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El Moustapha I, Ouldabdallahi Moukah M, Ould Ahmedou Salem MS, Brahim K, Briolant S, Basco L, Ould Mohamed Salem Boukhary A. Malaria prevalence in Mauritania: a systematic review and meta-analysis. Malar J 2023; 22:146. [PMID: 37131226 PMCID: PMC10152621 DOI: 10.1186/s12936-023-04569-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Understanding malaria epidemiology is a critical step toward efficient malaria control and elimination. The objective of this meta-analysis was to derive robust estimates of malaria prevalence and Plasmodium species from studies conducted in Mauritania and published since 2000. METHODS The present review followed the PRISMA guidelines. Searches were conducted in various electronic databases such as PubMed, Web of Science, and Scopus. To obtain pooled prevalence of malaria, meta-analysis was performed using the DerSimonian-Laird random-effects model. Methodological quality of eligible prevalence studies was assessed using Joanna Briggs Institute tool. Inconsistency and heterogeneity between studies were quantified by the I2 index and Cochran's Q test. Publication bias was assessed with funnel plots and Egger's regression tests. RESULTS A total of 16 studies with a good individual methodological quality were included and analysed in this study. The overall random effects pooled prevalence of malaria infection (symptomatic and asymptomatic) across all included studies was 14.9% (95% confidence interval [95% CI]: 6.64, 25.80, I2 = 99.8%, P < 0.0001) by microscopy, 25.6% (95% CI: 8.74, 47.62, I2 = 99.6%, P < 0.0001) by PCR and 24.3% (95% CI: 12.05 to 39.14, I2 = 99.7%, P < 0.0001) by rapid diagnostic test. Using microscopy, the prevalence of asymptomatic malaria was 1.0% (95% CI: 0.00, 3.48) against 21.46% (95% CI: 11.03, 34.21) in symptomatic malaria. The overall prevalence of Plasmodium falciparum and Plasmodium vivax was 51.14% and 37.55%, respectively. Subgroup analysis showed significant variation (P = 0.039) in the prevalence of malaria between asymptomatic and symptomatic cases. CONCLUSION Plasmodium falciparum and P. vivax are widespread in Mauritania. Results of this meta-analysis implies that distinct intervention measures including accurate parasite-based diagnosis and appropriate treatment of confirmed malaria cases are critical for a successful malaria control and elimination programme in Mauritania.
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Affiliation(s)
- Inejih El Moustapha
- Université de Nouakchott, UR-GEMI, nouveau campus universitaire, BP 5026, Nouakchott, Mauritania
| | | | | | - Khyarhoum Brahim
- Université de Nouakchott, UR-GEMI, nouveau campus universitaire, BP 5026, Nouakchott, Mauritania
| | - Sébastien Briolant
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France
| | - Leonardo Basco
- IHU-Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- Université de Nouakchott, UR-GEMI, nouveau campus universitaire, BP 5026, Nouakchott, Mauritania.
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.
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Djigo OKM, Gomez N, Ould Ahmedou Salem MS, Basco L, Ould Mohamed Salem Boukhary A, Briolant S. Performance of a Commercial Multiplex Allele-Specific Polymerase Chain Reaction Kit to Genotype African-Type Glucose-6-Phosphate Dehydrogenase Deficiency. Am J Trop Med Hyg 2023; 108:449-455. [PMID: 36535256 PMCID: PMC9896312 DOI: 10.4269/ajtmh.21-1081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/03/2022] [Indexed: 12/23/2022] Open
Abstract
8-Aminoquinoline antimalarial drugs (primaquine, tafenoquine) are required for complete cure of Plasmodium vivax malaria, but they are contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. In the absence of spectrophotometry, which is a gold standard for measuring G6PD activity, G6PD genotyping is one of the alternatives to establish a database and distribution map of G6PD enzyme deficiency in Mauritania, which has become a new epicenter of P. vivax malaria in West Africa. The aim of our study was to assess the performance of multiplex allele-specific polymerase chain reaction (PCR) (African-type Diaplex C™ G6PD kit) against PCR-restriction fragment length polymorphism and sequencing. Of 146 mutations associated with G6PD A- genotypes in 177 blood samples from Mauritanian patients, all but two samples were identified correctly using multiplex allele-specific PCR (100% sensitivity and 99% specificity; "almost perfect agreement" between allele-specific PCR and PCR-restriction fragment length polymorphism/sequencing, with a kappa coefficient of 0.977). Despite a suboptimal PCR protocol for dried blood spots and the inability of the commercial assay to predict unequivocally the G6PD enzyme level in heterozygous females, the African-type Diaplex C™ G6PD genotyping kit seemed to be a valuable screening tool for male subjects and for research purposes in resource-limited countries where spectrophotometer and DNA sequencing are not available.
