Abstract

Antimicrobial resistance (AMR) has become a global threat to not only public health impacts but also clinical and economic outcomes. During the past decades, there have been many studies focusing on surveillance, mechanisms, and diagnostics of AMR in infectious diseases but the impacts on public health, clinical and economic outcomes due to emergence of these AMRs are rarely studied and reported. This review was aimed to summarize the findings from published studies to report the outcome impacts due to AMR of malaria, tuberculosis and HIV and briefly discuss the implications for application to other infectious diseases. PubMed/Medline and Google Scholar databases were used for search of empirical and peer-reviewed papers reporting public health, clinical and economic outcomes due to AMR of malaria, tuberculosis and HIV. Papers published through 1 December 2019 were included in this review. A total of 76 studies were included for this review, including 16, 49 and 11 on public health, clinical and economic outcomes, respectively. The synthesized data indicated that the emergence and spread of AMR of malaria, tuberculosis and HIV have resulted in adverse public health, clinical and economic outcomes. AMR of malaria, tuberculosis and HIV results in significant adverse impacts on public health, clinical and economic outcomes. Evidence from this review suggests the needs to consider the similar studies for other infectious diseases.

Highlights

  • Antimicrobial resistance (AMR) is the ability of bacteria, parasites, viruses or fungi to grow and spread in the presence of antimicrobial medicines that are normally active against them [1]

  • Studies were predominantly conducted on tuberculosis, accounting for 56.2%, 53.1% and 54.5% on public health, clinical and economic outcomes, respectively, of the totals

  • Owing to the increased burden of these infectious diseases in developing countries, most of the studies were conducted in these countries, on clinical outcomes due to AMR. of the three diseases included in this review, tuberculosis’s outcomes due to AMR are mostly recognized by researchers to conduct studies which is probably because tuberculosis has a relatively high mortality—the leading cause of death from a single infectious agent and AMR

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Summary

Introduction

Antimicrobial resistance (AMR) is the ability of bacteria, parasites, viruses or fungi to grow and spread in the presence of antimicrobial medicines that are normally active against them [1]. AMR has currently become an alarming threat for human health in the world. Health Organization (WHO) estimates, there were 460,000 people infected with multi-drug resistant tuberculosis (MDR-TB) in 2017 globally [4], and drug resistance continues to complicate the fight against many other infectious diseases, such as HIV, malaria and gonorrhea, as well. As the serious infectious diseases in the world, tuberculosis, HIV and malaria share the common threat of AMR while gonorrhea has been listed as one of the antibiotic-resistant “priority pathogens” by WHO [5]. During the 1990s, sulphadoxine-pyrimethamine was introduced in many African countries to replace chloroquine. It encountered drug-resistant parasites about a year after this introduction [7].

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