Nigerians are set to face rising healthcare costs to treat common infectious diseases such as diarrhoea, pneumonia, urinary tract infections, tuberculosis, malaria, influenza A virus, etc. following increasing antimicrobial resistance (AMR) which now poses a serious threat to global public health.
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While infections are resistant to first-line drugs and more expensive therapies used to treat such ailments, longer duration of illness and treatment often in hospitals increases health care costs as well as the economic burden on families and societies, Investigations reveal.
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Prof. Emmanuel Elebute, founding chairman, Lagoon Hospitals, said that resistant microorganisms (including bacteria, fungi, viruses and parasites) are able to withstand attack by antimicrobial drugs, such as antibacterial drugs (e.g., antibiotics), antifungals, antivirals, and antimalarials, as standard treatments become ineffective and infections persist, increasing the risk of spread to others.
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Elebute disclosed that the use and misuse of antimicrobial drugs accelerates the emergence of drug-resistant strains. He pointed out that poor infection control practices, inadequate sanitary conditions and inappropriate food-handling encourages the further spread of AMR.
“Recently, the World Health Organisation (WHO) issued a major global report on antimicrobial resistance documenting high rates of resistance in bacteria that cause common infections (e.g. urinary tract infection, surgical site infections, pneumonia and bloodstream infections). Health workers can play a vital role to protect patients from infections that are difficult to treat by performing hand hygiene at 5 key moments.
Elebute stated that the ‘5 moments’ for hand hygiene include before touching a patient; before clean and aseptic procedures (e.g. Inserting devices such as catheters); after contact with body fluids; after touching a patient and after touching patient surroundings.
While the use of alcohol-based hand rub products is a key factor to achieve improvement because they can be promptly used at the point of care when hand hygiene is needed to ensure patient safety, Elebute added that they have higher antimicrobial effect than soap and water.
“Although the development of new antibiotics is vital to provide new treatment options, strengthening hand hygiene and other infection control best practices has the potential to stop antimicrobial resistance. Preventing the transmission and spread of the germs, avoids infections and the related treatment constraints and patient suffering,” Elebute added.
Dr. Michael Oji, consultant orthopaedic and trauma surgeon, Lagoon Hospitals, Lagos, said that the achievements of modern medicine are put at risk by AMR. Oji stated that without effective antimicrobials for prevention and treatment of infections, antimicrobial resistance has the potential to threaten health security, and damage trade and economies.
“The growth of global trade and travel allows resistant microorganisms to be spread rapidly to distant countries and continents through humans and food. Estimates show that AMR may give rise to losses in Gross Domestic Product of more than 1 percent and that the indirect costs affecting society may be more than 3 times the direct health care expenditures. It affects developing economies proportionally more than developed ones,” Dr. Oji disclosed.
Dr. Oji noted that declining drug pipeline to treat such disease conditions is becoming a major source of worry to public health experts.
According to Oji, “Resistance to earlier generation antimalarial drugs is widespread in most malaria-endemic countries. Further spread of artemisinin-resistant strains of malaria could jeopardize important recent gains in control of the disease.
A breakdown of the first global report on surveillance of antimicrobial resistance, with data provided by 114 countries published by the WHO in 2014 reveals major gaps in tracking of antibiotic resistance in the WHO African Region, with data gathered in a limited number of countries.