Assessment of antimicrobial stewardship programmes and antibiotic use among children admitted to two hospitals in Sierra Leone: a cross-sectional study DOI Creative Commons
Ibrahim Franklyn Kamara, Bobson Derrick Fofanah,

Innocent Nuwagira

et al.

Antimicrobial Resistance and Infection Control, Journal Year: 2024, Volume and Issue: 13(1)

Published: July 22, 2024

Abstract Introduction Antimicrobial resistance (AMR) is a global public health concern and irrational use of antibiotics in hospitals key driver AMR. Even though it not preventable, antimicrobial stewardship (AMS) programmes will reduce or slow down. Research evidence from Sierra Leone has demonstrated the high hospitals, but no study assessed hospital AMS antibiotic specifically among children. We conducted first-ever to assess two tertiary Leone. Methods This was hospital-based cross-sectional survey using World Health Organization (WHO) point prevalence (PPS) methodology. Data collected medical records eligible patients at Ola During Children’s Hospital (ODCH) Makeni Regional (MRH) WHO PPS questionnaire; required data collection forms. The prescribed were classified according Access, Watch, Reserve (AWaRe) classification. Ethics approval obtained Scientific Review Committee. Statistical analysis SPSS version 22. Results Both ODCH MRH did have infrastructure; policy practice; monitoring feedback mechanisms ensure rational prescribing. Of 150 included survey, 116 (77.3%) admitted 34 (22.7%) MRH, 77 (51.3%) males 73 (48.7%) females. mean age 2 years (SD=3.5). overall 84.7% (95% CI: 77.9% – 90.0%) (83.8%) children aged less than one year received an antibiotic. proportion that higher Most (58, 47.2 %) least antibiotics. top five gentamycin (100, 27.4%), ceftriaxone (76, 20.3%), ampicillin (71, 19.5%), metronidazole (44, 12.1%), cefotaxime (31, 8.5%). Community-acquired infections primary diagnoses for prescription. Conclusion non-existence might contributed MRH. potential increase selection pressure turn AMR burden country. There need establish teams train workers on

Language: Английский

Knowledge, awareness and practices of healthcare workers regarding antimicrobial use, resistance and stewardship in Zambia: a multi-facility cross-sectional study DOI Creative Commons
Steward Mudenda, Billy Chabalenge, Victor Daka

et al.

JAC-Antimicrobial Resistance, Journal Year: 2024, Volume and Issue: 6(3)

Published: May 6, 2024

Antimicrobial resistance (AMR) poses a threat to public health globally. Despite its consequences, there is little information about the knowledge, awareness, and practices towards AMR among healthcare workers (HCWs). Therefore, this study assessed awareness regarding antimicrobial use (AMU), stewardship (AMS) HCWs who are involved in implementation of AMS activities across eight hospitals Zambia.

Language: Английский

Citations

14
Antimicrobial resistance profiles of Escherichia coli isolated from clinical and environmental samples: findings and implications DOI Creative Commons
Maisa Kasanga, Doreen Mainza Shempela, Victor Daka

et al.

JAC-Antimicrobial Resistance, Journal Year: 2024, Volume and Issue: 6(2)

Published: March 5, 2024

Abstract Background The overuse and misuse of antimicrobials has worsened the problem antimicrobial resistance (AMR) globally. This study investigated AMR profiles Escherichia coli isolated from clinical environmental samples in Lusaka, Zambia. Methods was a cross-sectional conducted February 2023 to June using 450 samples. VITEK® 2 Compact used identify E. perform susceptibility testing. Data analysis done WHONET 2022 SPSS version 25.0. Results Of samples, 66.7% (n = 300) were whereas 33.3% 150) Overall, 47.8% 215) (37.8% 10% environmental) tested positive for coli. 215 isolates, 66.5% MDR 42.8% ESBL-producers. Most isolates resistant ampicillin (81.4%), sulfamethoxazole/trimethoprim (70.7%), ciprofloxacin (67.9%), levofloxacin (64.6%), ceftriaxone (62.3%) cefuroxime (62%). Intriguingly, highly susceptible amikacin (100%), imipenem (99.5%), nitrofurantoin (89.3%), ceftolozane/tazobactam (82%) gentamicin (72.1%). Conclusions found high some antibiotics that are commonly humans. isolation ESBL-producing is public health concern requires urgent action. Therefore, there need instigate strengthen interventional strategies including stewardship programmes combat

Language: Английский

Citations

12
Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening DOI Creative Commons
Kaunda Yamba, Joseph Yamweka Chizimu, Steven Mudenda

et al.

