What is the AMR PNG crisis?
In Papua New Guinea (PNG), antimicrobial therapy constitutes a major form of treatment for almost all our patients we attend to. Endemic and emerging infectious diseases are implicated in half of childhood deaths and over 40% of all mortality in the country. (1) It is mainly empirical due to a relative lack of appropriate laboratory facilities for culture and susceptibility testing of pathogens in our health facilities. (2) This has increased the development of resistance at an alarming rate in PNG.
A scoping literature review of scientific peer-reviewed publications on antimicrobial resistance in Papua New Guinea conducted by Page and Adiunegiya, 2023 summarized that most of the available data comes from Port Moresby and Goroka between 1960 and 2020. The data mostly focuses on Staphylococcus aureus and important paediatric pathogens such as Streptococcus pneumoniae and Haemophilus Influenzae.(3)
AMR is now a known threat to the public health of low-income countries and is uncontrolled and under estimated due to the paucity of information about AMR within Pacific Island countries and territories (PICTs) including PNG.(3–5)
What are the contributing factors to AMR? (2,6)
- Misuse and Overuse of Antibiotics
- Agricultural Use of Antibiotics
- Lack of access to clean water, sanitation and hygiene (WASH) for both humans and animals
- Poor infection and disease prevention and control in homes, healthcare facilities and farms
- Poor access to quality and affordable vaccines, diagnostics and medicines
- Lack of enforcement of relevant legislation
- Easy Travel Routes
- Biological Factors such as mutations and bacterial evolution
- Gaps in Knowledge; lack of awareness and education
The bottom line
A number of contributing factors increase the growing threat of AMR in PNG.
References
1. Kitur U, Adair T, Riley I, Lopez AD. Estimating the pattern of causes of death in Papua New Guinea. BMC Public Health. 2019 Oct 22;19(1):1322.
2. Chokshi A, Sifri Z, Cennimo D, Horng H. Global Contributors to Antibiotic Resistance. J Glob Infect Dis. 2019;11(1):36–42.
3. Page B, Adiunegiya S. Antimicrobial Resistance in Papua New Guinea: A Narrative Scoping Review. Antibiot Basel Switz. 2023 Nov 29;12(12):1679.
4. Newman MJ, Frimpong E, Donkor ES, Opintan JA, Asamoah-Adu A. Resistance to antimicrobial drugs in Ghana. Infect Drug Resist. 2011;4:215–20.
5. Loftus M, Stewardson A, Naidu R, Coghlan B, Jenney A, Kepas J, et al. Antimicrobial resistance in the Pacific Island countries and territories. BMJ Glob Health. 2020 Apr;5(4):e002418.
6. Dadgostar P. Antimicrobial Resistance: Implications and Costs. Infect Drug Resist. 2019 Dec 20;12:3903–10.
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