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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The challenges and successes of implementing a sustainable antimicrobial resistance surveillance programme in Nepal
BMC Public Health, Volume 14, No. 1, Article 269, Year 2014
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Description
Background: Antimicrobial resistance (AMR) is a major global public health concern and its surveillance is a fundamental tool for monitoring the development of AMR. In 1998, the Nepalese Ministry of Health (MOH) launched an Infectious Disease (ID) programme. The key components of the programme were to establish a surveillance programme for AMR and to develop awareness among physicians regarding AMR and rational drug usage in Nepal. Methods. An AMR surveillance programme was established and implemented by the Nepalese MOH in partnership with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) from 1998 to 2003. From 2004 to 2012, the programme was integrated and maintained as a core activity of the National Public Health Laboratory (NPHL) and resulted in an increased number of participating laboratories and pathogens brought under surveillance. The main strategies were to build national capacity on isolation, identification and AMR testing of bacterial pathogens, establish laboratory networking and an External Quality Assessment (EQA) programme, promote standardised recording and reporting of results, and to ensure timely analysis and dissemination of data for advocacy and national policy adaptations. The programme was initiated by nine participating laboratories performing AMR surveillance on Vibrio cholerae, Shigella spp., Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae. Results: The number of participating laboratories was ultimately increased to 13 and the number of pathogens under surveillance was increased to seven (Salmonella spp. was added to the surveillance programme in 2002 and extended spectrum β-lactamase producing Escherichia coli in 2011). From 1999 to 2012, data were available on 17,103 bacterial isolates. During the AMR programme, we observed changing trends in serovars/ species for Salmonella spp., Shigella spp. and V. cholerae and changing AMR trend for all organisms. Notably, N. gonorrhoeae isolates demonstrated increasing resistance to ciprofloxacin. Additionally, the performance of the participating laboratories improved as shown by annual EQA data evaluation. Conclusions: This Nepalese AMR programme continues and serves as a model for sustainable surveillance of AMR monitoring in resource limited settings. © 2014 Malla et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Malla, Sarala
Nepal, Kathmandu
Minister for Health and Population Nepal
Dumre, Shyam Prakash
Nepal, Kathmandu
Minister for Health and Population Nepal
Thailand
Tammasat University
Shakya, Geeta
Nepal, Kathmandu
Minister for Health and Population Nepal
Kansakar, Palpasa
Nepal, Kathmandu
Minister for Health and Population Nepal
Rai, Bhupraj
Nepal, Kathmandu
Minister for Health and Population Nepal
Hossain, Anowar K.M.Tanvir
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Nair, Gopinath Balakrish
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
India, New Delhi
Translational Health Science and Technology Institute
Albert, Manuel John
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Kuwait, Kuwait City
Kuwait University
Sack, David Allen
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Baker, Stephen G.
Viet Nam, Ho Chi Minh City
Oxford University Clinical Research Unit
Rahman, Motiur D.Abdur
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Viet Nam, Ho Chi Minh City
Oxford University Clinical Research Unit
Statistics
Citations: 34
Authors: 11
Affiliations: 7
Identifiers
Doi:
10.1186/1471-2458-14-269
e-ISSN:
14712458
Research Areas
Health System And Policy
Infectious Diseases
Study Approach
Systematic review