Antimicrobial Consumption Monitoring in Mauritius
Health professionals from the Ministry of Health and Quality of Life and appropriate officers from other ministries are being trained for 4 days by WHO on the antimicrobial consumption monitoring and pilot survey on antimicrobial use in hospitals in Mauritius. In fact, Mauritius is one of the three countries involved in the WHO Antimicrobial resistance (AMR) consumption monitoring and pilot survey. This training workshop is in line with the National Action Plan on Antimicrobial Resistance approved by the Government of Mauritius in August 2017. It follows the publication of the General Guidelines for Antibiotic prescription in December 2016 which provide advice to patients and prescribers on the management of symptoms associated with the use of antibiotics. Participants to the training will acquire the necessary knowledge and skills on the monitoring of antimicrobial consumption in Mauritius and how to conduct a point prevalence survey on antimicrobial use in hospitals in Mauritius
In January last year, representatives from Mauritius participated in the AMR National Focal point workshop in Harare, following which a national team was constituted to develop the National Action Plan on Antimicrobial resistance. The National Action Plan set out 6 following strategic objectives:
engagement and education on AMR amongst all stakeholders;
electronic surveillance of antimicrobial use and resistance in human, animal and environmental health;
effective bio-security and infection prevention and control measures;
evidence-based antimicrobial use in humans and animals;
enforceable regulations to advance AMR prevention and containment; and
equitable investment for National Action Plan Implementation.
Dr Musango, the WHO Representative in Mauritius stated his appreciation in the efforts made by the Government of Mauritius to work in an integrated and coordinated approach by involving key stakeholders, namely the Ministry of Health, Ministry of Agriculture, the Regulatory Authority and other institutions/organizations involved in procurement, supply, distribution and dispensing of pharmaceuticals at the national and subnational level as well as those involved in antimicrobial resistance surveillance. He reiterated the strong commitment of the three levels of the World Health Organization (Country, Regional and Head Quarters) to support Mauritius in fulfilling the noble objectives of combatting and containing AMR. He quoted Dr Moeti, the WHO Regional Director who said ‘I advise everyone to think twice, seek advice and always consult a qualified health professional before taking antibiotics’ during the World Antibiotic Awareness Week held on 13-19 November 2017.
Dr Timol, the Acting Director General Health Services of the Ministry of Health and Quality of Life thanked WHO for organising the workshop and for the selection of Mauritius to be part of the countries conducting the study on AMR. She highlighted the fact that antibiotic resistance is a global crisis and represents a major challenge to health and development as it can affect anyone, of any age in any country. She said that the launching of the workshop on a pilot study on WHO Methodology for a global programme surveillance of antimicrobial consumption is of high importance. The monitoring of antibiotic consumption can eventually help the country to decrease its antibiotic consumption.
The Director General Health Services, Dr Timol pointed out that antibiotic resistance is accelerated by the misuse and overuse of antibiotics and spread by poor infection control. She made an appeal to health professionals to ensure that all steps are taken at all levels for a proper use of antibiotics in the public health system. According to the latter, antibiotics should be used only for bacterial infections. In the human sector, antibiotics are often used for viral infections like colds, flu and gastroenteritis where they are ineffective. In the animal sector, antibiotics should be used to treat diseases only and for proper infection control to limit spread of resistant strains.
Antibiotic resistance can lead to higher medical costs, prolonged hospital stays and increased mortality. If nothing is done to reduce antimicrobial resistance by 2050, some 10 million people will die each year surpassing the mortality due to cancer and non-communicable diseases. As at date, a growing list of infections including pneumonia, tuberculosis, blood poisoning, gonorrhea and foodborne diseases are becoming harder to treat as antibiotics become less effective.
In Mauritius, resistance of respiratory tract, gastrointestinal and urinary tract pathogens to commonly used antibiotics have increased over the past decade. In addition, the resistance of urine Enterobacteriacea to ciprofloxacin has increased from 1% in 1998 to 61% in 2014. While for inpatients, the resistance of Escherichea coli to cefotaxime has increased from 17% in 2005 to 46% in 2014. Moreover, an increase in the last resort drugs usually kept for more complicated infections was noted in 2015.
Proper hand, environmental and equipment hygiene in the wards, proper disposal of waste and isolation precautions are the important rules to be observed by all to eliminate transmission of infections in every hospital, health centres as well as in the animal sector. It is to be noted that immunization can prevent infectious diseases whose treatment would require antimicrobial medicines. It can also reduce the prevalence of primary viral infections which are often inappropriately treated with antibiotics. In fact, antibiotics are essential in the treatment of serious infections and they save millions of lives. Their effectiveness needs to be preserved through a national change in behaviour.
This training workshop is a milestone in the implementation of the strategic objectives set in the Mauritius National Action Plan on Antimicrobial resistance 2017 – 2021 which aims at reducing the prevalence of antibiotic resistance in Mauritius. In the same vein, it contributes to the overall goal of the WHO Global Action Plan on Antimicrobial resistance adopted in 2015 by all member states, including Mauritius.