A situational analysis report by the Zimbabwe Anti-Microbial Resistance Core Group has revealed shocking abuse of antibiotics in a worrying trend that could see more people in the southern African country dying from such ailments as cuts and grazes,
diarrhea and flu as antibiotics lose their power to fight minor infections. AMR country coordinator, Dr. Sekesai Zinyowera has told a public lecture on Anti-Microbial Resistance recently at the University of Zimbabwe — Institute of Continuing Health (ICHE) that the sale of antibiotics without prescription in private pharmacies was rampant and posed serious public health risks.
She has said that private pharmacies and other illicit drug peddlers found on many street corners, flea markets and other settings in urban and rural areas had worsened the abuse of antibiotics.
Dr. Zinyowera has said that the situation in the country is very disturbing.”Unscrupulous dealers are peddling drugs while even some medical doctors are prescribing antibiotics for uncomplicated complaints such as a cough, runny nose or sore throat without fever.
“In other, worse situation, pharmacists are prescribing antibiotics without going through medical doctors’ report. There are so many loopholes in the country’s health sector that needs to be addressed as a matter of urgency.” In primary health care centres and outpatient clinics, the microbiologist further pointed out, antibiotics are prescribed for similar complaints while in hospitals and particularly intensive care units (ICU), antibiotic stewardship programmes are often absent.
As a result, she said that anti-biotic use is high and preliminary findings from the situational analysis conducted by the AMR Core Group show that antibiotics are being used without proper feedback from microbiology labs.
Dr. Zinyowera has said that Doctors in our hospitals are increasingly finding that antibiotics no longer work against urinary and skin infections, tuberculosis and gonorrhea. “In Zimbabwe, there is widespread use of Para-professionals. There are a lot of parallel structures that are used to prescribe and distribute antibiotics and these need to be minimized. It’s so easy to get antibiotics, it’s easy to prescribe and this is a huge problem.”
Health experts said that overuse and abuse of antibiotics leads to Anti-microbial Resistance (AMR), saying that the overuse and misuse of antimicrobial agents is accelerating this natural process, rapidly rendering modern treatments for infectious diseases partially or totally ineffective, resulting in increased or prolonged morbidity or mortality.
The AMR study also found out that many people who were prescribed with antibiotics were not finishing the full course and experts say if they stop mid-way the bacteria may become resistant.
Dr. Robert Gray-Choto of the UZ medical school has said that without urgent, co-ordinate action among all key stakeholders in Zimbabwe, we are headed for a disaster. “The risks are real and common infections and minor injuries which have been treatable for decades will once again kill many people. We risk losing the benefits that have come with effective antibiotics and unless we take significant actions to improve efforts to prevent infections, and also change how we produce, prescribe and use antibiotics, we risk losing many people. Zimbabwe needs to move with speed to draft a national action plan for AMR.”
The country situational analysis revealed that there had been a few researches that have been carried out in Zimbabwe which have revealed the presence of resistant microbials.
The survey for 101 Medical Doctors indicated that 78 percent worked in urban areas, 56,1 percent have had cases of AMR, 91,8 percent prescribed antibiotics empirically.
Out of the 102 pharmacy respondents, 87 percent worked in urban areas, 59,4 percent agreed that antibiotic resistance is a serious problem in Zimbabwe, 50 percent agreed that they sometimes prescribed antibiotics themselves, and that the most common antibiotics that they sold without a prescription were amoxicillin, cotrimoxazole and ciprofloxacin.
For veterinary doctors, the study showed that unqualified Veterinary Medicines General Dealers were the ones that dispense medicines to farmers.
They are also worried that antiviral medicines are becoming increasingly less effective against flu.
Dr Zinyowera and her team, found out that in Zimbabwe, 70 percent of Clostridium difficile isolated from diarrheic stools was found to be resistant to cotrimoxazole, salmonella typhii isolated during an outbreak were resistant to ciprofloxacilin, Neisseria gonorrhea has been found to be resistant to fluoroquinolines.
Experts say major causes of AMR in Africa include the HIV/AIDS epidemic where there is cotrimoxazole prophylaxis, inappropriate use, poor water and sanitation and hygiene, lack of proper diagnosis and poor nutrition.
Medicines Control Authority of Zimbabwe (MCAZ) head of evaluation and registration Dr William Wekwete told Zimpapers Syndication that the difficult economic situation has worsened the peddling of illegal drugs in flea marketers and other popular markets such as Mbare/Musika.
He said that the deteriorating economic situation has worsened the problem, “Fake antibiotics are being sold in flea markets and on street corners. We have tried to provide information to the public, to conduct raids and despite all this, illegal trading still goes on.
“We need more resources to fight this scourge and to enable us to build strong mechanisms to fight illegal trade in fake anti-biotic.”