January 04, 2024
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Key takeaways:
- Antimicrobial resistance accounted for more than 25% of the 3.83 million infection-related deaths in Africa in 2019.
- Four major pathogens were responsible for more than half of the deaths linked to resistance.
Researchers linked more than 1 million deaths in Africa in 2019 to antimicrobial resistance, more than half of which were linked to just four pathogens.
The study revealed that, of the estimated 3.83 million infection-related deaths in Africa that year, 1.86 million were linked to 33 priority bacterial pathogens in the region and 1.05 million deaths were associated with bacterial antimicrobial resistance (AMR).
Previous research has found that although the prevalence of AMR in sub-Saharan Africa is lower than any other region of the world, the burden of infectious diseases on the continent is high enough that it overcomes that low prevalence. In 2021, the region was one of three that experts suggested needs improved AMR surveillance.
“To contextualize in terms of other leading causes of infectious deaths in the region, which have far greater investment, the burden of deaths associated with bacterial AMR exceeds the estimated number deaths in 2019 due to HIV/AIDS (639,554) and malaria (594,348),” Benn Sartorius, PhD, a senior geospatial infectious disease modeler and global health epidemiologist at the University of Oxford, and colleagues wrote in the new study.
Sartorius and colleagues analyzed data representing 343 million individual records and 11,361 study-location-years collected in studies published between Nov. 1, 2019, and Sept. 30, 2020, to estimate the disease burden associated with and attributable to AMR in Africa. From this, the researchers determined AMR burden estimates for 47 countries, 23 bacterial pathogens and 88 pathogen-drug combinations.
Of 3.83 million infection-related deaths in Africa in 2019, more than one-quarter — 1.05 million — were linked to AMR, with the highest mortality rates found in the Central African Republic, Lesotho and Eritrea. Of the 1.05 million AMR-related deaths, more than 250,000 were directly attributable to AMR, the researchers reported.
The four most common pathogens were each linked to well over 100,000 deaths — Streptococcus pneumoniae (195,000), Klebsiella pneumoniae (184,000), Escherichia coli (147,000) and Staphylococcus aureus (136,000) — and responsible for roughly half the AMR-related deaths in Africa in 2019, according to the study.
Collectively, 1.93 million infection-related deaths were linked to one of three syndromes identified as an underlying or intermediate cause of death — lower respiratory and thorax infection, bloodstream infection or tuberculosis infection — and the three syndromes accounted for 75% of the fatal burden from bacterial infections in the region.
Sartorius and colleagues noted that in order to effectively tackle AMR, experts and officials need comprehensive population-based surveillance-based data for some nations, and improved data from other nations, the lack of which they considered a limitation in calculating the estimates.
“In countries with low access to quality health care and antibiotics, reducing infection is the greatest tool for reducing AMR. Conversely, in countries where access to health care and antibiotics are established, AMR can be reduced through improved antimicrobial stewardship and governance,” the researchers wrote. “To elicit a sustained response, it is necessary to have awareness and collaboration between key stakeholders such as policy makers, local communities and non-governmental organizations.”
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Sources/Disclosures
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Disclosures:
Sartorius reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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