12 research outputs found
Antibiotics and Antimicrobial Resistance in the COVID-19 Era: Perspective from Resource-Limited Settings
The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs, as well as infection prevention and control measures that could help reduce the microbial load and hence circulation of pathogens, with a reduction in dissemination of antimicrobial resistance. These measures should be improved particularly in developing countries. Studies need to be conducted to evaluate the worldwide evolution of antimicrobial resistance during the COVID-19 pandemic, because pathogens do not respect borders. This issue takes on even greater importance in developing countries, where data on resistance patterns are scarce, conditions for infectious pathogen transmission are optimal, and treatment resources are suboptimal
The health impact of rabies in Haiti and recent developments on the path toward elimination, 2010–2015
Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of caninemediated
human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the
world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that
compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs,
surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented
at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure
and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health
and Population and key health development partners (including the Pan-American Health Organization) to provide
technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease
control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from
multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on
seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance
system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable
human rabies biologics supply, 6) achievement of sustained canine vaccination rates of Âł 70%, and 7) finalization of a
national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for
canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which
an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of
rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog
population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the
positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and
access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past
5 years as a result of the efforts of Haiti’s health and agriculture sectors with assistance from multiple international
organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve
as a great example to many developing countries struggling with similar barriers and limitations.http://www.ajtmh.orgam2017Microbiology and Plant Patholog
The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010–2015
Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of caninemediated
human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the
world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that
compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs,
surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented
at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure
and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health
and Population and key health development partners (including the Pan-American Health Organization) to provide
technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease
control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from
multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on
seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance
system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable
human rabies biologics supply, 6) achievement of sustained canine vaccination rates of Âł 70%, and 7) finalization of a
national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for
canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which
an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of
rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog
population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the
positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and
access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past
5 years as a result of the efforts of Haiti’s health and agriculture sectors with assistance from multiple international
organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve
as a great example to many developing countries struggling with similar barriers and limitations.http://www.ajtmh.orgam2017Microbiology and Plant Patholog
Surveillance flow chart for reporting outpatient SARS-CoV-2 cases—Haiti: Data streams for the detection, investigation, and testing of persons suspected of having SARS-CoV-2 infection from March 18 to August 4, 2020.
NP: Nasopharyngeal; LNSP: National Public Health Laboratory (Laboratorie nationale de santé publique; NAAT: Nucleic acid amplification testing; DELR: Directorate of Epidemiology, Laboratories and Research (Direction d’epidemiologie, de laboratoire et de recherches).</p
Characteristics of all COVID-19 cases, by symptom status, Haiti, March to August 2020.
Characteristics of all COVID-19 cases, by symptom status, Haiti, March to August 2020.</p
SARS-CoV-2 outbreak by week of onset–Haiti: Number of suspected and confirmed outpatient SARS-CoV-2 cases and percent positivity of tests by epidemiological week from March 18 to August 4, 2020.
SARS-CoV-2 outbreak by week of onset–Haiti: Number of suspected and confirmed outpatient SARS-CoV-2 cases and percent positivity of tests by epidemiological week from March 18 to August 4, 2020.</p