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literature review

Problem:

Nigeria faces a severe and escalating AMR crisis. This is driven by multiple factors,

frequently intertwined:

  • High rates of infectious diseases: Nigeria has a high burden of common bacterial infections, creating significant demand for antimicrobials.
  • Overuse and misuse of antimicrobials: Antimicrobials are frequently prescribed inappropriately (without proper diagnosis or for viral infections), used without completing the prescribed course, and readily available without prescription (overthe-counter). This contributes significantly to the development and spread of resistant strains.
  • Poor infection prevention and control practices: Inadequate hygiene and sanitation in healthcare facilities and communities facilitate the transmission of resistant bacteria.
  • Limited access to diagnostics:** The lack of rapid and reliable diagnostic tests leads to empiric treatment with broad-spectrum antimicrobials, further fueling resistance.
  • **Weak regulatory frameworks:** Lax regulations on antimicrobial sales and use contribute to inappropriate antimicrobial use.
  • **Lack of awareness and education:** Limited public and healthcare professional awareness about AMR and appropriate antimicrobial use hampers effective stewardship.
  • **Inadequate healthcare infrastructure:** Overcrowded hospitals and understaffed facilities exacerbate the spread of infections and limit infection control measures.
  • **Counterfeit and substandard drugs:** The prevalence of counterfeit and substandard antimicrobials compromises treatment effectiveness and contributes to resistance development.

Addressing the Problem: Current Strategies and Challenges**

Studies show that Nigeria is actively working on various strategies to combat AMR, including:

  • **National Action Plans:** Development and implementation of national action plans to address AMR.
  • **Stewardship programs:** Initiatives focusing on improving antimicrobial prescribing practices in hospitals and communities.
  • **Surveillance systems:** Efforts to monitor antimicrobial resistance patterns and track the spread of resistant organisms.

 

  • **Research and development:** Studies focusing on the epidemiology of AMR, new diagnostic tools, and alternative treatments.
  • **Capacity building:** Training healthcare professionals on appropriate antimicrobial use and infection prevention and control.
  • **Public health campaigns:** Raising public awareness about AMR and promoting responsible antimicrobial use.

Challenges Remain:  

Despite these efforts, significant challenges persist:

Funding constraints:** Limited resources hinder the implementation of effective AMR control programs.

  • Weak healthcare infrastructure:** Overburdened healthcare systems struggle to implement infection prevention and control measures.
  • **Lack of political will:** Insufficient commitment from policymakers to address the AMR crisis effectively.
  • **Coordination challenges:** Lack of effective coordination between different stakeholders involved in AMR control.

In summary, the literature consistently highlights a serious AMR crisis in Nigeria, fueled by a complex interplay of factors. While various strategies are being implemented, significant challenges remain, requiring sustained multi-sectoral efforts and increased investment to effectively combat this growing threat to public health. Further research is needed to refine interventions and tailor them to the specific context of Nigeria.

 

 

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Dr. Omobosola Akinsete is a dedicated physician and a key member of the Nigerian Antimicrobial Stewardship Taskforce. She has been an internal medicine and adult Infectious Disease physician in the United States of America for 30  years . She graduated from Medical school at the University of Lagos, and has a masters in Public Health from Johns Hopkins school of Public Health. 

She did her Internal Medicine training at a Brown University hospital and her fellowship in Infectious Diseases  at the University of Minnesota where she is an associate professor. She has worked with the National Institutes of Health and Howard University a a coordinator for the Human Genome Project among other projects, she is a frequent public speaker and contributor to different types of media. She loves to advocate for healthcare in minority populations. She  has a lot of experience with  patients and health care providers on antimicrobial stewardship in her institution  HealthPartners in Minnesota U.S.A. Her expertise in the field of Infectious diseases and antimicrobial stewardship and her passion to improve health care in her home country will contribute significantly to the fight against antimicrobial resistance in Nigeria. Dr. Akinsete’s work with the taskforce focuses on leadership of the taskforce as chairperson and national coordinator, working closely with NCDC leadership, the Nigerian Federal Ministry of Health, stakeholders, and funding partners, and helping with capacity building of standardized antimicrobial stewardship and infectious disease educational programs. She will also use her expertise to guide providers and HealthCare institutions  on the ground . Her commitment to improving antimicrobial use and patient safety is invaluable to the nation’s public health efforts.