Journal of Hospital Infection, Journal Year: 2024, Volume and Issue: 148, P. 129 - 137

Published: April 15, 2024

BackgroundA well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears significant proportion the world's communicable disease burden. This study assessed capacity laboratories selected hospitals to conduct AMR Zambia.MethodsThis cross-sectional exploratory was conducted among eight (8) purposively between August 2023 and December 2023. Data were collected using self-scoring Laboratory Assessment Antibiotic Resistance Testing Capacity (LAARC) tool.FindingsOf facilities, none had full with varying capacities ranging from moderate [63% (5/8)] low [38% (3/8)]. Some barriers AMR-LBS lack electronic laboratory information system (LIS) locally generated antibiograms [75% (6/8)]. Quality control for susceptibility testing (AST), pathogen identification media preparation lowest overall score all facilities 14%, 20% 44% respectively. The highest scores specimen processing (79%), data management (78%), collection, transport, (71%) safety (70%). Most standard operating procedures (SOPs) place but lacked specimen-specific SOPs.ConclusionThe absence hinders efforts combat further complicates treatment outcomes infectious diseases. Establishing strengthening LBS systems are essential quantifying burden supporting development local guidelines.

Language: Английский

Citations

11
Global Burden of Fungal Infections and Antifungal Resistance from 1961 to 2024: Findings and Future Implications DOI Open Access
Steward Mudenda

Pharmacology &amp Pharmacy, Journal Year: 2024, Volume and Issue: 15(04), P. 81 - 112

Published: Jan. 1, 2024

Background: Antifungal resistance (AFR) is a global public health problem with devastating effects, especially among immunocompromised individuals. Addressing AFR requires One Health approach including Stewardship (AFS). This study aimed to comprehensively review studies published on fungal infections and recommend solutions address this growing problem. Materials Methods: was narrative that conducted using papers infections, AFR, AFS between January 1961 March 2024. The literature searched PubMed, Google Scholar, Web of Science, EMBASE. Results: found there has been an increase in globally, patients. Due proportionate the use antifungal agents prevent treat infections. increased worsened contributing morbidity mortality. Globally, have contributed 150 million annually 1.7 deaths per year. By year 2023, over 3.8 people died from remains challenge because treatment antifungal-resistant difficult. Finally, exacerbated by limited number invasive Conclusion: results indicated are prevalent across humans, animals, agriculture, environment. provision such as improving awareness conducting further research discovery new agents, implementing programs. If not addressed, mortality associated will continue rise future.

Language: Английский

Citations

10
Antibiotic use and adherence to the WHO AWaRe guidelines across 16 hospitals in Zambia: a point prevalence survey DOI Creative Commons
Joseph Yamweka Chizimu, Steward Mudenda, Kaunda Yamba

et al.

JAC-Antimicrobial Resistance, Journal Year: 2024, Volume and Issue: 6(5)

Published: Sept. 3, 2024

The inappropriate use of antibiotics in hospitals contributes to the development and spread antimicrobial resistance (AMR). This study evaluated prevalence antibiotic adherence World Health Organization (WHO) Access, Watch Reserve (AWaRe) classification across 16 Zambia.

Language: Английский

Citations

7
The Burden of Antimicrobial Resistance in Zambia, a Sub-Saharan African Country: A One Health Review of the Current Situation, Risk Factors, and Solutions DOI Open Access
Steward Mudenda, Webrod Mufwambi,

Shafiq Mohamed

et al.

Pharmacology &amp Pharmacy, Journal Year: 2024, Volume and Issue: 15(12), P. 403 - 465

Published: Jan. 1, 2024

Language: Английский

Citations

7
Surveillance of Antibiotic Use and Adherence to the WHO/INRUD Core Prescribing Indicators at a Primary Healthcare Hospital in Southern Zambia: Opportunities for Antimicrobial Stewardship Programs DOI Open Access
Steward Mudenda,

Ronald Simbaya,

Given Moonga

et al.

