Antibiotics help in preventing and treating infections and increasing life expectancy globally. G... more Antibiotics help in preventing and treating infections and increasing life expectancy globally. Globally, many people's lives are being threatened by the emergence of antimicrobial resistance (AMR). The cost of treating and preventing infectious diseases has increased due to AMR. Bacteria can resist the effects of antibiotics by altering drug targets, inactivating drugs, and activating drug efflux pumps. According to estimates, five million individuals died in 2019 from AMR-related causes, wherein 1.3 million deaths were directly linked to bacterial AMR. Sub-Saharan Africa (SSA) experienced the greatest mortality rate from AMR in 2019. In this article, we discuss AMR's causes and challenges SSA faces in implementing AMR prevention measures and propose recommendations to address the challenges. Antibiotic misuse and overuse, widespread usage in agriculture, and the pharmaceutical industry's absence of new antibiotic development are the factors contributing to AMR. SSA's challenges in preventing AMR include poor AMR surveillance and lack of collaboration, irrational use of antibiotics, weak medicine regulatory systems, lack of infrastructural and institutional capacities, lack of human resources, and inefficient infection prevention and control (IPC) practices. The challenges faced by countries in SSA can be addressed by increasing the public's knowledge of antibiotics and AMR, promoting antibiotic stewardship, improving AMR surveillance, promoting collaboration within and beyond countries, antibiotics regulatory enforcement, and improving the practice of IPC measures at home, food handling establishments, and healthcare facilities.
African Journal of Reproductive Health, Nov 29, 2023
The expected culmination of a positive pregnancy experience is a healthy mother and a bouncing li... more The expected culmination of a positive pregnancy experience is a healthy mother and a bouncing live baby. Unfortunately, globally an estimated 2 million babies are still born every year, with the largest incidence of stillbirths of about 50% of the global burden occurring in sub-Saharan Africa (SSA). Significant gaps in access to quality antenatal care (ANC) and labour and delivery remain in SSA. It is estimated that only 24% of women receive at least four ANC visits in SSA. Women are prepared for labour and delivery during this period, and risk factors are identified, and potential complications can be averted. Access to labour and delivery services is critical for picking up foetal compromise. Women must deliver in facilities that can offer assisted delivery and offer foetal and neonatal resuscitation, to prevent stillbirths and early neonatal deaths. In SSA, many primary healthcare facilities are unable to offer these services, whilst higher level facilities that can offer these may be difficult to access. The majority of stillbirths are preventable if women access quality ANC and can access modern facilities for labour and delivery. Therefore, stakeholders in reproductive health must ensure access to ANC for a positive pregnancy experience.
Journal of the International AIDS Society, Jul 1, 2023
IntroductionThe burden of HIV in sub‐Saharan Africa (SSA) remains unacceptably high, and dispropo... more IntroductionThe burden of HIV in sub‐Saharan Africa (SSA) remains unacceptably high, and disproportionately affects girls and women. While the introduction of oral HIV pre‐exposure prophylaxis (PrEP) in 2012 revolutionized HIV prevention, its effectiveness is dependent on user adherence and its implementation in SSA has faced numerous challenges. Patient‐level, interpersonal and structural barriers, including, for example, daily pill burden, side effects, lack of partner support, testing and disclosure, and costs have been found to reduce adherence to oral PrEP.DiscussionLong‐acting extended delivery (LAED) formulations for PrEP, such as injectable long‐acting cabotegravir (CAB‐LA) and dapivirine vaginal ring (DPV‐VR) are critical additions to the HIV prevention toolkit and are especially important for populations such as adolescent girls and young women (AGYW) and other key populations who remain at significant risk of HIV acquisition while facing substantial barriers to preventive services. These LAED formulations have been shown to result in better adherence and fewer side effects, with CAB‐LA being superior to oral PrEP in reducing the risk of HIV acquisition. They can be used to overcome user burden and adherence challenges. However, the successful rollout of the DPV‐VR and CAB‐LA may be hampered by issues such as a shortage of healthcare providers (HCPs), inadequate parenteral medication infrastructure, increased workload for HCPs, patient concerns, the price of the medications and the possibility of drug resistance.ConclusionsSSA must develop laboratory capabilities for monitoring patients on LAED formulations and enhance research on developing more non‐injectable LAED formulations. There is a need to train and retain more HCPs, implement task shifting, invest in healthcare infrastructure and integrate healthcare services. To reduce costs and improve availability, the region must advocate for patent license waivers for LAED formulations and procure drugs collectively as a region.
