It is a common practice for patients in different parts of the country to move around with cannulas on their wrists or arms. However, medical experts warn that this exposes patients to further infection.
Ibrahim Mugerwa, a Senior Antimicrobial Resistance Surveillance Officer under the Uganda National Health Laboratory Services explains that cannulas were designed for inpatients.
Mugerwa notes that wrong prescription is one of the reasons for the increasing burden of antimicrobial resistance. He was speaking at a meeting held at the Laboratory headquarters in Butabika to discuss Uganda’s position on the new global campaign launched by the World Health Organization (WHO) to tackle antibiotics resistance.
WHO is calling upon countries to adopt a tool dubbed ‘AWARE’ which classifies antibiotics into three categories including – Access, Watch and Reserve. The tool specifies which antibiotics to use for the most common and serious infections, which ones should be available at all times in the healthcare system, and those that must be used sparingly or preserved and used only as a last resort.
The tool was developed after reports showed that more than 50% antibiotics in many countries are used inappropriately such as for treatment of viruses when they only treat bacterial infections thus contributing to the spread of Antimicrobial resistance.
In Uganda, Mugerwa says while they know that people are abusing drugs, the magnitude is not yet clear as experts are just in the process of developing standard procedures, which laboratories will use to test and generate data.
He said that even as they updated the clinical guidelines and the essential medicines lists in 2016 that classify which antibiotics should be used at what stage of infection, some health workers don’t follow them while administering treatment to patients.
As a result, he says, people with viral infections are being given antibiotics that are primarily meant to treat bacterial infections something that breeds resistance especially when they the microorganisms are subjected to sub-optimal doses.
He says the laboratory, which is also the National Antimicrobial Resistance Coordination Center, has developed a roadmap whereby they plan to have all the data they need on antimicrobial resistance by 2020 such that national policies can be developed from an informed point of view.
According to him they are currently in addition to coming up with a training manual for health worker’s monitoring right from all affiliated laboratories to establish the resistant bacteria in humans country wide and what exactly they are resistant to.
However, even without a country wide survey, several smaller studies have showed resistance to both first and second line antibiotics. For instance, Makerere University School of Public Health released results of a study three months ago which revealed up to 23 percent of body organisms are resisting second line antibiotics.
Dr. Henry Kajumbula, a microbiologist who chairs the task-force that conducted the study, said that in their research they found that there was resistance to a drug, which is considered the last resort option for patients in intensive care and that the reason for resistance was poor clinical practices by doctors who prescribe strong antibiotics for conditions that can be treated by first line antibiotics.
What is antimicrobial resistance?
Antimicrobial resistance (AMR) refers to the inheritable genetic changes that microbes accumulate to reduce or eliminate the efficacy of antimicrobials.
Over the past 60 years, millions of metric tons of antimicrobials have been distributed worldwide in various products. This extensive exposure has led to the emergence of Multidrug-Resistant (MDR), Extensively Drug-Resistant (XDR), and Pandrug-Resistant (PDR) organisms such as the Klebsiella and Acinetobacter species. Resistant pathogenic strains can develop within only a year of antimicrobial exposure, and the death rate from infections with these strains can approach 50%.
Despite antibiotics only being in extensive use for several decades, certain bacterial infections are now on the verge of becoming untreatable.