Antimicrobial resistance has been steadily increasing over the years and is nearing crisis levels. Although much resistance is due to patients in nations like the United States demanding antibiotics for diseases like the cold that are often caused by viruses, antimicrobial resistance is also on the rise in developing nations. The priority of these drug-resistant superbugs was determined by a number of criteria including mortality, burden, the prevalence of resistance, the trend of resistance, transmissibility, treatability and preventability.

Because there are already concerted efforts to combat drug-resistant tuberculosis and malaria, they are not part of the dirty dozen list of drug-resistant superbugs. Here are a few of the priority pathogens that affect the developing world:

    1. CampylobacterCampylobacter is the most common cause of bacterial gastroenteritis worldwide. In developing countries, infections are seasonal. One of the major risk factors is exposure to contaminated drinking water.
    2. Salmonella – Salmonella is one of four major causes of diarrheal disease. Although most cases are mild, some can be life-threatening, especially in young children. Treatment with electrolyte replacement is usually sufficient, but for more vulnerable populations antibiotics may be warranted. With the rise in drug resistance, guidelines need to be reviewed regularly to ensure the most effective treatment remains first-line.
    3. Gonorrhea – Gonorrhea is a sexually transmitted disease that causes vaginal pain or discharge in women. It is often asymptomatic in men but can cause a burning sensation on urination and testicular pain. Left untreated, it can lead to serious complications like infertility and sterility. In rare cases, the infection can become life-threatening if it invades the bloodstream or joints. With the rise of antimicrobial resistance, serious cases of gonorrhea could become more common.
    4. ShigellaShigella is the most common cause of dysentery or bloody diarrhea. Bloody diarrhea is often the result of hemolytic uremic syndrome (HUS), one of the complications associated with shigella. HUS develops when the bacteria produces a red blood cell-destroying toxin. Like gonorrhea, a Shigella infection can become especially problematic if it spreads to the joints or bloodstream.

Also featured on WHO’s list were: acinetobacter, pseudomonas, enterobacteria, Enterococcus faecium, H. pylori, Staphylococcus aureus, streptococcus pneumonia and Haemophilus influenza. Without swift and effective intervention, the dirty dozen drug-resistant superbugs could devastate communities all over the world. In the words of the WHO director-general, “The emergence and spread of drug-resistant pathogens have accelerated. The trends are clear and ominous. No action today means no cure tomorrow.”

Rebecca Yu

Photo: Flickr

10 Facts about Malaria
Malaria is a parasitic infection transmitted through the Anopheles mosquito, a genus found on every continent except Antarctica. Humans have known about malaria for thousands of years, but it remains one of the most threatening diseases in the world. Here are 10 facts about malaria and its epidemiology.

1. Malaria threatens almost half of the world’s population.
According to the World Health Organization (WHO), 3.2 billion people in at least 95 countries are at risk for malaria today.

2. Malaria killed nearly half a million people last year.
WHO estimates that malaria killed 438,000 people in 2015 and infected more than 200 million. Children under the age of five account for two-thirds of malaria deaths.

3. Pregnant women are at especially high risk.
Women who contract malaria while pregnant are more likely to die from the illness. The disease also threatens fetal health and can cause a variety of birth-related problems. Babies born to mothers who have malaria are likely to have health problems. According to WHO, malaria is responsible for one-third of all preventable low birth weight cases.

4. Africa suffers the most from the disease.
While malaria is endemic on four continents, Africa bears the brunt of the burden. Last year, Africa accounted for 89 percent of all cases and 91 percent of all deaths from malaria, the vast majority of which occurred in just 15 countries.

5. Drug resistance is an increasing problem.
When malaria patients don’t finish their full courses of treatment, the parasites can develop resistance to the drugs used to treat them. The development of drug resistance has always been an aspect of dealing with malaria, but scientists are reporting alarming multi-drug resistance in the Mekong region of Southeast Asia. The spread of a strain that doesn’t respond to the strongest drugs could undo years of work fighting malaria elsewhere.

6. Malaria reinforces poverty.
Malaria not only threatens people living in poverty; it exacerbates the problem. Where malaria is rampant, economic growth and development suffer enormously.

7. Climate change will expand the scourge of malaria.
Rising temperatures and increased rainfall and humidity will increase the range and number of malaria-carrying mosquitoes. Studies suggest that a rise in global temperatures of just two to three degrees Celsius could put hundreds of millions more people at risk for contracting malaria.

8. Malaria is easily treatable and preventable.
Preventing malaria is as simple as avoiding mosquito bites. Since the mosquitoes that transmit the parasite are nocturnal, sleeping under a bed net at night is generally an adequate prevention measure.

If detected early, malaria can be treated and cured with a course of prescription drugs in a matter of days. The disease becomes dangerous when it is not detected quickly and medicine is not readily available.

9. Globally, humanity is winning the battle.
In the last 15 years, malaria incidence has decreased by 37 percent among at-risk populations. In those same populations, death rates were more than halved. Additionally, the death rate among young children has gone down 65 percent.

10. Malaria can be eradicated.
Adult mosquitoes only live for one or two weeks, and they don’t travel far from the location at which they hatched. If communities have the means to prevent transmission completely, the disease can be erased locally in a matter of weeks. According to Bill Gates, the international community can, with some determination, eradicate the disease globally in the next two or three decades.

Global efforts have proven that eradication is possible. In the past decade, Europe eliminated its indigenous cases of malaria completely, and in September, WHO declared Sri Lanka, a country of more than 20 million people, malaria-free. If Gates is right, the rest of the world may soon follow.

Charlie Tomb

Photo: Flickr

Drug-Resistant _TB
Several are in shock about the tuberculosis situation in South Africa and no solution has been given. Patients who have drug-resistant tuberculosis are being sent home despite the high likelihood that they will transmit it to their family members. These findings have been released after a study was published in the medical journal, The Lancet.

According to the report, 107 patients were monitored while they were treated for tuberculosis. Out of these people, 78 died in spite of being treated with six drugs to 10 drugs. These South African patients who were diagnosed as untreatable but infectious were discharged due to insufficient beds in hospitals. Several doctors are advocating for funding so that patients can be treated away from the community. Tuberculosis is highly infectious and can just as easily spread like the flu, ultimately infecting the lungs and potentially causing death.

South Africa does not have advanced treatments for tuberculosis and according to the World Health Organization, 450,000 people have multi-drug resistant tuberculosis in Eastern Europe, Asia and South Africa. Research professors are in support of reintroducing old sanatoriums so that these patients will have comfort and long-term care while they struggle with the untreatable disease. According to The Lancet, 42 percent of patients being sent home have drug-resistant tuberculosis. In several cases they were being sent back to their one bedroom homes shared with children and other family members.

Keertan Dheda, a professor of medicine in Cape Town reports that new drugs are urgently needed. Most tuberculosis patients may live for more than a year and are risking the lives of others they come in contact with during that time. Those with virtually untreatable tuberculosis, XDR-TB, pose extreme danger to communities. In one case, one patient passed on the infection to his brother and both died.

Such cases have led to global strategies in the past with development of new forms of tuberculosis control. Due to the current lack of funding, the situation does not look promising. There is a large need for investments in drug development and diagnostics for global tuberculosis research.

-Maybelline Martez

Sources: The Guardian, Reuters
Photo: MSF