Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo

There is no doubt that antibiotics have reduced the burden of bacterial infectious diseases. Antimicrobial resistance threatens the effectiveness of successful treatment of infections and constitutes a public health concern with national and global dimensions. This problem is worrisome in war-torn a...

Full description

Bibliographic Details
Main Authors: Gabriel Kambale Bunduki, Jean-Louis Mumbere Katembo, Ildéfonse Soly Kamwira
Format: Article
Language:English
Published: Elsevier 2020-06-01
Series:One Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2352771419300746
_version_ 1818278760379580416
author Gabriel Kambale Bunduki
Jean-Louis Mumbere Katembo
Ildéfonse Soly Kamwira
author_facet Gabriel Kambale Bunduki
Jean-Louis Mumbere Katembo
Ildéfonse Soly Kamwira
author_sort Gabriel Kambale Bunduki
collection DOAJ
description There is no doubt that antibiotics have reduced the burden of bacterial infectious diseases. Antimicrobial resistance threatens the effectiveness of successful treatment of infections and constitutes a public health concern with national and global dimensions. This problem is worrisome in war-torn areas like the Eastern Democratic Republic of the Congo. The difficulties experienced by war-torn nations in addressing antimicrobial resistance are significant for the rest of the globe as microbes do not acknowledge boundaries and do not distinguish between peace and wartime. In this paper, we describe the impact of warfare on the social determinants of health, the environment and biodiversity, and its consequences on the antibiotic use and the host-pathogen interplay. Furthermore, we describe different pillars to be taken into account, learned in a war-torn area, in combating antimicrobial resistance. These lessons are summarized in terms of tools to be used for combating antimicrobial resistance, challenges to overcome in war-torn setting and core actions to be undertaken. Surveillance is a valuable tool to combat antimicrobial resistance as it helps to detect resistant bacteria, enables correct decisions to be taken, guides policy recommendations and tracks the antibiotic use and misuse. The challenges encountered in this region include the shortage of competent laboratories, poor infrastructure and data management, lack of standard protocols, low coverage of surveillance, lack of intersectoral cooperation, and inadequate national, regional and international collaboration. Regarding this situation, the core actions to be undertaken include the establishment of ABR surveillance and monitoring systems, building laboratory capacity for rapid and reliable diagnostic testing, and engagement in national, regional and global surveillance networks. Therefore, this study showed an urgent need for establishing and implementing sentinel site surveillance laboratories and elaborating and implementing national action plans for combating antimicrobial resistance. Keywords: Antimicrobial resistance, National action plans, Surveillance, Laboratory, War-torn, DRC
first_indexed 2024-12-12T23:22:33Z
format Article
id doaj.art-ff7c9eec71e34269be3b44149278b9e5
institution Directory Open Access Journal
issn 2352-7714
language English
last_indexed 2024-12-12T23:22:33Z
publishDate 2020-06-01
publisher Elsevier
record_format Article
series One Health
spelling doaj.art-ff7c9eec71e34269be3b44149278b9e52022-12-22T00:08:14ZengElsevierOne Health2352-77142020-06-019Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the CongoGabriel Kambale Bunduki0Jean-Louis Mumbere Katembo1Ildéfonse Soly Kamwira2Department of Infectious diseases, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo; Association for Health Innovation in Africa, Butembo, Democratic Republic of the Congo; Corresponding author at: Department of Infectious diseases, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.Department of Anatomo-Pathology, Cliniques Universitaires du Graben, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the CongoFaculty of Pharmaceutical sciences, Université Catholique du Graben, Butembo, Democratic Republic of the CongoThere is no doubt that antibiotics have reduced the burden of bacterial infectious diseases. Antimicrobial resistance threatens the effectiveness of successful treatment of infections and constitutes a public health concern with national and global dimensions. This problem is worrisome in war-torn areas like the Eastern Democratic Republic of the Congo. The difficulties experienced by war-torn nations in addressing antimicrobial resistance are significant for the rest of the globe as microbes do not acknowledge boundaries and do not distinguish between peace and wartime. In this paper, we describe the impact of warfare on the social determinants of health, the environment and biodiversity, and its consequences on the antibiotic use and the host-pathogen interplay. Furthermore, we describe different pillars to be taken into account, learned in a war-torn area, in combating antimicrobial resistance. These lessons are summarized in terms of tools to be used for combating antimicrobial resistance, challenges to overcome in war-torn setting and core actions to be undertaken. Surveillance is a valuable tool to combat antimicrobial resistance as it helps to detect resistant bacteria, enables correct decisions to be taken, guides policy recommendations and tracks the antibiotic use and misuse. The challenges encountered in this region include the shortage of competent laboratories, poor infrastructure and data management, lack of standard protocols, low coverage of surveillance, lack of intersectoral cooperation, and inadequate national, regional and international collaboration. Regarding this situation, the core actions to be undertaken include the establishment of ABR surveillance and monitoring systems, building laboratory capacity for rapid and reliable diagnostic testing, and engagement in national, regional and global surveillance networks. Therefore, this study showed an urgent need for establishing and implementing sentinel site surveillance laboratories and elaborating and implementing national action plans for combating antimicrobial resistance. Keywords: Antimicrobial resistance, National action plans, Surveillance, Laboratory, War-torn, DRChttp://www.sciencedirect.com/science/article/pii/S2352771419300746
spellingShingle Gabriel Kambale Bunduki
Jean-Louis Mumbere Katembo
Ildéfonse Soly Kamwira
Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo
One Health
title Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo
title_full Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo
title_fullStr Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo
title_full_unstemmed Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo
title_short Antimicrobial resistance in a war-torn country: Lessons learned in the Eastern Democratic Republic of the Congo
title_sort antimicrobial resistance in a war torn country lessons learned in the eastern democratic republic of the congo
url http://www.sciencedirect.com/science/article/pii/S2352771419300746
work_keys_str_mv AT gabrielkambalebunduki antimicrobialresistanceinawartorncountrylessonslearnedintheeasterndemocraticrepublicofthecongo
AT jeanlouismumberekatembo antimicrobialresistanceinawartorncountrylessonslearnedintheeasterndemocraticrepublicofthecongo
AT ildefonsesolykamwira antimicrobialresistanceinawartorncountrylessonslearnedintheeasterndemocraticrepublicofthecongo