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Cited by 479Antibiotic Use and ResistanceAntibiotic Resistance in BacteriaSalmonella and Campylobacter epidemiology

Surveillance of antimicrobial resistance in low- and middle-income countries: a scattered picture

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Iskandar, Katia, Molinier, Laurent, Hallit, Souheil, Sartelli, Massimo, Hardcastle, Timothy Craig, Haque, Mainul, Lugova, Halyna, Dhingra, Sameer +9 more·2021·Antimicrobial Resistance & Infection Control
DOI 10.1186/s13756-021-00931-wPMC PMC8011122
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Abstract

Data on comprehensive population-based surveillance of antimicrobial resistance is lacking. In low- and middle-income countries, the challenges are high due to weak laboratory capacity, poor health systems governance, lack of health information systems, and limited resources. Developing countries struggle with political and social dilemma, and bear a high health and economic burden of communicable diseases. Available data are fragmented and lack representativeness which limits their use to advice health policy makers and orientate the efficient allocation of funding and financial resources on programs to mitigate resistance. Low-quality data means soaring rates of antimicrobial resistance and the inability to track and map the spread of resistance, detect early outbreaks, and set national health policy to tackle resistance. Here, we review the barriers and limitations of conducting effective antimicrobial resistance surveillance, and we highlight multiple incremental approaches that may offer opportunities to strengthen population-based surveillance if tailored to the context of each country.

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  • Limited availability of validated diagnostics (culture and sensitivity) poses difficulties in prompt identification and management of maternal infection in Sub-Saharan Africa.

    “In addition, limited availability of validated diagnostics (culture and sensitivity) poses difficulties in prompt identification and management of maternal infection in SSA [8].”

    From The aetiology and antimicrobial resistance of bacterial maternal infections in Sub-Saharan Africa—a systematic review and meta-analysis (2024) · cites this paper as [8]

    The sections on limited diagnostics and communication issues (page not provided) describe shortages, unreliable laboratory results, reporting delays, and physicians relying on clinical judgment. They support a general difficulty with testing and clinical decisions in low- and middle-income countries, but do not establish the claim specifically for culture and sensitivity testing, maternal infection, or Sub-Saharan Africa. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The scarcity of data is mainly due to insufficient laboratory infrastructure and capacity, scarce or absent microbiological facilities, weak health systems and governance and information systems, and scarce resources.

    “Such sparsity is mainly due to insufficient laboratory infrastructure and capacity, scarce or absent microbiological facilities, weak health systems and governance and information systems, and scarce resources.60, 72, 73”

    From Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050 (2024) · cites this paper as [72]

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Cited by

Sorted by citations

Authors
Iskandar, K., Molinier, L., Hallit, S., Sartelli, M., Hardcastle, T. C., Haque, M., Lugova, H., Dhingra, S., Sharma, P., Islam, S., Mohammed, I., Naina Mohamed, I., Hanna, P. A., Hajj, S. E., Jamaluddin, N. A. H., Salameh, P., & Roques, C.
Affiliations
  • Université Toulouse III - Paul Sabatier (FR)
  • Holy Spirit University of Kaslik (LB)
  • University of Macerata (IT)
  • University of KwaZulu-Natal (ZA)
  • National Defence University of Malaysia (MY)
  • National Institute of Pharmaceutical Education and Research (IN)
  • Jahangirnagar University (BD)
  • Lebanese University (LB)
  • National University of Malaysia (MY)
Corresponding author
Iskandar, Katia
ORCID
Venue
Antimicrobial Resistance & Infection Control
Publisher
Springer Science and Business Media LLC
Published
2021-03-31
Volume
10
Issue
1
Pages
63-63
ISSN
2047-2994 (ISSN-L)
DOI
10.1186/s13756-021-00931-w
PMC
PMC8011122
OpenAlex
W3146403582
Cited by
479
References
1
Citations by year
2026: 109 · 2025: 112 · 2024: 108 · 2023: 96 · 2022: 40 · 2021: 14
FWCI
7.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Antimicrobial Resistance and Infection Control (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Greater South Information System
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
Keywords
antimicrobial resistance surveillance, low- and middle-income countries, population-based surveillance, surveillance data quality, laboratory capacity, health information systems, health system governance, infectious diseases, health policy
MeSH terms
Anti-Bacterial Agents, Communicable Diseases, Developing Countries, Health Policy, Humans, Population Surveillance, Drug Resistance, Bacterial

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