The role of Environmental Health in preventing antimicrobial resistance in low- and middle-income countries - PubMed (original) (raw)

The role of Environmental Health in preventing antimicrobial resistance in low- and middle-income countries

David Musoke et al. Environ Health Prev Med. 2021.

Abstract

Antimicrobial resistance (AMR) is increasingly becoming a threat to global public health, not least in low- and middle-income countries (LMICs) where it is contributing to longer treatment for illnesses, use of higher generation drugs, more expenditure on antimicrobials, and increased deaths attributed to what should be treatable diseases. Some of the known causes of AMR include misuse and overuse of antimicrobials in both humans and animals, unnecessary use of antimicrobials in animals as growth promoters, and lack of awareness among the public on how to protect antimicrobials. As a result, resistant organisms are circulating in the wider environment, and there is a need to consider the One Health approach to minimise the continuing development of AMR. Environmental Health, specifically water, sanitation and hygiene (WASH), waste management, and food hygiene and safety, are key components of One Health needed to prevent the spread of antimicrobial-resistant microorganisms particularly in LMICs and reduce the AMR threat to global public health. The key Environmental Health practices in the prevention of AMR include: (1) adequate WASH through access and consumption of safe water; suitable containment, treatment and disposal of human excreta and other wastewater including from health facilities; good personal hygiene practices such as washing hands with soap at critical times to prevent the spread of resistant microorganisms, and contraction of illnesses which may require antimicrobial treatment; (2) proper disposal of solid waste, including the disposal of unused and expired antimicrobials to prevent their unnecessary exposure to microorganisms in the environment; and (3) ensuring proper food hygiene and safety practices, such as sale and consumption of animal products in which adequate antimicrobial withdrawal periods have been observed, and growing vegetables on unpolluted soil. Environmental Health is therefore crucial in the prevention of infectious diseases that would require antimicrobials, reducing the spread of resistant organisms, and exposure to antimicrobial residues in LMICs. Working with other professionals in One Health, Environmental Health Practitioners have a key role in reducing the spread of AMR including health education and promotion, surveillance, enforcement of legislation, and research.

Keywords: Antimicrobial resistance; Environmental Health; Food safety; Hygiene; One Health; Sanitation; Solid waste; Waste management; Wastewater; Water.

© 2021. The Author(s).

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Similar articles

Cited by

References

    1. Dadgostar P. Antimicrobial resistance: implications and costs. Infect Drug Resist. 2019;12:3903. doi: 10.2147/IDR.S234610. - DOI - PMC - PubMed
    1. WHO. New report calls for urgent action to avert antimicrobial resistance crisis: World Health Organization; 2019. Available from: https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-act.... [Accessed 11 Dec 2020].
    1. Quintela-Baluja M, Chan C, Alnakip ME, Abouelnaga M, Graham DW. Sanitation, water quality and antibiotic resistance dissemination. In: Méndez-Vilas A, editor. The Battle Against Microbial Pathogens: Basic Science, Technological Advances Educational Programs. Newcastle University: Fomatex Research Center; 2015. pp. 965–975.
    1. Clift C. Review of progress on antimicrobial resistance: background and analysis. In: Security CoGH, editor. London: Chatham House; 2019. Available: https://www.chathamhouse.org/sites/default/files/publications/research/2... [Accessed 11 Feb 2021].
    1. Allcock S, Young E, Holmes M, Gurdasani D, Dougan G, Sandhu M, et al. Antimicrobial resistance in human populations: challenges and opportunities. Glob Health Epidemiol Genom. 2017;2 10.1017/gheg.2017.4. - PMC - PubMed

MeSH terms

LinkOut - more resources