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Affiliation(s)
- Oum Kelthoum Mamadou Djigo
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott, Mauritania
| | - Nicolas Gomez
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire–Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Mohamed Salem Ould Ahmedou Salem
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott, Mauritania
| | - Leonardo Basco
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire–Méditerranée Infection, Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott, Mauritania
| | - Sébastien Briolant
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs–Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire–Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
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El Moustapha I, Deida J, Dadina M, El Ghassem A, Begnoug M, Hamdinou M, Mint Lekweiry K, Ould Ahmedou Salem MS, Khalef Y, Semane A, Ould Brahim K, Briolant S, Bogreau H, Basco L, Ould Mohamed Salem Boukhary A. Changing epidemiology of Plasmodium vivax malaria in Nouakchott, Mauritania: a six-year (2015-2020) prospective study. Malar J 2023; 22:18. [PMID: 36650533 PMCID: PMC9843100 DOI: 10.1186/s12936-023-04451-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Plasmodium vivax malaria is one of the major infectious diseases of public health concern in Nouakchott, the capital city of Mauritania and the biggest urban setting in the Sahara. The assessment of the current trends in malaria epidemiology is primordial in understanding the dynamics of its transmission and developing an effective control strategy. METHODS A 6 year (2015-2020) prospective study was carried out in Nouakchott. Febrile outpatients with a clinical suspicion of malaria presenting spontaneously at Teyarett Health Centre or the paediatric department of Mother and Children Hospital Centre were screened for malaria using a rapid diagnostic test, microscopic examination of Giemsa-stained blood films, and nested polymerase chain reaction. Data were analysed using Microsoft Excel and GraphPad Prism and InStat software. RESULTS Of 1760 febrile patients included in this study, 274 (15.5%) were malaria-positive by rapid diagnostic test, 256 (14.5%) were malaria-positive by microscopy, and 291 (16.5%) were malaria-positive by PCR. Plasmodium vivax accounted for 216 of 291 (74.2%) PCR-positive patients; 47 (16.1%) and 28 (9.6%) had P. falciparum monoinfection or P. vivax-P. falciparum mixed infection, respectively. During the study period, the annual prevalence of malaria declined from 29.2% in 2015 to 13.2% in 2019 and 2.1% in 2020 (P < 0.05). Malaria transmission was essentially seasonal, with a peak occurring soon after the rainy season (October-November), and P. vivax infections, but not P. falciparum infections, occurred at low levels during the rest of the year. The most affected subset of patient population was adult male white and black Moors. The decline in malaria prevalence was correlated with decreasing annual rainfall (r = 0.85; P = 0.03) and was also associated with better management of the potable water supply system. A large majority of included patients did not possess or did not use bed nets. CONCLUSIONS Control interventions based on prevention, diagnosis, and treatment should be reinforced in Nouakchott, and P. vivax-specific control measures, including chloroquine and 8-aminoquinolines (primaquine, tafenoquine) for treatment, should be considered to further improve the efficacy of interventions and aim for malaria elimination.
