Back
Full-text
Journal article

Urban informal settlements as hotspots of antimicrobial resistance and the need to curb environmental transmission.

  • Nadimpalli ML Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA.
  • Marks SJ Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.
  • Montealegre MC Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.
  • Gilman RH Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA.
  • Pajuelo MJ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA.
  • Saito M Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Tsukayama P Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Njenga SM Kenya Medical Research Institute, Nairobi, Kenya.
  • Kiiru J Kenya Medical Research Institute, Nairobi, Kenya.
  • Swarthout J Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA.
  • Islam MA Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA.
  • Julian TR Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.
  • Pickering AJ Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA. amy.pickering@tufts.edu.
Show more…
  • 2020-05-30
Published in:
  • Nature microbiology. - 2020
Anti-Infective Agents
Communicable Diseases
Drug Resistance, Microbial
Environment
Environmental Exposure
Humans
Sanitation
Urban Health
Urban Renewal
Waste Water
English Antimicrobial resistance (AMR) is a growing public health challenge that is expected to disproportionately burden lower- and middle-income countries (LMICs) in the coming decades. Although the contributions of human and veterinary antibiotic misuse to this crisis are well-recognized, environmental transmission (via water, soil or food contaminated with human and animal faeces) has been given less attention as a global driver of AMR, especially in urban informal settlements in LMICs-commonly known as 'shanty towns' or 'slums'. These settlements may be unique hotspots for environmental AMR transmission given: (1) the high density of humans, livestock and vermin living in close proximity; (2) frequent antibiotic misuse; and (3) insufficient drinking water, drainage and sanitation infrastructure. Here, we highlight the need for strategies to disrupt environmental AMR transmission in urban informal settlements. We propose that water and waste infrastructure improvements tailored to these settings should be evaluated for their effectiveness in limiting environmental AMR dissemination, lowering the community-level burden of antimicrobial-resistant infections and preventing antibiotic misuse. We also suggest that additional research is directed towards developing economic and legal incentives for evaluating and implementing water and waste infrastructure in these settings. Given that almost 90% of urban population growth will occur in regions predicted to be most burdened by the AMR crisis, there is an urgent need to build effective, evidence-based policies that could influence massive investments in the built urban environment in LMICs over the next few decades.
Language
  • English
Open access status
green
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/190620
Statistics
Document views: 23 File downloads:
  • fulltext.pdf: 0