Suchergebnisse

South Asia is home to nearly 1.4 billion people, a vast part
of humanity. The countries in the region vary widely in the size of the
population as well as area and physiography. On one side of the scale is
India with a population of more than a billion while on the other side
is Maldives with a population no more than half a million. There is
Bangladesh which is essentially a flat delta, island countries such as
Sri Lanka and Maldives and countries full of high rise mountains such as
Nepal and Bhutan. In between are India and Pakistan with some of
everything. While there are several such external differences among the
countries in the region and their people, these are literally only
skin-deep. The people in the region share, by and large, the same basic
culture. In many cases the same or a similar language is spoken across
the borders. There are, of course, local variations in the general
pattern. But that diversity makes it all the more interesting and
attractive. It is only natural that the countries of the region will
band together to show a united face to the world. This is yet to happen,
though.

INTRODUCTION: Antimicrobial resistance (AMR) has a critical global impact, mostly affecting low- and middle-income countries. A major knowledge gap exists in understanding the transmission pathway of the gut colonisation with AMR bacteria between healthy humans and their animals in addition to the presence of those AMR bacteria in the surrounding environment. A One Health (OH) approach is necessary to address this multisectoral problem. METHODS AND ANALYSIS: This cross-sectional, mixed-method OH study design will use both quantitative and qualitative methods of data collection. Quantitative methods will be carried out to assess the prevalence and risk factors associated with multidrug resistant Gram-negative bacteria and vancomycin-resistant enterococci in humans, animals (cattle) and the environment. The focus will be on cattle rearing as an exposure risk for AMR among humans. The assessment of AMR in the population of Jimma, Ethiopia with or without exposure to cattle will reinforce the importance of OH research to identify the impending exchange of resistance profile between humans and animals as well as its ultimate dissemination in the surrounding environment. The targeted semistructured key stakeholder interviews will aid to strengthen the OH-AMR surveillance in Ethiopia by understanding the acceptability of an integrated AMR surveillance platform based on the District Health Information Software-2 and the feasibility of its context-specific establishment. ETHICS AND DISSEMINATION: The study has been approved by the Regional Ethics Committee, Norway, and the Institutional Review Board of Jimma University, Ethiopia. The study's data will be stored on a secure server known as Services for Sensitive Data hosted by the University of Oslo. In addition, the new European Union Global Data Protection Guidelines for data sharing, storage and protection will be followed. We will publish the results in peer-reviewed journals and present the findings at national and international conferences.

Introduction Antimicrobial resistance (AMR) has a critical global impact, mostly affecting low- and middle-income countries. A major knowledge gap exists in understanding the transmission pathway of the gut colonisation with AMR bacteria between healthy humans and their animals in addition to the presence of those AMR bacteria in the surrounding environment. A One Health (OH) approach is necessary to address this multisectoral problem. Methods and analysis This cross-sectional, mixed-method OH study design will use both quantitative and qualitative methods of data collection. Quantitative methods will be carried out to assess the prevalence and risk factors associated with multidrug resistant Gram-negative bacteria and vancomycin-resistant enterococci in humans, animals (cattle) and the environment. The focus will be on cattle rearing as an exposure risk for AMR among humans. The assessment of AMR in the population of Jimma, Ethiopia with or without exposure to cattle will reinforce the importance of OH research to identify the impending exchange of resistance profile between humans and animals as well as its ultimate dissemination in the surrounding environment. The targeted semistructured key stakeholder interviews will aid to strengthen the OH-AMR surveillance in Ethiopia by understanding the acceptability of an integrated AMR surveillance platform based on the District Health Information Software-2 and the feasibility of its context-specific establishment. Ethics and dissemination The study has been approved by the Regional Ethics Committee, Norway, and the Institutional Review Board of Jimma University, Ethiopia. The study's data will be stored on a secure server known as Services for Sensitive Data hosted by the University of Oslo. In addition, the new European Union Global Data Protection Guidelines for data sharing, storage and protection will be followed. We will publish the results in peer-reviewed journals and present the findings at national and international conferences. ; Understanding transmission ...

