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Antimicrobial resistance in the context of the Syrian conflict: Drivers before and after the onset of conflict and key recommendations
Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine). Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR).
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2018 (English)In: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 73, p. 1-6Article, review/survey (Refereed) Published
Abstract [en]

Current evidence describing antimicrobial resistance (AMR) in the context of the Syrian conflict is of poor quality and sparse in nature. This paper explores and reports the major drivers of AMR that were present in Syria pre-conflict and those that have emerged since its onset in March 2011. Drivers that existed before the conflict included a lack of enforcement of existing legislation to regulate over-the-counter antibiotics and notification of communicable diseases. This contributed to a number of drivers of AMR after the onset of conflict, and these were also compounded by the exodus of trained staff, the increase in overcrowding and unsanitary conditions, the increase in injuries, and economic sanctions limiting the availability of required laboratory medical materials and equipment. Addressing AMR in this context requires pragmatic, multifaceted action at the local, regional, and international levels to detect and manage potentially high rates of multidrug-resistant infections. Priorities are (1) the development of a competent surveillance system for hospital-acquired infections, (2) antimicrobial stewardship, and (3) the creation of cost-effective and implementable infection control policies. However, it is only by addressing the conflict and immediate cessation of the targeting of health facilities that the rehabilitation of the health system, which is key to addressing AMR in this context, can progress. 

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 73, p. 1-6
Keywords [en]
Antimicrobial resistance, Syria, Conflict, Surveillance, Refugees
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-150645DOI: 10.1016/j.ijid.2018.05.008ISI: 000440348300001PubMedID: 29793039Scopus ID: 2-s2.0-85048323122OAI: oai:DiVA.org:umu-150645DiVA, id: diva2:1242782
Available from: 2018-08-29 Created: 2018-08-29 Last updated: 2018-08-29Bibliographically approved

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Karah, NabilUhlin, Bernt Eric

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Karah, NabilUhlin, Bernt Eric
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Department of Molecular Biology (Faculty of Medicine)Molecular Infection Medicine Sweden (MIMS)Umeå Centre for Microbial Research (UCMR)
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