One Health Approach and Antimicrobial Resistance: From Global to Ethiopian Context

Recently, antimicrobial resistance is considered as a global health crisis. Some are thought that we are now in post-antibiotic era. Despite data gaps are largest; it creates particularly significant intimidation to low- and middle-income countries. Many factors are responsible for the development of resistance to antimicrobials by microorganisms. Weak regulations and usage inaccuracies are the major causes for the occurrence of antibiotic resistance. In the last three decades, greater than thirty new infectious diseases, most originated from animals, have been emerged. There is also rising of antimicrobial consumption across the world. The growth
of human populations and an increase in contact with wildlife contribute to the spread of resistance and making it a global health concern. Since there are many routes by which drug metabolites and resistant microbes can disseminate among humans, animals and the environment, One Health Approach is urgently required to address antimicrobial resistance in global, national and local level, including Ethiopia. Internationally, the worst threat comes from the emergence and rapid spread of multi-drug resistant Gramnegative bacteria. Once again, an intercontinental, interdisciplinary and multiple approaches should be taken to combat this problem among worldwide nations with special emphasis in developing countries encompassing Africa and Ethiopia.

Epidemiology and outcomes of trauma patients at The Indus Hospital, Karachi, Pakistan, 2017 – 2018

Objective: Structured trauma care has proven to improve patient outcomes, and this is more relevant in the low- and middle-income countries (LMICs). The objective of this study was to determine the distribution, etiology, severity and outcomes of trauma patients at the Indus Hospital.
Methods: All adult poly-trauma patients presenting to The Indus Hospital from July 2017 to June 2018 were included in this retrospective review. Data was extracted on etiology of trauma, severity of injury, investigations and final disposition of patients.
Results: Of 972 trauma patients presenting to TIH Emergency Department, 663 (68.2%) were males with a mean age of 36 (17.4) years. Road traffic accidents (RTAs) led to trauma in 766 patients (78.8%), followed by 121 falls (12.7%). Injury Severity score (ISS) was calculated upon arrival and 528 (54.3%) were found to be critically injured. Median length of stay was 60 (24-720) minutes while none utilized pre-hospital Emergency Medical services.
Conclusion: Most trauma patients were males suffering from RTA. Nearly half of the patients were critically injured on arrival. EMS is not utilized by trauma patients. There were gaps identified in the diagnosis and treatment of trauma.