Background Education institutions promptly implemented a set of steps to prevent the spread of COVID-19 among international Chinese students, such as restrictive physical exercise, mask wear, daily health reporting, etc. Success of such behavioral change campaigns largely depends on awareness building, satisfaction and trust on the authorities. The purpose of this current study is to assess the preventive, supportive and awareness-building steps taken during the COVID-19 pandemic for international students in China, that will be useful for planning such a behavioral change campaign in the potential pandemic situation in other parts of the world. Methods We conducted an online-based e-questionnaire survey among 467 international students in China through WeChat. The data collection duration was from February 20, 2020 to March 10, 2020 and we focused on their level of awareness, satisfaction, and trust in authorities regarding pandemic measures. Simple bivariate statistics was used to describe the background characteristics of the respondents along with adoption of the partial least squares-structural equation modeling (PLS-SEM) as the final model to demonstrate the relationship between the variables. Results In our study, the leading group of the respondents were within 31 to 35 years' age group (39.82%), male (61.88%), living single (58.24%) and doctoral level students (39.8%). The preventive and supportive measures taken by students and/or provided by the respective institution or authorities were positively related to students' satisfaction and had an acceptable strength (β = 0.611, t = 9.679, p < 0.001). The trust gained in authorities also showed an acceptable strength (β = 0.381, t = 5.653, p < 0.001) with a positive direction. Again, the personnel awareness building related to both students' satisfaction (β = 0.295, t = 2.719, p < 0.001) and trust gain (β = 0.131, t = 1.986, p < 0.05) in authorities had a positive and acceptable intensity. Therefore, our study clearly demonstrates the great impact of preventive and supportive measures in the development of students' satisfaction (R2 = 0.507 indicating moderate relationship). The satisfied students possessed a strong influence which eventually helped in building sufficient trust on their institutions (R2 = 0.797 indicating above substantial relationship). Conclusions The worldwide student group is one of the most affected and vulnerable communities in this situation. So, there is a profound ground of research on how different states or authorities handle such situation. In this study, we have depicted the types and magnitude of care taken by Chinese government and educational institutions towards international students to relieve the panic of pandemic situation. Further research and such initiatives should be taken in to consideration for future emerging conditions.

Background: There is increasing concern around the use of antibiotics in animal food production and the risk of transmission of antimicrobial resistance within the food chain. In many low and middle-income countries, including Bangladesh, the commercial poultry sector comprises small-scale producers who are dependent on credit from poultry dealers to buy day-old chicks and poultry feed. The same dealers also supply and promote antibiotics. The credit system is reliant upon informal relationships among multiple actors as part of social capital. This paper aims to describe dependencies and relationships between different actors within unregulated broiler poultry production systems to understand the social and contextual determinants of antibiotic use in low-resource settings. Methods: We used a cross-sectional qualitative design including in-depth interviews among purposefully selected commercial poultry farmers (n = 10), poultry dealers (n = 5), sales representatives of livestock pharmaceutical companies (n = 3) and the local government livestock officer as a key-informant (n = 1). We describe the food production cycle and practices relating to credit purchases and sales using social capital theory. Findings: Poultry dealers provide credit and information for small-scale poultry farmers to initiate and operate their business. In return for credit, farmers are obliged to buy poultry feed and medicine from their dealer and sell their market-ready poultry to that same dealer. All farms applied multiple antibiotics to poultry throughout the production cycle, including banned antibiotics such as colistin sulfate. The relationship between dealers and poultry farmers is reciprocal but mostly regulated by the dealers. Dealers were the main influencers of decision-making by farmers, particularly around antibiotic use as an integral part of the production cycle risk management. Our findings suggest that strategies to improve antibiotic stewardship and responsible use should exploit the patron-client relationship which provides the social and information network for small-scale farmers. Conclusion: Social capital theory can be applied to the patron-client relationship observed among poultry farmers and dealers in Bangladesh to identify influences on decision making and antibiotic use. Within unregulated food production systems, strategies to promote the prudent use of antibiotics should target commercial feed producers and livestock pharmaceutical manufacturers as a first step in developing a sustainable poultry value chain.

