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      Antimicrobial Resistance in Migratory Paths, Refugees, Asylum Seekers and Internally Displaced Persons: A Narrative Review

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          Abstract

          Purpose of Review

          Antimicrobial resistance (AMR) is a significant global health challenge, especially for populations with limited access to healthcare services and poor living conditions. This narrative review focuses on the determinants and figures related to AMR in the context of migration.

          Recent Findings

          Migrants face the risk of MDRO (multidrug resistant organisms) acquisition at every stage of their migration journey, from their country of origin to the transit centres and destination countries. While there is a lack of systematic data, the existing information justifies raising alertness among the global health community. Moreover, in recent years, a growing body of literature has reported that armed conflicts act as a magnifier of AMR spreading.

          Summary

          Targeted interventions at each stage of migration are urgently needed to limit the spread of the AMR pandemic, particularly among this vulnerable population.

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          Most cited references65

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          Anthropological and socioeconomic factors contributing to global antimicrobial resistance: a univariate and multivariable analysis

          Peter Collignon, John J. Beggs, Timothy R. Walsh … (2018)
          Understanding of the factors driving global antimicrobial resistance is limited. We analysed antimicrobial resistance and antibiotic consumption worldwide versus many potential contributing factors.
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            Antibiotic prescription practices in primary care in low- and middle-income countries: A systematic review and meta-analysis

            Giorgia Sulis, Pierrick Adam, Vaidehi Nafade … (2020)
            Background The widespread use of antibiotics plays a major role in the development and spread of antimicrobial resistance. However, important knowledge gaps still exist regarding the extent of their use in low- and middle-income countries (LMICs), particularly at the primary care level. We performed a systematic review and meta-analysis of studies conducted in primary care in LMICs to estimate the prevalence of antibiotic prescriptions as well as the proportion of such prescriptions that are inappropriate. Methods and findings We searched PubMed, Embase, Global Health, and CENTRAL for articles published between 1 January 2010 and 4 April 2019 without language restrictions. We subsequently updated our search on PubMed only to capture publications up to 11 March 2020. Studies conducted in LMICs (defined as per the World Bank criteria) reporting data on medicine use in primary care were included. Three reviewers independently screened citations by title and abstract, whereas the full-text evaluation of all selected records was performed by 2 reviewers, who also conducted data extraction and quality assessment. A modified version of a tool developed by Hoy and colleagues was utilized to evaluate the risk of bias of each included study. Meta-analyses using random-effects models were performed to identify the proportion of patients receiving antibiotics. The WHO Access, Watch, and Reserve (AWaRe) framework was used to classify prescribed antibiotics. We identified 48 studies from 27 LMICs, mostly conducted in the public sector and in urban areas, and predominantly based on medical records abstraction and/or drug prescription audits. The pooled prevalence proportion of antibiotic prescribing was 52% (95% CI: 51%–53%), with a prediction interval of 44%–60%. Individual studies’ estimates were consistent across settings. Only 9 studies assessed rationality, and the proportion of inappropriate prescription among patients with various conditions ranged from 8% to 100%. Among 16 studies in 15 countries that reported details on prescribed antibiotics, Access-group antibiotics accounted for more than 60% of the total in 12 countries. The interpretation of pooled estimates is limited by the considerable between-study heterogeneity. Also, most of the available studies suffer from methodological issues and report insufficient details to assess appropriateness of prescription. Conclusions Antibiotics are highly prescribed in primary care across LMICs. Although a subset of studies reported a high proportion of inappropriate use, the true extent could not be assessed due to methodological limitations. Yet, our findings highlight the need for urgent action to improve prescription practices, starting from the integration of WHO treatment recommendations and the AWaRe classification into national guidelines. Trial registration PROSPERO registration number: CRD42019123269.
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              Antimicrobial resistance in low- and middle-income countries: current status and future directions

              Giorgia Sulis, Sena Sayood, Sumanth Gandra (2021)
              Rising rates of antimicrobial resistance (AMR) globally continue to pose agrave threat to human health. Low- and middle-income countries (LMICs) are disproportionately affected, partly due to the high burden of communicable diseases.
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                Author and article information

                Journal
                Title: Current Tropical Medicine Reports
                Abbreviated Title: Curr Trop Med Rep
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 2196-3045
                Publication date Created: September 2024
                Publication date (Electronic): June 11 2024
                Volume: 11
                Issue: 3
                Pages: 153-166
                Article
                DOI: 10.1007/s40475-024-00322-2
                SO-VID: dad05639-c61e-432d-8069-e41b23d04d55
                Copyright © © 2024
                License:

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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