotic resistance3
Few reliable estimates are available for lower and middle income countries, but the higher burden of infectious disease and restricted access to new antibiotics suggest a far higher burden than in high-income countries1
Healthcare Associated InfectionsIncidence of infections acquired in intensive care
units in developing countries was three times the rate in the USA4
Health-care associated infections in neonatal intensive care units in some developing countries are up to nine times more common than in the USA4
In lower and middle income countries the burden of resistance seems only likely to increase with the rate of health-care associated infections4
Increased Cost of Treatment
A global need for more expensive antibiotics to treat resistant infections has been driving up treatment costs in both developing and developed countries1
In lower and middle income countries, the ability to pay for second-line drugs is limited when cheaper, first line drugs are ineffective1
Leads to much worse health outcomes, especially in neonates1
Some ImprovementsResistance to MRSA in some parts of Western
Europe has been decreasing5 In high-income countries, it is being tackled with
a combination of new antibiotics and better hospital infection control5
Many of the lower and middle income countries have been unable to implement many of these policies, and have not seen the same improvements5
See the following map5
References1. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, et al.
Antibiotic resistance—the need for global solutions. The Lancet infectious diseases. 2013;13(12):1057-1098
2. ECDC/EMEA Technical Report. The bacterial challenge: time to react http://www.ecdc.europa.eu/en/publications/Publications/0909_TER_The_Bacterial_Challenge_Time_to_React.pdf (Sept 2009)
3. US Centers for Disease Control and Prevention Antibiotic resistance threats in the United States, 2013 http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf (April 2013)
4. Allegranzi B, Nejad SB, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. The Lancet. 2011;377(9761):228-241.
5. Hede K. Antibiotic resistance: an infectious arms race. Nature. 2014;509(7498):S2-S3.