da Costa Romay Coragem, Serrano Isa, Chambel Lélia, Oliveira Manuela
CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal.
Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisboa, Portugal.
One Health. 2024 Feb 1;18:100691. doi: 10.1016/j.onehlt.2024.100691. eCollection 2024 Jun.
The dissemination of multidrug-resistant (MDR) bacterial isolates in low- and middle-income countries, including several African countries, is a major concern. The poor sanitary conditions of rural and urban families observed in certain regions may favor the transmission of bacterial infections between animals and humans, including those promoted by strains resistant to practically all available antibiotics. In Angola, in particular, the presence of these strains in human hospitals has already been described. Nevertheless, the information on antimicrobial resistance (AMR) prevalence in Angola is still scarce, especially regarding veterinary isolates. This review aimed to synthesize data on antimicrobial resistance in African countries, with a special focus on Angola, from a One Health perspective. The main goals were to identify research gaps that may require further analysis, and to draw attention to the importance of the conscious use of antimicrobials and the establishment of preventive strategies, aiming to guarantee the safeguarding of public health. To understand these issues, the available literature on AMR in Africa was reviewed. We searched PubMed for articles pertinent to AMR in relevant pathogens in Angola and other African countries. In this review, we focused on AMR rates and surveillance capacity. The principal findings were that, in Africa, especially in sub-Saharan countries, AMR incidence is high due to the lack of legislation on antibiotics, to the close interaction of humans with animals and the environment, and to poverty. The information about current resistance patterns of common pathogenic bacteria is sparse, and the number of quality studies is limited in Angola and in some other Sub-Saharan African countries. Also, studies on the "One Health Approach" focusing on the environment, animals, and humans, are scarce in Africa. The surveillance capacity is minimal, and only a low number of AMR surveillance programs and national health programs are implemented. Most international and cooperative surveillance programs, when implemented, are not properly followed, concluded, nor reported. In Angola, the national health plan does not include AMR control, and there is a consistent omission of data submitted to international surveillance programs. By identifying One Health strengths of each country, AMR can be controlled with a multisectoral approach and governmental commitment.
包括若干非洲国家在内的低收入和中等收入国家中多重耐药（MDR）细菌分离株的传播是一个主要问题。在某些地区观察到的城乡家庭卫生条件差，可能有利于动物与人类之间细菌感染的传播，包括那些由对几乎所有可用抗生素耐药的菌株所促成的感染。特别是在安哥拉，这些菌株在人类医院中的存在已有报道。然而，安哥拉关于抗菌药物耐药性（AMR）流行情况的信息仍然匮乏，尤其是关于兽医分离株的信息。本综述旨在从“同一健康”视角综合非洲国家，特别是安哥拉的抗菌药物耐药性数据。主要目标是确定可能需要进一步分析的研究空白，并提请注意合理使用抗菌药物以及制定预防策略的重要性，以保障公众健康。为了解这些问题，对非洲现有的关于AMR的文献进行了综述。我们在PubMed上搜索了与安哥拉和其他非洲国家相关病原体中AMR相关的文章。在本综述中，我们重点关注AMR发生率和监测能力。主要发现是，在非洲，特别是撒哈拉以南国家，由于缺乏抗生素立法、人类与动物及环境的密切互动以及贫困，AMR发生率很高。关于常见病原菌当前耐药模式的信息稀少，在安哥拉和其他一些撒哈拉以南非洲国家，高质量研究的数量有限。此外，在非洲，关注环境、动物和人类的“同一健康方法”研究也很稀少。监测能力极低，仅有少数AMR监测项目和国家卫生项目得以实施。大多数国际和合作监测项目在实施时，没有得到妥善的跟踪、总结和报告。在安哥拉，国家卫生计划不包括AMR控制，并且一直存在向国际监测项目提交数据缺失的情况。通过确定每个国家的“同一健康”优势，可以通过多部门方法和政府承诺来控制AMR。