Background: There is increasing concern around the use of antibiotics in animal food production and the risk of transmission of antimicrobial resistance within the food chain. In many low and middle-income countries, including Bangladesh, the commercial poultry sector comprises small-scale producers who are dependent on credit from poultry dealers to buy day-old chicks and poultry feed. The same dealers also supply and promote antibiotics. The credit system is reliant upon informal relationships among multiple actors as part of social capital. This paper aims to describe dependencies and relationships between different actors within unregulated broiler poultry production systems to understand the social and contextual determinants of antibiotic use in low-resource settings. Methods: We used a cross-sectional qualitative design including in-depth interviews among purposefully selected commercial poultry farmers (n = 10), poultry dealers (n = 5), sales representatives of livestock pharmaceutical companies (n = 3) and the local government livestock officer as a key-informant (n = 1). We describe the food production cycle and practices relating to credit purchases and sales using social capital theory. Findings: Poultry dealers provide credit and information for small-scale poultry farmers to initiate and operate their business. In return for credit, farmers are obliged to buy poultry feed and medicine from their dealer and sell their market-ready poultry to that same dealer. All farms applied multiple antibiotics to poultry throughout the production cycle, including banned antibiotics such as colistin sulfate. The relationship between dealers and poultry farmers is reciprocal but mostly regulated by the dealers. Dealers were the main influencers of decision-making by farmers, particularly around antibiotic use as an integral part of the production cycle risk management. Our findings suggest that strategies to improve antibiotic stewardship and responsible use should exploit the patron-client relationship which ...

BACKGROUND: Cholera is endemic in Bangladesh, with outbreaks reported annually. Currently, the majority of epidemic cholera reported globally is El Tor biotype Vibrio cholerae isolates of the serogroup O1. However, in Bangladesh, outbreaks attributed to V. cholerae serogroup O139 isolates, which fall within the same phylogenetic lineage as the O1 serogroup isolates, were seen between 1992 and 1993 and in 2002 to 2005. Since then, V. cholerae serogroup O139 has only been sporadically isolated in Bangladesh and is now rarely isolated elsewhere. METHODS: Here, we present case histories of four cholera patients infected with V. cholerae serogroup O139 in 2013 and 2014 in Bangladesh. We comprehensively typed these isolates using conventional approaches, as well as by whole genome sequencing. Phenotypic typing and PCR confirmed all four isolates belonging to the O139 serogroup. FINDINGS: Whole genome sequencing revealed that three of the isolates were phylogenetically closely related to previously sequenced El Tor biotype, pandemic 7, toxigenic V. cholerae O139 isolates originating from Bangladesh and elsewhere. The fourth isolate was a non-toxigenic V. cholerae that, by conventional approaches, typed as O139 serogroup but was genetically divergent from previously sequenced pandemic 7 V. cholerae lineages belonging to the O139 or O1 serogroups. CONCLUSION: These results suggest that previously observed lineages of V. cholerae O139 persist in Bangladesh and can cause clinical disease and that a novel disease-causing non-toxigenic O139 isolate also occurs. ; This study was supported by a Grant OPP50419 from the Bill & Melinda Gates Foundation and National Institutes of Health (U01A1077883, R01AI106878 and U01AI058935). Additionally, the study was supported by the core grants of icddr,b. icddr,b is thankful to the Governments of Australia, Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support. AEM and NRT were supported by Wellcome Trust grant 098051. AEM is supported by Biotechnology and Biological Sciences Research Council grant BB/M014088/1. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ; This is the final version of the article. It first appeared from PLOS via http://dx.doi.org/10.1371/journal.pntd.0004183