Antibiotics help in preventing and treating infections and increasing life expectancy globally. G... more Antibiotics help in preventing and treating infections and increasing life expectancy globally. Globally, many people's lives are being threatened by the emergence of antimicrobial resistance (AMR). The cost of treating and preventing infectious diseases has increased due to AMR. Bacteria can resist the effects of antibiotics by altering drug targets, inactivating drugs, and activating drug efflux pumps. According to estimates, five million individuals died in 2019 from AMR-related causes, wherein 1.3 million deaths were directly linked to bacterial AMR. Sub-Saharan Africa (SSA) experienced the greatest mortality rate from AMR in 2019. In this article, we discuss AMR's causes and challenges SSA faces in implementing AMR prevention measures and propose recommendations to address the challenges. Antibiotic misuse and overuse, widespread usage in agriculture, and the pharmaceutical industry's absence of new antibiotic development are the factors contributing to AMR. SSA's challenges in preventing AMR include poor AMR surveillance and lack of collaboration, irrational use of antibiotics, weak medicine regulatory systems, lack of infrastructural and institutional capacities, lack of human resources, and inefficient infection prevention and control (IPC) practices. The challenges faced by countries in SSA can be addressed by increasing the public's knowledge of antibiotics and AMR, promoting antibiotic stewardship, improving AMR surveillance, promoting collaboration within and beyond countries, antibiotics regulatory enforcement, and improving the practice of IPC measures at home, food handling establishments, and healthcare facilities.
African Journal of Reproductive Health, Nov 29, 2023
The expected culmination of a positive pregnancy experience is a healthy mother and a bouncing li... more The expected culmination of a positive pregnancy experience is a healthy mother and a bouncing live baby. Unfortunately, globally an estimated 2 million babies are still born every year, with the largest incidence of stillbirths of about 50% of the global burden occurring in sub-Saharan Africa (SSA). Significant gaps in access to quality antenatal care (ANC) and labour and delivery remain in SSA. It is estimated that only 24% of women receive at least four ANC visits in SSA. Women are prepared for labour and delivery during this period, and risk factors are identified, and potential complications can be averted. Access to labour and delivery services is critical for picking up foetal compromise. Women must deliver in facilities that can offer assisted delivery and offer foetal and neonatal resuscitation, to prevent stillbirths and early neonatal deaths. In SSA, many primary healthcare facilities are unable to offer these services, whilst higher level facilities that can offer these may be difficult to access. The majority of stillbirths are preventable if women access quality ANC and can access modern facilities for labour and delivery. Therefore, stakeholders in reproductive health must ensure access to ANC for a positive pregnancy experience.
Journal of the International AIDS Society, Jul 1, 2023
IntroductionThe burden of HIV in sub‐Saharan Africa (SSA) remains unacceptably high, and dispropo... more IntroductionThe burden of HIV in sub‐Saharan Africa (SSA) remains unacceptably high, and disproportionately affects girls and women. While the introduction of oral HIV pre‐exposure prophylaxis (PrEP) in 2012 revolutionized HIV prevention, its effectiveness is dependent on user adherence and its implementation in SSA has faced numerous challenges. Patient‐level, interpersonal and structural barriers, including, for example, daily pill burden, side effects, lack of partner support, testing and disclosure, and costs have been found to reduce adherence to oral PrEP.DiscussionLong‐acting extended delivery (LAED) formulations for PrEP, such as injectable long‐acting cabotegravir (CAB‐LA) and dapivirine vaginal ring (DPV‐VR) are critical additions to the HIV prevention toolkit and are especially important for populations such as adolescent girls and young women (AGYW) and other key populations who remain at significant risk of HIV acquisition while facing substantial barriers to preventive services. These LAED formulations have been shown to result in better adherence and fewer side effects, with CAB‐LA being superior to oral PrEP in reducing the risk of HIV acquisition. They can be used to overcome user burden and adherence challenges. However, the successful rollout of the DPV‐VR and CAB‐LA may be hampered by issues such as a shortage of healthcare providers (HCPs), inadequate parenteral medication infrastructure, increased workload for HCPs, patient concerns, the price of the medications and the possibility of drug resistance.ConclusionsSSA must develop laboratory capabilities for monitoring patients on LAED formulations and enhance research on developing more non‐injectable LAED formulations. There is a need to train and retain more HCPs, implement task shifting, invest in healthcare infrastructure and integrate healthcare services. To reduce costs and improve availability, the region must advocate for patent license waivers for LAED formulations and procure drugs collectively as a region.
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