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Affiliation(s)
- Inejih El Moustapha
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Jemila Deida
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Mariem Dadina
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Abdellahi El Ghassem
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Mariem Begnoug
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Mariem Hamdinou
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Khadijetou Mint Lekweiry
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania ,Unité de Recherche Ressources Génétique et Environnement, Institut Supérieur d’Enseignement Technologique (ISET), Rosso, Mauritania
| | - Mohamed Salem Ould Ahmedou Salem
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Yacoub Khalef
- Department of Pediatrics, Mother and Children Hospital Centre, Centre Hospitalier Mère et Enfant (CHME), Nouakchott, Mauritania
| | - Amal Semane
- Teyarett Health Centre (Centre de Santé de Teyarett), Nouakchott, Mauritania
| | - Khyarhoum Ould Brahim
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania
| | - Sébastien Briolant
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France ,grid.483853.10000 0004 0519 5986IHU-Méditerranée Infection, Marseille, France ,grid.418221.cUnité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France
| | - Hervé Bogreau
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France ,grid.483853.10000 0004 0519 5986IHU-Méditerranée Infection, Marseille, France ,grid.418221.cUnité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), Marseille, France
| | - Leonardo Basco
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France ,grid.483853.10000 0004 0519 5986IHU-Méditerranée Infection, Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- grid.442613.60000 0000 8717 1355Unité de Recherche Génomes et Milieux (GEMI), Université de Nouakchott, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania ,grid.483853.10000 0004 0519 5986IHU-Méditerranée Infection, Marseille, France
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Djigo OKM, Ould Ahmedou Salem MS, Diallo SM, Bollahi MA, Boushab BM, Garre A, Papa Mze N, Basco L, Briolant S, Ould Mohamed Salem Boukhary A. Molecular Epidemiology of G6PD Genotypes in Different Ethnic Groups Residing in Saharan and Sahelian Zones of Mauritania. Pathogens 2021; 10:pathogens10080931. [PMID: 34451395 PMCID: PMC8398068 DOI: 10.3390/pathogens10080931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022] Open
Abstract
Plasmodium vivax malaria is endemic in Mauritania. Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency may develop acute hemolytic anemia when exposed to 8-aminoquinoline antimalarial drugs, which are indispensable for a complete cure. The prevalence of G6PD allelic variants was assessed in different ethno-linguistic groups present in Mauritania. A total of 996 blood samples (447 males and 549 females; 499 white Moors and 497 individuals of black African ancestry) were collected from febrile patients in 6 different study sites: Aleg, Atar, Kiffa, Kobeni, Nouakchott, and Rosso. The presence of the African-type G6PD A- (G202A, A376G, A542T, G680T, and T968C mutations) and the Mediterranean-type G6PD B- (C563T) variants was assessed by PCR followed by restriction fragment length polymorphism and/or DNA sequencing. The prevalence of African-type G6PD A- genotype was 3.6% (36/996), with 6.3% (28/447) of hemizygote (A-) males and 1.5% (8/549) of homozygous (A-A-) females. Forty of 549 (7.3%) women were heterozygous (AA-). The following genotypes were observed among hemizygous men and/or homozygous women: A376G/G202A (22/996; 2.2%), A376G/T968C Betica-Selma (12/996; 1.2%), and A376G/A542T Santamaria (2/996; 0.2%). The Mediterranean-type G6PD B- genotype was not observed. The prevalence rates of G6PD A- genotype in male (10/243; 4.1%) and heterozygous female (6/256; 2.3%) white Moors were lower (p < 0.05) than those of males (18/204; 8.8%) and heterozygous females (34/293; 11.6%) of black African ancestry. There were only a few homozygous women among both white Moors (3/256; 1.2%) and those of black African ancestry (5/293; 1.7%). The prevalence of G6PD deficiency in Mauritania was comparable to that of neighboring countries in the Maghreb. Because of the purportedly close ethnic ties between the Mauritanian white Moors and the peoples in the Maghreb, further investigations on the possible existence of the Mediterranean-type allele are required. Moreover, a surveillance system of G6PD phenotype and/or genotype screening is warranted to establish and monitor a population-based prevalence of G6PD deficiency.