Pharmacology &amp Pharmacy, Journal Year: 2025, Volume and Issue: 16(01), P. 1 - 19

Published: Jan. 1, 2025

Background: The irrational use of medicines remains a key health problem in many developing countries. overuse antibiotics is driver antimicrobial resistance (AMR). This study surveyed antibiotic and adherence to the World Health Organization (WHO) prescribing indicators at Request Muntanga Hospital Kalomo District Southern Province, Zambia. Materials Methods: cross-sectional was conducted from July 2023 September Zambia reviewed 600 medical record prescriptions which were issued 1, 2022 June 30, using WHO indicators. collected data analyzed Statistical Package for Social Sciences version 23.0. Results: From sampled, 1246 prescribed, with making up 86.7% encounters. Additionally, average number drugs prescribed per encounter 2.1 prevalence polypharmacy 61.3%. Further, 17.8% as injectables. Furthermore, 76.7% Essential Medicines List 38.9% by generic names. Conclusions: found high deviations WHO/International Network Rational Use Drugs (INRUD) core indicating non-adherence There need promote WHO/INRUD rational prevent emergence spread AMR.

Language: Английский

Citations

1
Point Prevalence Survey of Antibiotic Use in Level 1 hospitals in Zambia: Future Prospects for Antimicrobial Stewardship Programs DOI Creative Commons
Steward Mudenda, Adriano Focus Lubanga, Shazia Jamshed

et al.

Infection and Drug Resistance, Journal Year: 2025, Volume and Issue: Volume 18, P. 887 - 902

Published: Feb. 1, 2025

The inappropriate prescribing and use of antibiotics have contributed to the emergence spread antimicrobial resistance (AMR). In Zambia, there is a paucity information on patterns among hospitalized patients in level 1 hospitals. This study investigated antibiotic five hospitals Lusaka, Zambia. cross-sectional utilized World Health Organization (WHO) Point Prevalence Survey (PPS) methodology in-patients admitted before 08:00 a.m. survey day August 2024. Data were analysed using IBM SPSS version 23.0. prevalence inpatients was 59.0%, with ceftriaxone being most prescribed. Antibiotics prescribed mainly for paediatrics male inpatients. found that 53.0% from Access group while 38.2% Watch Access, Watch, Reserve (AWaRe) classification. Adherence national treatment guidelines 36.0%, empirically without evidence culture sensitivity tests. high low adherence findings this demonstrate need establish strengthen stewardship programs laboratory capacity aid clinicians diagnosing, treating, managing across

Language: Английский

Citations

1
Current status and future direction of antimicrobial stewardship programs and antibiotic prescribing in primary care hospitals in Zambia DOI Creative Commons

Faustina Makiko,

Aubrey Chichonyi Kalungia, Martin Kampamba

et al.

JAC-Antimicrobial Resistance, Journal Year: 2025, Volume and Issue: 7(3)

Published: April 29, 2025

Antimicrobial Stewardship Programs (ASPs) intended to optimize antibiotic use will be more effective if informed by the current status and patterns of utilisation. In Zambia's primary healthcare (PHC) settings, data on ASPs utilisation were inadequate guide improvements. As a first step, this study assessed prescribing ASP core elements among PHC first-level hospitals (FLHs) in Zambia. A point prevalence survey was conducted at five FLHs Lusaka using Global-PPS® protocol. Hospital evaluated included hospital leadership commitment, accountability, pharmacy expertise, action, tracking, reporting, education. Antibiotic 79.8% (146/183). total 220 prescription encounters recorded inpatients, with ceftriaxone (J01DD04, Watch) being most (50.0%) prescribed. Over 90.0% (202) prescriptions targeted suspected community-acquired infections, but only 36.8% (81) compliant national treatment guidelines. element implementation 36.0% (16.2/45), two achieving over 50.0%. The deficient reporting. providing sub-optimal, high rates, frequent broad-spectrum Watch group antibiotics, low compliance key ways forward, require strengthening adapting WHO AWaRe recommendations improving actions, reporting improve stewardship practice reduce AMR.

Language: Английский

Citations

1
The World Health Organization Access, Watch, and Reserve classification of antibiotics: an awareness survey among pharmacy professionals in a sub-Saharan country, Zambia DOI Creative Commons
Steward Mudenda,

McDonald David Wataya,

Webrod Mufwambi

et al.

Antimicrobial Stewardship & Healthcare Epidemiology, Journal Year: 2024, Volume and Issue: 4(1)

Published: Jan. 1, 2024

Antimicrobial stewardship programs are very essential in addressing the problem of drug-resistant infections. The WHO Access, Watch, and Reserve (AWaRe) classification antibiotics is monitoring rational use antibiotics. Therefore, this study evaluated awareness AWaRe among pharmacy professionals Zambia.

Language: Английский

Citations

4