Containing antimicrobial resistance in rural Cambodia: a one-health multi-disciplinary intervention to improve village healthcare and farming practice

遏制柬埔寨农村的抗菌素耐药性:一项单一健康的多学科干预措施,以改善村庄医疗保健和农业实践

基本信息

  • 批准号:
    MR/R015147/1
  • 负责人:
  • 金额:
    $ 10.16万
  • 依托单位:
  • 依托单位国家:
    英国
  • 项目类别:
    Research Grant
  • 财政年份:
    2017
  • 资助国家:
    英国
  • 起止时间:
    2017 至 无数据
  • 项目状态:
    已结题

项目摘要

Antibiotic resistance has been termed the greatest menace of the current century by the World Health Organization. If appropriate measures to mitigate antibiotic resistance are not taken immediately, it is estimated that millions of people will die, in the near future due to complications arising out of inability to treat resistant infections and most of this burden will fall on the poor, underdeveloped part of the world. The main drivers of antibiotic resistance are antibiotic use and antibiotic residues in the environment. Both generate resistant bacteria. Appropriate monitoring and mitigation of both is neglected in poorer countries due to inadequacy of awareness, infrastructure, economics, political will, socio-cultural dimensions and a myriad of other factors. Resistance knows no geographical or political boundaries; it spreads quickly all over the world. So, not only the poorer human beings from underdeveloped countries suffer, these countries also become 'hot spots' of resistance generation and spread. Cambodia is the poorest country in the Greater Mekong Sub-Region and continues to recover from a prolonged civil war which saw its institutions and infrastructure destroyed, which resulted in the loss of most of its educated personnel. With support of international partners, Cambodia is rapidly developing; Cambodia was one of the countries, which achieved the millennium development goals in reducing infant and child mortality. The proposed provinces for the antibiotic resistance study and intervention are among the most remote and underserved both within the formal health and agricultural systems and rely for care on personnel who have minimal training for both care of patients and animals. When a person or animal becomes ill, medicines including antibiotics, often of dubious quality are bought from local pharmacies or market stalls and administered by the persons themselves. Human antibiotics are often given to animals and vice versa. Due to the deficit of trained health personnel, Cambodia has developed a cadre of village level healthcare workers, who have minimal training and little supervision to treat villagers or their sick animals. Little care is taken in disposing of antibiotics, which must be resulting in huge amount of residues in Cambodian environment. The proposed project will investigate and map the current status of antibiotic use, antibiotic resistance and antibiotic residues in the target area and would examine the drivers for these in these remote areas, involving various stakeholders including human and animal healthcare providers and policy makers. We would involve the newly instituted laboratory and personnel in the Royal University of Agriculture and Veterinary Medicine as well as our partners, the Ministry of Health and the Ministry of Fisheries and Agriculture. We would also seek to evaluate the efficacy of a community dialogue intervention in improving the knowledge and understanding of use, handling and disposal of antibiotics to achieve appropriate antibiotic resistance management.
抗生素耐药性已被世界卫生组织称为本世纪最大的威胁。如果不立即采取适当措施减轻抗生素耐药性,估计在不久的将来,数百万人将死于因无法治疗耐药性感染而引起的并发症,而这一负担的大部分将落在世界上贫穷、不发达的地区。抗生素耐药性的主要驱动因素是抗生素的使用和环境中的抗生素残留。两者都会产生耐药细菌。由于认识不足、基础设施、经济、政治意愿、社会文化层面和无数其他因素,较贫穷国家忽视了对这两种情况的适当监测和缓解。抵抗运动不分地理或政治界限,它迅速蔓延到全世界。因此,不仅来自不发达国家的穷人受苦,这些国家也成为耐药性产生和传播的“热点”。柬埔寨是大湄公河次区域最贫穷的国家,继续从长期内战中恢复,内战摧毁了其机构和基础设施,导致其大部分受过教育的人员丧生。在国际伙伴的支持下,柬埔寨正在迅速发展;柬埔寨是实现降低婴儿和儿童死亡率的千年发展目标的国家之一。拟议进行抗生素耐药性研究和干预的省份是正规卫生和农业系统中最偏远和服务不足的省份之一,依赖于在照顾病人和动物方面接受过最低限度培训的人员提供护理。当人或动物生病时,包括抗生素在内的药品往往质量可疑,从当地药店或市场摊位购买,由人自己服用。人用抗生素经常给动物使用,反之亦然。由于缺乏训练有素的保健人员,柬埔寨培养了一批村级保健工作者,他们在治疗村民或他们生病的牲畜方面几乎没有受过什么培训,也没有受到什么监督。在处理抗生素时很少注意,这必然导致柬埔寨环境中存在大量残留物。拟议的项目将调查和绘制目标地区抗生素使用、抗生素耐药性和抗生素残留的现状,并将研究这些偏远地区的驱动因素,涉及包括人类和动物保健提供者和政策制定者在内的各种利益相关者。我们将参与新设立的实验室和皇家农业和兽医大学的人员以及我们的合作伙伴,卫生部和渔业和农业部。我们还将寻求评估社区对话干预措施在提高对抗生素使用、处理和处置的知识和理解以实现适当的抗生素耐药性管理方面的功效。

项目成果

期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Conference research results poster
会议研究成果海报
  • DOI:
  • 发表时间:
    2018
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Chea Rortana
  • 通讯作者:
    Chea Rortana
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John Walley其他文献

Assessing health needs in developing countries
评估发展中国家的健康需求
  • DOI:
    10.1136/bmj.316.7147.1819
  • 发表时间:
    1998
  • 期刊:
  • 影响因子:
    0
  • 作者:
    John Wright;John Walley
  • 通讯作者:
    John Walley
Delivering enhanced cardiovascular (Hypertension) disease care through private health facilities in Pakistan
  • DOI:
    10.1186/1471-2261-13-76
  • 发表时间:
    2013-09-25
  • 期刊:
  • 影响因子:
    2.300
  • 作者:
    Muhammad Amir Khan;Wajiha Javed;Maqsood Ahmed;John Walley;Haroon Jahangir Khan
  • 通讯作者:
    Haroon Jahangir Khan
Sexually Transmitted Disease Syndromic Case Management Through Public Sector Facilities: Development and Assessment Study in Punjab Pakistan
  • DOI:
    10.1016/j.aogh.2015.02.002
  • 发表时间:
    2014-11-01
  • 期刊:
  • 影响因子:
  • 作者:
    Muhammad Amir Khan;Wajiha Javed;Maqsood Ahmed;John Walley;Muhammad Arif Munir
  • 通讯作者:
    Muhammad Arif Munir
Care for AIDS patients in developing countries: a review.
发展中国家艾滋病患者的护理:回顾。
  • DOI:
  • 发表时间:
    1992
  • 期刊:
  • 影响因子:
    1.7
  • 作者:
    D. Schopper;John Walley
  • 通讯作者:
    John Walley

John Walley的其他文献

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