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Affiliation(s)
- Oum Kelthoum Mamadou Djigo
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouakchott, Mauritania; (O.K.M.D.); (M.S.O.A.S.); (S.M.D.)
| | - Mohamed Salem Ould Ahmedou Salem
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouakchott, Mauritania; (O.K.M.D.); (M.S.O.A.S.); (S.M.D.)
| | - Sileye Mamadou Diallo
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouakchott, Mauritania; (O.K.M.D.); (M.S.O.A.S.); (S.M.D.)
| | | | - Boushab Mohamed Boushab
- Department of Internal Medicine and Infectious Diseases, Kiffa Regional Hospital, Assaba, Mauritania;
| | - Aymeric Garre
- Aix Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Santé des Armées (SSA), Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), 13005 Marseille, France; (A.G.); (N.P.M.); (L.B.); (S.B.)
- Institut Hospitalo-Universitaire (IHU)—Méditerranée Infection, 13005 Marseille, France
| | - Nasserdine Papa Mze
- Aix Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Santé des Armées (SSA), Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), 13005 Marseille, France; (A.G.); (N.P.M.); (L.B.); (S.B.)
- Institut Hospitalo-Universitaire (IHU)—Méditerranée Infection, 13005 Marseille, France
| | - Leonardo Basco
- Aix Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Santé des Armées (SSA), Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), 13005 Marseille, France; (A.G.); (N.P.M.); (L.B.); (S.B.)
- Institut Hospitalo-Universitaire (IHU)—Méditerranée Infection, 13005 Marseille, France
| | - Sébastien Briolant
- Aix Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Santé des Armées (SSA), Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), 13005 Marseille, France; (A.G.); (N.P.M.); (L.B.); (S.B.)
- Institut Hospitalo-Universitaire (IHU)—Méditerranée Infection, 13005 Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées (IRBA), 13005 Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- Unité de Recherche “Génomes et Milieux” (Jeune Equipe Associée à l’Institut de Recherche pour le Développement), Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouakchott, Mauritania; (O.K.M.D.); (M.S.O.A.S.); (S.M.D.)
- Correspondence:
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Boushab BM, Ould Ahmedou Salem MS, Ould Mohamed Salem Boukhary A, Parola P, Basco L. Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania. Trop Med Infect Dis 2020; 6:tropicalmed6010001. [PMID: 33375214 PMCID: PMC7838900 DOI: 10.3390/tropicalmed6010001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022] Open
Abstract
Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.
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Affiliation(s)
- Boushab Mohamed Boushab
- Department of Internal Medicine and Infectious Diseases, Kiffa Regional Hospital, Assaba, Mauritania;
| | - Mohamed Salem Ould Ahmedou Salem
- Unité de Recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania; (M.S.O.A.S.); (A.O.M.S.B.)
| | - Ali Ould Mohamed Salem Boukhary
- Unité de Recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott Al-Aasriya, Nouveau Campus Universitaire, BP 5026, Nouakchott, Mauritania; (M.S.O.A.S.); (A.O.M.S.B.)
- Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France;
- Institut Hospitalo-Universitaire (IHU)-Méditerranée Infection, 13005 Marseille, France
| | - Philippe Parola
- Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France;
- Institut Hospitalo-Universitaire (IHU)-Méditerranée Infection, 13005 Marseille, France
| | - Leonardo Basco
- Institut de Recherche pour le Développement (IRD), Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France;
- Institut Hospitalo-Universitaire (IHU)-Méditerranée Infection, 13005 Marseille, France
- Correspondence:
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Berndtson AE. Increasing Globalization and the Movement of Antimicrobial Resistance between Countries. Surg Infect (Larchmt) 2020; 21:579-585. [PMID: 32434446 DOI: 10.1089/sur.2020.145] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: The threat of antimicrobial resistance continues to grow worldwide, exacerbated by poor antibiotic stewardship practices, limited development of new antimicrobial agents, and increasing globalization. Methods: This review covers previously published studies examining how human movement contributes to the global spread of antimicrobial resistance, including between low- and middle-income and high-income countries. Results: The emergence of resistance in one country or part of the world can become a worldwide event quickly. Human movement, including travel, medical tourism, military service, and migration, results in the globalization of resistant bacterial strains. Conclusions: Increased surveillance, whole-genome sequencing, focused infection control, and effective stewardship practices are needed to maintain the efficacy of antibiotics.
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Affiliation(s)
- Allison E Berndtson
- Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, University of California-San Diego, San Diego, California, USA
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